PMID- 33588318
OWN - NLM
STAT- MEDLINE
DCOM- 20210420
LR  - 20210420
IS  - 1525-5069 (Electronic)
IS  - 1525-5050 (Linking)
VI  - 117
DP  - 2021 Apr
TI  - Psychogenic nonepileptic seizures: The effect of accurate diagnosis on cognition.
PG  - 107766
LID - S1525-5050(20)30946-X [pii]
LID - 10.1016/j.yebeh.2020.107766 [doi]
AB  - OBJECTIVE: Much remains to be elucidated about the cognitive profile of patients 
      with psychogenic nonepileptic seizures (PNES) and about how this changes over 
      time and compares to that of patients with epilepsy. The aim of this study was to 
      study the neuropsychological profile of patients with PNES and an age-matched 
      group of patients with temporal lobe epilepsy (TLE) during admission to a video 
      electroencephalography monitoring unit (VEMU) and 1 year after discharge. 
      METHODS: Patients diagnosed with PNES or TLE at a VEMU were prospectively 
      recruited. Neuropsychological, demographic, clinical, and treatment variables 
      were collected at baseline and 1 year. To minimize multiple comparisons, scores 
      from different cognitive tests were computed for attention and psychomotor speed, 
      verbal memory, visual memory, language, and executive function. A global 
      cognitive impairment index (GCII) was also created. Post hoc analyses were 
      conducted to identify clinical variables that might mediate the differences 
      observed in cognition over time between the groups. These included seizure 
      frequency, number of antiseizure medication (ASM), number of psychotropic drugs, 
      depression, and quality of life. RESULTS: We studied 24 patients with PNES and 24 
      patients with TLE. The groups performed similarly in the baseline 
      neuropsychological tests. There was a significant time (baseline to 1-year 
      follow-up) by group (PNES vs TLE) interaction for the GCII (p = 0.006), language 
      (p = 0.04), and executive function (p = 0.013), with PNES patients showing 
      improvement and TLE patients remaining stable. The time by group interaction for 
      attention and psychomotor speed showed a trend toward significance (p = 0.056), 
      Reduction in number of ASM was associated with improved cognition in PNES 
      patients at 1 year. CONCLUSION: PNES patients showed improved cognition at 1 year 
      of follow-up, particularly in language and executive functions. This finding 
      shows the potential benefits of an early, accurate diagnosis, which range from 
      improved cognition to better management.
CI  - Copyright (c) 2021 Elsevier Inc. All rights reserved.
FAU - Caceres, Cynthia
AU  - Caceres C
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Grau-Lopez, Laia
AU  - Grau-Lopez L
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain. Electronic address: laiagrlo@yahoo.es.
FAU - Martinez, Silvia
AU  - Martinez S
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Mariscal, Carla
AU  - Mariscal C
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Gonzalez-Fuxa, Anna
AU  - Gonzalez-Fuxa A
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Jimenez, Marta
AU  - Jimenez M
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Ciurans, Jordi
AU  - Ciurans J
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Gea, Mireia
AU  - Gea M
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Fumanal, Alejandra
AU  - Fumanal A
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
FAU - Becerra, Juan Luis
AU  - Becerra JL
AD  - Department of Neurosciences, Hospital Germans Trias i Pujol, C/Canyet s/n, 08916 
      Badalona, Spain.
LA  - eng
PT  - Journal Article
DEP - 20210212
PL  - United States
TA  - Epilepsy Behav
JT  - Epilepsy & behavior : E&B
JID - 100892858
SB  - IM
MH  - Cognition
MH  - Electroencephalography
MH  - *Epilepsy
MH  - *Epilepsy, Temporal Lobe
MH  - Humans
MH  - Psychophysiologic Disorders/complications/diagnosis
MH  - Quality of Life
MH  - Seizures/diagnosis/drug therapy
OTO - NOTNLM
OT  - Executive functions
OT  - Neuropsychological deficits
OT  - Neuropsychological follow up
OT  - Psychogenic nonepileptic seizures
OT  - Temporal lobe epilepsy
EDAT- 2021/02/16 06:00
MHDA- 2021/04/21 06:00
CRDT- 2021/02/15 20:16
PHST- 2020/11/02 00:00 [received]
PHST- 2020/12/26 00:00 [revised]
PHST- 2020/12/28 00:00 [accepted]
PHST- 2021/02/16 06:00 [pubmed]
PHST- 2021/04/21 06:00 [medline]
PHST- 2021/02/15 20:16 [entrez]
AID - S1525-5050(20)30946-X [pii]
AID - 10.1016/j.yebeh.2020.107766 [doi]
PST - ppublish
SO  - Epilepsy Behav. 2021 Apr;117:107766. doi: 10.1016/j.yebeh.2020.107766. Epub 2021 
      Feb 12.