TY - JOUR
T1 - An interplay between post-traumatic epilepsy and associated cognitive decline
T2 - A systematic review
AU - Ngadimon, Irma Wati
AU - Aledo-Serrano, Angel
AU - Arulsamy, Alina
AU - Mohan, Devi
AU - Khoo, Ching Soong
AU - Cheong, Wing Loong
AU - Shaikh, Mohd Farooq
N1 - Funding Information:
The authors were supported by Monash University Malaysia-School of Medicine Strategic Grant 2021.
Funding Information:
We would like to thank Ms Julia Khaw; MA of Clinical Psychology; MSc Neuropsychology from Department of Psychiatry, Faculty of Health Sciences, The National University of Malaysia, Kuala Lumpur for assisting us in identifying the relevant cognitive tests in the articles.
Publisher Copyright:
Copyright © 2022 Ngadimon, Aledo-Serrano, Arulsamy, Mohan, Khoo, Cheong and Shaikh.
PY - 2022/2/24
Y1 - 2022/2/24
N2 - Background: Post-traumatic epilepsy (PTE) is a devastating neurological outcome of traumatic brain injury (TBI), which may negatively impact the quality of life of patients with TBI, and may impose a huge socioeconomic burden. This burden may be due to long-term functional outcomes associated with PTE, particularly cognitive dysfunction. To date, the relationship between TBI and PTE remains unclear, with little known about how the effect of their link on cognitive function as well. Objective: Thus, this systematic review aimed at elucidating the relationship between PTE and cognitive impairment in adults after TBI based on available clinical studies, in hopes to aid in the development of therapeutic strategies for PTE. Methods: A systematic literature search was performed using 6 databases; MEDLINE, Embase, CINAHL, Psych INFO, Web of Science, and Cochrane to retrieve relevant clinical studies investigating the link between PTE and cognition in the context of TBI. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of relevant studies. Results: A total of six eligible studies were included for critical appraisal in this review after performing the inclusion and exclusion criteria, which involved 1,100 individuals, from 1996 to 2021. The selected studies were derived from the civilian and military population, with a follow-up period that ranged from 6 months to 35 years. The average quality of the involved studies was moderate (6.6, SD = 1.89). Five out of six studies found poorer cognitive performance in people with PTE, compared with those without PTE. Although the association between PTE and cognitive impairment was insignificant after controlling for specific covariates, there was a statistical trend toward significance. Conclusion: This systematic review suggests that there may be a possible link between PTE and cognitive decline in TBI patients, with the latter being reported to occur up to 35 years post injury. Variations in sample sizes, follow-up periods, and neuropsychological assessment tools may be the limitations affecting the interpretation and significance of this relationship. Therefore, future studies with standard cognitive assessment tools may be warranted to solidify the link between TBI-PTE-cognitive dysfunction, prior to the development of therapeutic strategies.
AB - Background: Post-traumatic epilepsy (PTE) is a devastating neurological outcome of traumatic brain injury (TBI), which may negatively impact the quality of life of patients with TBI, and may impose a huge socioeconomic burden. This burden may be due to long-term functional outcomes associated with PTE, particularly cognitive dysfunction. To date, the relationship between TBI and PTE remains unclear, with little known about how the effect of their link on cognitive function as well. Objective: Thus, this systematic review aimed at elucidating the relationship between PTE and cognitive impairment in adults after TBI based on available clinical studies, in hopes to aid in the development of therapeutic strategies for PTE. Methods: A systematic literature search was performed using 6 databases; MEDLINE, Embase, CINAHL, Psych INFO, Web of Science, and Cochrane to retrieve relevant clinical studies investigating the link between PTE and cognition in the context of TBI. The Newcastle-Ottawa Scale (NOS) was used to assess the methodological quality of relevant studies. Results: A total of six eligible studies were included for critical appraisal in this review after performing the inclusion and exclusion criteria, which involved 1,100 individuals, from 1996 to 2021. The selected studies were derived from the civilian and military population, with a follow-up period that ranged from 6 months to 35 years. The average quality of the involved studies was moderate (6.6, SD = 1.89). Five out of six studies found poorer cognitive performance in people with PTE, compared with those without PTE. Although the association between PTE and cognitive impairment was insignificant after controlling for specific covariates, there was a statistical trend toward significance. Conclusion: This systematic review suggests that there may be a possible link between PTE and cognitive decline in TBI patients, with the latter being reported to occur up to 35 years post injury. Variations in sample sizes, follow-up periods, and neuropsychological assessment tools may be the limitations affecting the interpretation and significance of this relationship. Therefore, future studies with standard cognitive assessment tools may be warranted to solidify the link between TBI-PTE-cognitive dysfunction, prior to the development of therapeutic strategies.
KW - cognitive decline
KW - head injury
KW - neuropsychological deficit
KW - post-traumatic epilepsy
KW - traumatic brain injury
UR - http://www.scopus.com/inward/record.url?scp=85126195667&partnerID=8YFLogxK
U2 - 10.3389/fneur.2022.827571
DO - 10.3389/fneur.2022.827571
M3 - Review Article
C2 - 35280285
AN - SCOPUS:85126195667
SN - 1664-2295
VL - 13
JO - Frontiers in Neurology
JF - Frontiers in Neurology
M1 - 827571
ER -