Researchers from Rhode Island Hospital have found a link between cognitive impairment and epilepsy, according to a study published in the journal Epilepsy and Behavior this month. While epilepsy itself is not always neurodegenerative, the study revealed that those with epilepsy exhibit “much higher clinical cognitive impairment,” said Lindsay Miller, postdoctoral fellow in neuropsychology at Rhode Island Hospital.
The study involved epileptic patients 55 or older and a control group of healthy adults with no cognitive impairments. Patients were tested on their ability to learn and retain information over time.
Scientists conducted a variety of experiments to evaluate each patient’s memory. “One test was for verbal information, looking at how well they remembered word lists or a story they might be hearing,” said Jennifer Davis, an author of the study and associate professor of psychiatry and human behavior at the Alpert Medical School and neuropsychologist at Rhode Island Hospital. “The other type is looking at pictures. We would give them a series of geometric shapes that could not be easily named,” she added.
“We found that the group with epilepsy had worse cognitive performance across all different domains we tested,” Davis said.
While the study sheds new light on some of the disease’s effects, there are still many questions to be answered about whether epileptic episodes can be predicted and how epilepsy can be treated.
Compared to other neurological diseases, such as Alzheimer’s, epilepsy’s symptoms are far more varied, making universal treatment difficult. While most people associate epilepsy with regular seizures, there are many other symptoms: Patients commonly exhibit memory problems or anxiety or mood disorders.
Treatments currently available for Alzheimer’s have been tested on epilepsy patients, but they showed little success in alleviating symptoms. In the future, Davis suggests researchers focus on “screening for mood,” especially because patients often lack an outlet to discuss epilepsy’s comorbidities — the presence of more than one chronic disease in a patient — or simply “don’t think about going to a psychiatrist.”
“Fifty percent of patients with epilepsy have depression,” Davis said. “We already know how depression and anxiety affect the brain, so how do both of these diseases come together to affect thinking even more?” she asked.
Miller also expressed concern about the lack of focus on epilepsy’s comorbidities. “Things like depression and anxiety are common in epilepsy, but no one has looked at the impact on cognition,” Miller said.
Today, there are a variety of treatments for those with epilepsy, but they do not address the side effects with which patients are most concerned. Patients “rely mainly on medications and” anti-epileptic drugs to alleviate seizures, said Andrew Blum, medical director of the comprehensive epilepsy program at Rhode Island Hospital. “But in epilepsy, cognitive changes and memory problems are the most common complaints from patients,” Blum said. “It can be the biggest problem they face.”
The research completed by Miller, Davis and Blum has the potential to address these concerns and acknowledge the role anxiety and depression play in the patients’ test results. As they look toward the future, the scientists hope to further develop their research in order to address many patients’ concerns about the progression of cognitive impairment.
“We’re looking to develop interventions for patients and their families to cope with seizures,” Davis said. This new focus could provide many patients with the kind of support they need, she added.
Additionally, Blum and Miller hope to further study how epilepsy develops over time. While the team will need to find funding for further research, its members are not worried about finding a wide body of participants for their experiments. Recruiting patients for the most recent study was easy, Blum said. “The fact that people really wanted to participate reflected that they were interested and worried about the problem,” he added.
With a greater sample size and more time, Miller, Davis and Blum’s research has the potential to not only shed more light on the markers and treatment of epilepsy, but ultimately improve the lives of their patients and their families.
