Neuropsychological test performance in frontal-lobe epilepsy: The influence of aetiology, seizure type, seizure frequency and duration of disorder

Objective:To assess whether increased seizure frequency during pregnancy and post-partum is influenced by epilepsy type, seizure location, and antiseizure medications.Methods:Clinical data was collected in a longitudinal prospective database of pregnant women with epilepsy at Brigham and Women’s Hospital. Within each individual participant, baseline seizure frequency was calculated for the 9 months preconception, and it was determined if seizure frequency increased during pregnancy or the postpartum period. Seizure frequency was calculated for each 4-week interval during pregnancy. Generalized estimating equations for logistic regression were applied.Results:Ninety-nine patients contributing 114 pregnancies were included from 2013-2018. Increased seizure frequency occurred more often during pregnancies of women with focal versus generalized epilepsy (21.1% vs 5.3%, OR 4.70; 95% CI (1.00, 22.00); p = 0.0497). Among women with focal epilepsy, increased seizure frequency occurred more often in those with frontal lobe epilepsy (OR 8.00; 95 % CI (2.19, 29.21); p = 0.0017). There was no difference in seizure worsening in the postpartum period between focal and generalized (11.1% vs 9.1%, p=0.4478), or frontal and other focal (18.8% vs 6.0%; p=0.1478) epilepsy groups. Pregnancies on polytherapy had higher odds of seizure worsening compared to monotherapy (OR = 8.36, 95% CI = (2.07, 33.84), p = 0.0029), regardless of the medication or epilepsy type. A lack of preconception seizure freedom was also associated with increased seizure frequency during pregnancy (OR = 6.418; p = 0.0076).Conclusion:Women with focal epilepsy have higher likelihood of seizure worsening during pregnancy compared to women with generalized epilepsy; frontal lobe epilepsy poses an especially elevated risk. Polytherapy and lack of preconception seizure freedom are additional predictors for an increased likelihood of seizure worsening.

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Eye movements and neurocognitive function in treatment resistant schizophrenia: a pilot study

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700007448 ◽

2003 ◽

Vol 20 (1) ◽

pp. 6-10 ◽

Cited By ~ 2

Author(s):

Annette Thampi ◽

Clarke Campbell ◽

Mary Clarke ◽

Suzanne Barrett ◽

David J King

Keyword(s):

Frontal Lobe ◽

Eye Movement ◽

Test Performance ◽

Neuropsychological Test ◽

Treatment Resistance ◽

Treatment Resistant ◽

Schizophrenic Patients ◽

Resistant Group ◽

The Difference ◽

Neuropsychological Impairments

AbstractObjectives: It is increasingly important to develop predictors of treatment response and outcome in schizophrenia. Neuropsychological impairments, particularly those reflecting frontal lobe function, appear to predict poor outcome. Eye movement abnormalities probably also reflect frontal lobe deficits. We wished to see if these two aspects of schizophrenia were correlated and whether they could distinguish a treatment resistant from a treatment responsive group.Methods: Ten treatment resistant schizophrenic patients were compared with ten treatment responsive patients on three eye movement paradigms (reflexive saccades, antisaccades and smooth pursuit), clinical psychopathology (BPRS, SANS and CGI) and a neuropsychological test battery designed to detect frontal lobe dysfunction. Ten aged-matched controls also carried out the eye movement tasks.Results: Both treatment responsive (p = 0.038) and treatment resistant (p = 0.007) patients differed significantly from controls on the antisaccade task. The treatment resistant group had a higher error rate than the treatment responsive group, but the difference was not statistically significant. Similar poor neuropsychological test performance was found in both groups.Conclusions: To demonstrate the biological differences characteristic of treatment resistance, larger sample sizes and wider differences in outcome between the two groups are necessary.

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Frontal and non-frontal lobe neuropsychological test performance and clinical symptomatology in schizophrenia

Psychological Medicine ◽

10.1017/s0033291700030294 ◽

1992 ◽

Vol 22 (2) ◽

pp. 353-359 ◽

Cited By ~ 47

Author(s):

S. L. Morrison-Stewart ◽

P. C. Williamson ◽

W. C. Corning ◽

S. P. Kutcher ◽

W. G. Snow ◽

...

Keyword(s):

Frontal Lobe ◽

Test Performance ◽

Neuropsychological Tests ◽

Negative Symptoms ◽

Neuropsychological Test ◽

Normal Subjects ◽

Matched Group ◽

Clinical Symptomatology ◽

Frontal Lobe Function

SYNOPSISSchizophrenic subjects performed significantly worse on neuropsychological tests of frontal lobe function but not on tests of non-frontal lobe function when compared to a matched group of normal subjects. Correlations expected between frontal lobe neuropsychological test performance and negative symptoms were not found.

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Factors Associated with Attention Deficit Hyperactivity Disorder in Children with Frontal Lobe Epilepsy

Journal of Pediatric Epilepsy ◽

10.1055/s-0037-1604354 ◽

2017 ◽

Vol 06 (03) ◽

pp. 133-140

Author(s):

Fumikazu Sano ◽

Tetsuo Ohyama ◽

Kanji Sugita ◽

Masao Aihara ◽

Hideaki Kanemura

Keyword(s):

Attention Deficit Hyperactivity Disorder ◽

Frontal Lobe ◽

Seizure Frequency ◽

Attention Deficit ◽

Rating Scale ◽

Clinical Manifestations ◽

Wisconsin Card Sorting Test ◽

Frontal Lobe Epilepsy ◽

Card Sorting ◽

Hyperactivity Disorder

AbstractThe relationship between attention deficit/hyperactivity disorder (ADHD) and frontal lobe epilepsy (FLE) in children is not well understood. Patients with FLE between 6 and 15 years of age were studied. Scores on the ADHD rating scale (ADHD-RS) and Wisconsin card sorting test (WCST) were obtained at baseline. Behavioral changes were evaluated using the ADHD-RS scores at 6, 12, and 24 months after seizure onset. Perseverative errors of Nelson (PEN) scales on WCST were also evaluated at same time periods. The relationships between clinical manifestations and neuropsychological disturbances were analyzed. In 34 patients, the ADHD-RS score at 24 months after onset was most strongly associated with the presence of status epilepticus (SE, p = 0.004, β = 0.490) followed by seizure frequency (p = 0.021, β = 0.382). The increase in ADHD-RS score was most strongly associated with seizure frequency (p < 0.001, β = 0.635). The PEN score on WCST at 24 months was most strongly associated with seizure frequency (p = 0.001, β = 0.724). The increase in PEN score on WCST was most strongly associated with seizure frequency (p = 0.001, β = 0.872). The only clinical factor associated with both the ADHD-RS and the PEN scores on the WCST was seizure frequency. Seizure frequency may be correlated with risk for ADHD in children with FLE.

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Event-related desynchronization of cortical rhythms during a voluntary movement in frontal lobe epilepsy

Electroencephalography and Clinical Neurophysiology ◽

10.1016/s0013-4694(97)88717-6 ◽

1997 ◽

Vol 103 (1) ◽

pp. 155

Author(s):

P Derambure

Keyword(s):

Frontal Lobe ◽

Voluntary Movement ◽

Frontal Lobe Epilepsy ◽

Event Related Desynchronization ◽

Cortical Rhythms

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Posttraumatic Stress Disorder Exacerbates Emotional Complaints but not Cognitive Impairments in Individuals Suffering from Postconcussional Disorder after Mild Traumatic Brain Injury

Zeitschrift für Neuropsychologie ◽

10.1024/1016-264x/a000132 ◽

2015 ◽

Vol 26 (1) ◽

pp. 35-50 ◽

Cited By ~ 1

Author(s):

Sara C. Schroeder ◽

Ronald M. Ruff ◽

Lutz Jäncke

Keyword(s):

Traumatic Brain Injury ◽

Posttraumatic Stress Disorder ◽

Brain Injury ◽

Posttraumatic Stress ◽

Mild Traumatic Brain Injury ◽

Test Performance ◽

Stress Disorder ◽

Negative Impact ◽

Neuropsychological Test ◽

Composite Scale

The aim of this study was to examine the effect of posttraumatic stress disorder (PTSD) on (a) neuropsychological test performance and (b) self-reported emotional complaints within individuals suffering from postconcussional disorder (PCD) after a mild traumatic brain injury (MTBI). A two-group comparative research design was employed. Two MTBI samples with and without PTSD were assessed with a neuropsychological test battery and the Ruff Neurobehavioral Inventory (RNBI). On the neurocognitive test performances no significant between group differences were found, but the MTBI group with PTSD endorsed a significantly greater number of emotional complaints, especially in the RNBI subscales of anxiety and depression. The patients with PTSD also endorsed a significantly greater number of premorbid sequelae in the RNBI emotional composite scale as well as the RNBI premorbid subscales of pain, anxiety and abuse. In sum, PTSD has a negative impact on emotional but not cognitive functioning within individuals suffering from PCD after a mild TBI.

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