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Title:

Cognitive impairment and quality of life of people with epilepsy and neurocysticercosis in Zambia

Document type:
Article
Author(s):
Nau, Anne L.; Mwape, Kabemba E.; Wiefek, Jasmin; Schmidt, Kathie; Abatih, Emmanuel; Dorny, Pierre; Praet, Nicolas; Chiluba, Clarance; Schmidt, Holger; Phiri, Isaac K.; Winkler, Andrea S.; Gabriël, Sarah; Blocher, Joachim
Abstract:
Cognitive impairment and quality of life (Qol) are important to assess the burden of epilepsy and neurocysticercosis (NCC), which are common but neglected in Sub-Saharan Africa (SSA). The aims of this study were to assess cognitive performance and Qol of people with epilepsy (PWE) in Zambia and to explore differences in PWE with and without NCC. In this community based, cross-sectional case-control-study, 47 PWE and 50 healthy controls completed five neuropsychological tests (Mini Mental State Examination (MMSE), Digit Span, Selective Reminding Test (SRT), Spatial Recall Test (SPART), Test Battery of Attentional Performance (TAP)) and a World Health Organization (WHO) questionnaire of Qol. Comparisons were made between PWE (n = 47) and healthy controls (n 50) and between PWE with NEC (n 28) and without NCC (n = 19), respectively, using Analysis of Covariance (ANCOVA) and Linear Models (LMs) while correcting for confounders such as age, sex, and schooling years, and adjusting for multiplicity. Working memory, spatial memory, verbal memory, verbal learning, orientation, speech and language reception, visuoconstructive ability, and attentional performance were significantly reduced in PWE compared with healthy controls (ANCOVA and LM, p < 0.05). Quality of life of PWE was significantly lower in three domains (psychological, social, environmental) and in overall Qol compared with healthy controls (ANCOVA, p < 0.05). There were no significant differences between PWE with NEC and PWE without NEC detected by ANCOVA. Using LM, significant differences between the groups were detected in four tests, indicating worse performance of PWE without NEC in MMSE, Digit Span, SPART, and lower physical Qol. Epilepsy was found to be associated with cognitive impairment and reduced Qol. People with epilepsy due to NEC had similar cognitive impairment and Qol compared with PWE due to other causes. Further studies should investigate the role of different conditions of NEC and the role of seizures on cognition and Qol. (C) 2017 Elsevier Inc. All rights reserved.
Journal title abbreviation:
Epilepsy Behav
Year:
2018
Journal volume:
80
Pages contribution:
354-359
Fulltext / DOI:
doi:10.1016/j.yebeh.2017.10.042
Pubmed ID:
http://view.ncbi.nlm.nih.gov/pubmed/29221763
Print-ISSN:
1525-5050
TUM Institution:
Neurologische Klinik und Poliklinik
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