Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

Helena Gauffin; Anne-Marie Landtblom; Patrick Vigren; Andreas Frick; Maria Engström; Anita McAllister; Thomas Karlsson

doi:10.3389/fneur.2021.746381

Similar Profile and Magnitude of Cognitive Impairments in Focal and Generalized Epilepsy: A Pilot Study

Front Neurol. 2022 Jan 12:12:746381. doi: 10.3389/fneur.2021.746381. eCollection 2021.

Authors

Helena Gauffin^{1

2}, Anne-Marie Landtblom^{1

2

3

4

5}, Patrick Vigren^{1

2}, Andreas Frick⁶, Maria Engström^{5

7}, Anita McAllister^{8

9}, Thomas Karlsson^{3

5}

Affiliations

¹ Department of Neurology, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.
² Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences Linköping University, Linköping, Sweden.
³ Department of Neuroscience, Neurology, Uppsala University, Uppsala, Sweden.
⁴ Neurology Division, Clinic of Medical Specialist, Motala General Hospital, Motala, Sweden.
⁵ Center for Medical Image Science and Visualization, Linköping University, Linköping, Sweden.
⁶ The Beijer Laboratory, Department of Neuroscience, Psychiatry, Uppsala University, Uppsala, Sweden.
⁷ Department of Medical, Health and Caring Sciences, Linköping University, Linköping, Sweden.
⁸ Division of Speech Language Pathology, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
⁹ Women's Health and Allied Health Professionals Theme, Medical Unit Speech and Language Pathology, Karolinska University Hospital, Stockholm, Sweden.

Abstract

Introduction: Cognitive impairments in epilepsy are not well-understood. In addition, long-term emotional, interpersonal, and social consequences of the underlying disturbances are important to evaluate. Purpose: To compare cognitive function including language in young adults with focal or generalized epilepsy. In addition, quality of life and self-esteem were investigated. Patients and Methods: Young adults with no primary intellectual disability, 17 with focal epilepsy and 11 with generalized epilepsy participated and were compared to 28 healthy controls. Groups were matched on age (mean = 26 years), sex, and education. Participants were administered a battery of neuropsychological tasks and carried out self-ratings of quality of life, self-esteem, and psychological problems. Results: Similar impairments regarding cognitive function were noted in focal and generalized epilepsy. The cognitive domains tested were episodic long-term memory, executive functions, attention, working memory, visuospatial functions, and language. Both epilepsy groups had lower results compared to controls (effect sizes 0.24-1.07). The total number of convulsive seizures was predictive of episodic long-term memory function. Participants with focal epilepsy reported lower quality of life than participants with generalized epilepsy. Lowered self-esteem values were seen in both epilepsy groups and particularly in those with focal epilepsy. Along with measures of cognitive speed and depression, the total number of seizures explained more than 50% of variation in quality of life. Conclusion: Interestingly, similarities rather than differences characterized the widespread cognitive deficits that were seen in focal and generalized epilepsy, ranging from mild to moderate. These similarities were modified by quality of life and self-esteem. This study confirms the notion that epilepsy is a network disorder.

Keywords: cognition; epilepsy; focal epilepsy; generalized epilepsy; language; quality of life; self-esteem.