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Hermann B, Busch RM, Reyes A, Arrotta K, Fujikawa M, Ives-Deliperi V, Dollman A, Shah U, McDonald CR. A user's guide for the International Classification of Cognitive Disorders in Epilepsy. Epileptic Disord 2024. [PMID: 39141394 DOI: 10.1002/epd2.20268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Accepted: 07/24/2024] [Indexed: 08/15/2024]
Abstract
To present the background, rationale, details pertaining to use and essential computational steps, synopsis of findings to date, and future directions for the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE)-an initiative of the ILAE Neuropsychology Task Force. Examined are: (a) the 6 steps leading to the derivation of a cognitive phenotype from neuropsychological test data with an accompanying case example, (b) concise review of all IC-CoDE research to date, (c) summary of identified correlates of IC-CoDE outcomes, and (d) future research and clinical directions for the initiative. The IC-CoDE is computationally uncomplicated with individual or group data and represents a novel approach leading to new insights in the neuropsychology of epilepsy, with applications to diverse datasets internationally informing the reliability and validity of the approach. The IC-CoDE represents a novel approach to the analysis and interpretation of neuropsychological data in epilepsy that offers to advance a global taxonomy of cognitive disorders in epilepsy facilitating international collaboration and big data science.
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Affiliation(s)
| | - Robyn M Busch
- Epilepsy Center, Cleveland Clinic, Cleveland, Ohio, USA
| | - Anny Reyes
- University of California-San Diego, San Diego, California, USA
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Shah U, Rathore C, Radhakrishnan K, Baheti N, Kadaba S, Sahu A, Alladi S, Chitnis S, George A, Bansal AR, Murthy JMK. A survey of the prevalence and patterns of neuropsychological assessment practices across epilepsy surgery centers in India: Toward establishing a national guideline. Epilepsia Open 2024. [PMID: 39012159 DOI: 10.1002/epi4.13005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Revised: 06/21/2024] [Accepted: 06/23/2024] [Indexed: 07/17/2024] Open
Abstract
Neuropsychology plays an important role in optimizing epilepsy management, but there are no practice guidelines for low- and middle-income countries with emerging services. The National Epilepsy Surgery Support Activity Network (NESSAN), a national working group that supports and optimizes epilepsy surgery programs in India, explored the present status of pre- and post epilepsy surgery neuropsychological assessment practices across India as an initial step in developing national evidence-based test guidelines. An online survey was conducted using two questionnaires, one for neurologists and the second for neuropsychologists and speech-language pathologists working in epilepsy surgery centers. The questions to neurologists covered the setting, description, and nature of the neuropsychology services provided for adults and children as part of the epilepsy surgery program, and their perceptions about the importance and indications for neuropsychological assessment in epilepsy surgery. The questions to neuropsychologists inquired about their qualifications and training, pre- and postsurgical assessment procedures, and domain-specific cognitive tests and scales for mood, quality of life, and language evaluations. Forty-three centers responded, and neuropsychology services were available at three fourth of the centers, but a dedicated full-time neuropsychologist was available in only 16% of centers. Ninety percent of the neurologists considered neuropsychological evaluation an indispensable part of presurgical evaluation. However, only a few of them believed that the results influenced their decision about the extent of resection and ruling against surgery. The survey found considerable heterogeneity in terms of qualifications and training of neuropsychologists, evaluation procedures, test protocols, and normative data that will need to be harmonized to ensure uniform practice across the country. We believe that the results from this survey provide a road map for implementing measures to minimize existing inadequacies and harmonize neuropsychology services in India and as well as in other countries with emerging neuropsychology services. PLAIN LANGUAGE SUMMARY: Neuropsychological assessment is an integral part of the pre- and post epilepsy surgery evaluations. In India, the National Epilepsy Surgery Support Activity Network (NESSAN), a body of multidisciplinary professionals, conducted a survey to examine existing neuropsychology practices. The responses from 43 centers across the country revealed considerable heterogeneity in tests and few trained and qualified neuropsychologists. In low- and middle-income countries (LMIC) with emerging neuropsychology services, there is a need to have uniform test protocols, specialized training, and guidelines for optimizing neuropsychology services across all the epilepsy surgery centers.
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Affiliation(s)
- Urvashi Shah
- Department of Neurology, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Chaturbhuj Rathore
- Department of Neurology, Zydus Hospital & Smt. B. K. Shah Medical Institute and Research Center, Sumandeep Vidyapeeth, Vadodara, Gujarat, India
| | | | - Neeraj Baheti
- Department of Neurology, Central India Institute of Medical Sciences, Nagpur, Maharashtra, India
| | - Shweta Kadaba
- Institute of Neurosciences, Sakra World Hospital, Bengaluru, Karnataka, India
| | - Aparna Sahu
- Department of Neurology, King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - Suvarna Alladi
- Department of Neurology, National Institute of Mental Health and NeuroSciences, Bengaluru, India
| | - Sonal Chitnis
- Bajaj Allianz Epilepsy Center, Deenanath Mangeshkar Hospital, Pune, Maharashtra, India
| | - Annamma George
- Sree Chitra Tirunal Institute of Medical Science and Technology, Trivandrum, Kerala, India
| | - Atma Ram Bansal
- Medanta Institute of Neuroscience, The Medicity, Gurugram, India
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Laguitton V, Boutin M, Brissart H, Breuillard D, Bilger M, Forthoffer N, Guinet V, Hennion S, Kleitz C, Mirabel H, Mosca C, Pradier S, Samson S, Voltzenlogel V, Planton M, Denos M, Bulteau C. Neuropsychological assessment in pediatric epilepsy surgery: A French procedure consensus. Rev Neurol (Paris) 2024; 180:494-506. [PMID: 37949750 DOI: 10.1016/j.neurol.2023.08.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 07/11/2023] [Accepted: 08/08/2023] [Indexed: 11/12/2023]
Abstract
Neuropsychological assessment is a mandatory part of the pre- and post-operative evaluation in pediatric epilepsy surgery. The neuropsychology task force of the ILAE - French Chapter aims to define a neuropsychological procedure consensus based on literature review and adapted for French practice. They performed a systematic review of the literature published between 1950 and 2023 on cognitive evaluation of individuals undergoing presurgical work-up and post-surgery follow-up and focused on the pediatric population aged 6-16. They classified publications listed in the PubMed database according to their level of scientific evidence. The systematic literature review revealed no study with high statistical power and only four studies using neuropsychological scales in their French version. Afterwards, the experts defined a neuropsychological consensus strategy in pediatric epilepsy surgery according to the psychometric determinants of cognitive tests, specificity of epilepsy, surgery context, French culture and literature reports. A common French neuropsychological procedure dedicated to pediatric epilepsy surgery is now available. This procedure could serve as a guide for the pre- and post-surgical work-up in French centers with pediatric epilepsy surgery programs. The main goal is to anticipate the functional risks of surgery, to support the postoperative outcome beyond the seizure-related one, while taking into consideration the plasticity and vulnerability of the immature brain and allowing the possibility of collaborative studies.
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Affiliation(s)
- V Laguitton
- Clinical Neurophysiology AP-HM, Timone Hospital, Marseille, France; Department of Pediatric Neurology, APHM, Timone Hospital, Marseille, France.
| | - M Boutin
- GHU-Paris Pôle Neuro-Sainte-Anne - Neurosurgery Unity, 1, rue Cabanis, Paris, France
| | - H Brissart
- Université de Lorraine, CNRS, CRAN, 54000 Nancy, France; Université de Lorraine, CHRU-Nancy, Service de Neurologie, 54000 Nancy, France
| | - D Breuillard
- Reference Center Rare Epilepsies, Hôpital Necker Enfants-Malades, Paris, France
| | - M Bilger
- Neurology Department, Hôpital Hautepierre, CHRU Strasbourg, Strasbourg, France
| | - N Forthoffer
- Université de Lorraine, CNRS, CRAN, 54000 Nancy, France
| | - V Guinet
- Department of Functional Neurology and Epileptology, Hospices Civils de Lyon, Lyon, France
| | - S Hennion
- Reference Center Rare Epilepsies, Epilepsy Unit, University Lille, INSERM, CHU Lille, U1171 Degenerative and vascular cognitive disorders, Lille, France
| | - C Kleitz
- Neurology Department, Hôpital Hautepierre, CHRU Strasbourg, Strasbourg, France
| | - H Mirabel
- Neurology Department, Hôpital Pierre-Paul Riquet, CHU de Toulouse, Toulouse, France
| | - C Mosca
- Epilepsy Unit, CHU Grenoble-Alpes, Grenoble-Alpes, France
| | - S Pradier
- Functional Explorations of the Nervous System, Clinical Neurosciences Center, University Hospital Center Pellegrin, Bordeaux, France
| | - S Samson
- Neurology Department, Rehabilitation Unit, GH Pitié-Salpêtrière, APHP, Paris, France; Équipe Neuropsychologie: Audition, Cognition et Action (EA 4072), UFR de psychologie, Université Lille-Nord de France, Villeneuve d'Ascq, France
| | - V Voltzenlogel
- Centre d'études et de recherches en psychopathologie et psychologie de la santé, université de Toulouse, UT2J, Toulouse, France
| | - M Planton
- Neurology Department, Hôpital Pierre-Paul Riquet, CHU de Toulouse, Toulouse, France; Toulouse NeuroImaging Center, Université de Toulouse, Inserm, UPS, Toulouse, France
| | - M Denos
- Neurology Department, Rehabilitation Unit, GH Pitié-Salpêtrière, APHP, Paris, France
| | - C Bulteau
- Pediatric Neurosurgery Department, Rothschild Foundation Hospital, EpiCare Member, Paris, France; University of Paris Cité, MC(2)Lab, Institute of Psychology, 92000 Boulogne-Billancourt, France
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Gardette J, Mosca C, Asien C, Borg C, Mazzola L, Convers P, Gal G, Banjac S, Baciu M, Durocher B, Kahane P, Hot P. Complex visual discrimination is impaired after right, but not left, anterior temporal lobectomy. Hippocampus 2023; 33:1113-1122. [PMID: 37483092 DOI: 10.1002/hipo.23569] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 05/24/2023] [Accepted: 07/06/2023] [Indexed: 07/25/2023]
Abstract
The prevailing view in human cognitive neuroscience associates the medial temporal lobes (MTLs) with declarative memory. Compelling experimental evidence has, however, demonstrated that these regions are specialized according to the representations processed, irrespective of the cognitive domain assessed. This account was supported by the study of patients with bilateral medial temporal amnesia, who exhibit impairments in perceptual tasks involving complex visual stimuli. Yet, little is known regarding the impact of unilateral MTL damage on complex visual abilities. To address this issue, we administered a visual matching task to 20 patients who underwent left (N = 12) or right (N = 8) anterior temporal lobectomy for drug-resistant epilepsy and to 38 healthy controls. Presentation viewpoint was manipulated to increase feature ambiguity, as this is critical to reveal impairments in perceptual tasks. Similar to control participants, patients with left-sided damage succeeded in all task conditions. In contrast, patients with right-sided damage had decreased accuracy compared with that of the other two groups, as well as increased response time. Notably, the accuracy of those with right-sided damage did not exceed chance level when feature ambiguity was high (i.e., when stimuli were presented from different viewpoints) for the most complex classes of stimuli (i.e., scenes and buildings, compared with single objects). The pattern reported in bilateral patients in previous studies was therefore reproduced in patients with right, but not left, resection. These results suggest that the complex visual-representation functions supported by the MTL are right-lateralized, and raise the question as to how the representational account of these regions applies to representations supported by left MTL regions.
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Affiliation(s)
- Jeremy Gardette
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Chrystèle Mosca
- Neurology Department, Chu Grenoble-Alpes, Univ. Grenoble Alpes, Grenoble Institut Neuroscience, Inserm U1216, Grenoble, France
| | - Cassandra Asien
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
- Neurology Department, Chu Grenoble-Alpes, Univ. Grenoble Alpes, Grenoble Institut Neuroscience, Inserm U1216, Grenoble, France
| | - Céline Borg
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Laure Mazzola
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Philippe Convers
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Guillaume Gal
- Neurology Department, University Hospital, Saint-Etienne, France
| | - Sonja Banjac
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Monica Baciu
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Bastien Durocher
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
| | - Philippe Kahane
- Neurology Department, Chu Grenoble-Alpes, Univ. Grenoble Alpes, Grenoble Institut Neuroscience, Inserm U1216, Grenoble, France
| | - Pascal Hot
- LPNC, CNRS, UMR 5105, Université Grenoble Alpes, Université Savoie Mont Blanc, Grenoble, France
- Institut Universitaire de France, Paris, France
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Qi L, Zhao J, Zhao P, Zhang H, Zhong J, Pan P, Wang G, Yi Z, Xie L. Theory of mind and facial emotion recognition in adults with temporal lobe epilepsy: A meta-analysis. Front Psychiatry 2022; 13:976439. [PMID: 36276336 PMCID: PMC9582667 DOI: 10.3389/fpsyt.2022.976439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 09/16/2022] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND Mounting studies have investigated impairments in social cognitive domains (including theory of mind [ToM] and facial emotion recognition [FER] in adult patients with temporal lobe epilepsy (TLE). However, to date, inconsistent findings remain. METHODS A search of PubMed, Web of Science, and Embase databases was conducted until December 2021. Hedges g effect sizes were computed with a random-effects model. Meta-regressions were used to assess the potential confounding factors of between-study variability in effect sizes. RESULTS The meta-analysis included 41 studies, with a combined sample of 1,749 adult patients with TLE and 1,324 healthy controls (HCs). Relative to HCs, adult patients with TLE showed large impairments in ToM (g = -0.92) and cognitive ToM (g = -0.92), followed by medium impairments in affective ToM (g = -0.79) and FER (g = -0.77). Besides, no (statistically) significant differences were observed between the magnitude of social cognition impairment in adult with TLE who underwent and those who did not undergo epilepsy surgery. Meta-regressions exhibited that greater severity of executive functioning was associated with more severe ToM defects, and older age was associated with more severe FER defects. CONCLUSIONS Results of this meta-analysis suggest that adult patients with TLE show differential impairments in the core aspects of social cognitive domains (including ToM and FER), which may help in planning individualized treatment with appropriate cognitive and behavioral interventions.
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Affiliation(s)
- Liang Qi
- Department of Neurosurgery, The Affiliated Huai'an Hospital of Xuzhou Medical University, The Second People's Hospital of Huai'an, Huaian, China
| | - Jing Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - PanWen Zhao
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - Hui Zhang
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - JianGuo Zhong
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - PingLei Pan
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China.,Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - GenDi Wang
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - ZhongQuan Yi
- Department of Central Laboratory, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
| | - LiLi Xie
- Department of Neurology, The Sixth Affiliated Hospital of Nantong University, Yancheng Third People's Hospital, Yancheng, China
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Lemesle B, Barbeau EJ, Rigal EM, Denuelle M, Valton L, Pariente J, Curot J. Hidden Objective Memory Deficits Behind Subjective Memory Complaints in Patients With Temporal Lobe Epilepsy. Neurology 2021; 98:e818-e828. [PMID: 34906979 DOI: 10.1212/wnl.0000000000013212] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 11/24/2021] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To test the hypothesis that temporal lobe epilepsy (TLE) patients with subjective initial memory complaints (not confirmed by an objective standard assessment) and various phenotypes also show objective very long-term memory deficit with accelerated long-term forgetting. We tested TLE patients with two surprise memory tests after three weeks: the standard Free and Cued Selective Reminding Test (FCSRT), and Epireal, a new test specifically designed to capture more ecological aspects of autobiographical memory. METHODS 47 TLE patients (12 hippocampal sclerosis, 12 amygdala enlargement, 11 extensive lesions, 12 normal MRI) who complained about their memory, but for whom the standard neuropsychological assessment did not reveal any memory impairment after a standard delay of 20 minutes, underwent two surprise memory tests after three weeks. They were compared to 35 healthy control subjects. RESULTS After three weeks, FCSRT and Epireal recall scores were significantly lower in patients than in controls (p<0.001). There was no significant correlation between FCSRT and Epireal scores (p=0.99). Seventy-six percent of TLE patients had objective impairment on at least one of these very long-term memory tests, regardless of the existence and type of lesion or response to antiseizure medication. Easily applicable, Epireal had a higher effect size, detected deficits in 28% more patients, and is a useful addition to the standard workup. CONCLUSION Assessing long-term memory should be broadened to a wide spectrum of TLE patients with a memory complaint, regardless of the epileptic syndrome, whether or not associated with a lesion. This could lead to rethinking TLE nosology associated with memory.
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Affiliation(s)
- Béatrice Lemesle
- Department of Cognitive Neurology, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Emmanuel J Barbeau
- Brain and Cognition Research Center - CerCo, CNRS, UMR5549, Toulouse, France.,Brain and Cognition Research Center, Toulouse University, Paul Sabatier University, Toulouse, France
| | - Emilie Milongo Rigal
- Department of Cognitive Neurology, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Marie Denuelle
- Brain and Cognition Research Center - CerCo, CNRS, UMR5549, Toulouse, France.,Brain and Cognition Research Center, Toulouse University, Paul Sabatier University, Toulouse, France.,Department of Neurophysiological Explorations, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Luc Valton
- Brain and Cognition Research Center - CerCo, CNRS, UMR5549, Toulouse, France.,Brain and Cognition Research Center, Toulouse University, Paul Sabatier University, Toulouse, France.,Department of Neurophysiological Explorations, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
| | - Jeremie Pariente
- Department of Cognitive Neurology, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France.,INSERM, U1214, TONIC, Toulouse Mind and Brain Institute, Toulouse, France
| | - Jonathan Curot
- Brain and Cognition Research Center - CerCo, CNRS, UMR5549, Toulouse, France .,Brain and Cognition Research Center, Toulouse University, Paul Sabatier University, Toulouse, France.,Department of Neurophysiological Explorations, Pierre Paul Riquet Hospital, Toulouse University Hospital, Toulouse, France
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Rahim F, Azizimalamiri R, Sayyah M, Malayeri A. Experimental Therapeutic Strategies in Epilepsies Using Anti-Seizure Medications. J Exp Pharmacol 2021; 13:265-290. [PMID: 33732031 PMCID: PMC7959000 DOI: 10.2147/jep.s267029] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Accepted: 02/10/2021] [Indexed: 02/02/2023] Open
Abstract
Epilepsies are among the most common neurological problems. The disease burden in patients with epilepsy is significantly high, and epilepsy has a huge negative impact on patients' quality of life with epilepsy and their families. Anti-seizure medications are the mainstay treatment in patients with epilepsy, and around 70% of patients will ultimately control with a combination of at least two appropriately selected anti-seizure medications. However, in one-third of patients, seizures are resistant to drugs, and other measures will be needed. The primary goal in using experimental therapeutic medication strategies in patients with epilepsy is to prevent recurrent seizures and reduce the rate of traumatic events that may occur during seizures. So far, various treatments using medications have been offered for patients with epilepsies, which have been classified according to the type of epilepsy, the effectiveness of the medications, and the adverse effects. Medications such as Levetiracetam, valproic acid, and lamotrigine are at the forefront of these patients' treatment. Epilepsy surgery, neuro-stimulation, and the ketogenic diet are the main measures in patients with medication-resistant epilepsies. In this paper, we will review the therapeutic approach using anti-seizure medications in patients with epilepsy. However, it should be noted that some of these patients still do not respond to existing treatments; therefore, the limited ability of current therapies has fueled research efforts for the development of novel treatment strategies. Thus, it seems that in addition to surgical measures, we should look for more specific agents that have less adverse events and have a greater effect in stopping seizures.
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Affiliation(s)
- Fakher Rahim
- Molecular Medicine and Bioinformatics, Research Center of Thalassemia & Hemoglobinopathy, Health Research Institute, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Reza Azizimalamiri
- Department of Pediatrics, Division of Pediatric Neurology, Golestan Medical, Educational, and Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mehdi Sayyah
- Education Development Center (EDC), Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Alireza Malayeri
- Medicinal Plant Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
- Department of Pharmacology, School of Pharmacy, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Norman M, Wilson SJ, Baxendale S, Barr W, Block C, Busch RM, Fernandez A, Hessen E, Loring DW, McDonald CR, Hermann BP. Addressing neuropsychological diagnostics in adults with epilepsy: Introducing the International Classification of Cognitive Disorders in Epilepsy: The IC CODE Initiative. Epilepsia Open 2021; 6:266-275. [PMID: 34033259 PMCID: PMC8166800 DOI: 10.1002/epi4.12478] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 01/25/2021] [Accepted: 01/30/2021] [Indexed: 01/03/2023] Open
Abstract
This paper addresses the absence of an international diagnostic taxonomy for cognitive disorders in patients with epilepsy. Initiated through the 2020 Memorandum of Understanding between the International League Against Epilepsy and the International Neuropsychological Society, neuropsychological representatives from both organizations met to address the problem and consequences of the absence of an international diagnostic taxonomy for cognitive disorders in epilepsy, overview potential solutions, and propose specific solutions going forward. The group concluded that a classification of cognitive disorders in epilepsy, including an overall taxonomy and associated operational criteria, was clearly lacking and sorely needed. This paper reviews the advantages and shortcomings of four existing cognitive diagnostic approaches, including taxonomies derived from the US National Neuropsychology Network, DSM-V Neurocognitive Disorders, the Mild Cognitive Impairment classification from the aging/preclinical dementia literature, and the Research Domain Criteria Initiative. We propose a framework to develop a consensus-based classification system for cognitive disorders in epilepsy that will be international in scope and be applicable for clinical practice and research globally and introduce the International Classification of Cognitive Disorders in Epilepsy (IC-CODE) project.
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Affiliation(s)
- Marc Norman
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.,Executive Director of the International Neuropsychological Society
| | - Sarah J Wilson
- Melbourne School of Psychological Sciences, The University of Melbourne, Melbourne, Vic., Australia.,Chair, Diagnostic Methods Commission, International League Against Epilepsy
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, London, UK
| | - William Barr
- Departments of Neurology and Psychiatry, NYU-Langone Medical Center and NYU Grossman School of Medicine, New York, NY, USA
| | - Cady Block
- Department of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA
| | - Robyn M Busch
- Epilepsy Center and Department of Neurology, Cleveland Clinic, Cleveland, OH, USA
| | - Alberto Fernandez
- Neuropsychology Department, Universidad Nacional de Córdoba & Universidad Católica de Córdoba, Córdoba, Argentina
| | - Erik Hessen
- Departments of Psychology and Neurology, University of Oslo and Akershus University Hospital, Oslo, Norway.,Chair of the European Federation of Psychological Association's Standing Committee on Clinical Neuropsychology
| | - David W Loring
- Department of Neurology and Pediatrics, Emory University School of Medicine, Atlanta, GA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Carrie R McDonald
- Department of Psychiatry, University of California, San Diego, San Diego, CA, USA.,Center for Multimodal Imaging and Genetics, University of California, San Diego, San Diego, CA, USA
| | - Bruce P Hermann
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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