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2021, Number 1

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Revista del Hospital Psiquiátrico de La Habana 2021; 18 (1)

Fenotipos o perfiles cognitivos en las epilepsias farmacorresistentes

Zaldivar-Bermúdez M, Morales-Chacón LM, Cabrera-Muñoz A, Mendoza-Quiñones R

Language: Spanish
References: 50
Page:
PDF size: 378.13 Kb.


ABSTRACT

Introduction: Neurocognitive impairment has been increasingly reported in patients with Drug-Resistant Epilepsy (DRE) and this deficit may be not limited to a single domain, but rather a mosaic of differentially expressed cognitive impairment across individuals. Exploring distinct cognitive phenotypes in association with clinical and neuroimaging correlates could improve the prognosis and postsurgical outcomes.
Objective: To evaluate the existence of differential patterns of cognitive impairment in DRE in a systematic review.
Methodology: A broad literature search on electronic databases in NCBI PubMed was conducted. According to PRISMA guidelines, research journals that were published in English-peer reviewed journals from January 2000 to February 2021 were included in this study. Statistically significant cognitive impairment in DRE was used as primary outcome and the existence of cognitive phenotypes associated with clinical and neuroimaging correlates was examined as secondary outcome.
Results: Twenty-four studies (n=4495 participants) with 3684 DRE patients and 811 controls were identified. The most prevalent diagnosis was Temporal Lobe Epilepsy (72 %). The greatest impairments were found in the domains of memory (88 %) and executive function (63 %). The analyses also revealed distinct patterns of cognitive deficit profiles or cognitive phenotypes were identified with different regrouping strategies: based on cognitive domains (42 %), on statistical methods (25 %) and clinical criteria (17 %).
Conclusions: DRE patients clearly showed different cognitive phenotypes with different patterns of severity that involve several affected cognitive domains. The strategy of phenotyping is valid; however, future researches are needed to improve better comparability of test designs for reliable and stable DRE cognitive profiles.


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