Photo Credit: Metamorworks
The following is a summary of “Cognitive performance in functional seizures compared with epilepsy and healthy controls: a systematic review and meta analysis,” published in the July 2024 issue of Psychiatry by Patten et al.
Researchers conducted a retrospective study reviewing and analyzing cognitive performance in adults with functional seizures, comparing them to epilepsy (including left temporal lobe epilepsy) and healthy non-seizure groups.
They conducted a systematic review and meta-analysis (February 2023, updated October 2023). A medical librarian searched MEDLINE, Embase, PsycINFO, and Web of Science. Studied included adults with functional seizures vs. epilepsy or HCs, documenting cognitive test data. Grey literature was included with no language or date restrictions, and bias risk was assessed using a modified Newcastle-Ottawa Scale. Studies reporting on mixed functional seizures and epilepsy, or mixed functional neurological samples, with no pure functional seizures group.
The results showed 3,834 records, only 84 articles involving 8,654 participants (functional seizures 4,193, epilepsy 3,638, healthy comparisons 823). The mean age was 36 (SD 12) years for both functional seizures and epilepsy and 34 (10) years for healthy comparisons. Women made up 72% (range 18-100) of the functional seizures group, 59% (range 15-100) of the epilepsy group, and 69% (range 34-100) of healthy comparisons. There was little data on race or ethnicity. Cognitive performance was better in functional seizures vs. epilepsy (Hedges’ g=0.17 [95% CI 0·10–0·25)], P<0.0001), with moderate-to-high heterogeneity (Q[56]=128·91, P=0·0001, I2=57%). Functional seizures scored higher in global cognition and IQ (g=0.15 [0·02–0·28], P=0.022) and language (g=0.28 [0·14–0·43], P=0.0001) than epilepsy (k=5; g=0·51 [0·10 to 0·91], P=0·015). Lower than healthy comparisons were scored across all cognitive domains (g=-0.61 [−0·78 to −0·44], P<0.0001).
Investigators concluded that patients with functional seizures showed significant cognitive impairments across various domains, though somewhat less severe than in epilepsy, suggesting a need for clinical evaluation and targeted treatment considerations.
Source: thelancet.com/journals/lanpsy/article/PIIS2215-0366(24)00132-9/abstract#%20
