Abstracts

Rationale: The gold standard for assessing cognitive function for drug-resistant epilepsy (DRE) is comprehensive neuropsychological assessment.The information provided assists in surgical planning and prediction of postsurgical cognitive outcomes.A comprehensive neuropsychological assessment consists of a lengthy battery of tests interpreted by a neuropsychologist.The NIH Toolbox Cognition Battery (NIHTB-CB) was developed to assess key components of cognition and is a quick, iPad-based assessment that is easy to administer, score, and interpret.The NIH Toolbox measures have been widely used and validated among individuals with various clinical conditions, but to our knowledge, no studies have been published on patients with DRE.In this study, we aim to demonstrate how NIHTB-CB subtests and comprehensive neuropsychological battery tests correlate in an effort to help validate its use in DRE

Methods: Patients with DRE undergoing pre-surgical evaluation at our Level IV NAEC Epilepsy Center were recruited.Patients who were age 18 or older and had confirmed TLE by continuous video EEG monitoring were included in the study.All patients completed the NIHTB-CB and comprehensive neuropsychological assessment.Tests were compared within the following domains (Table 1): Attention and executive function (Flanker Inhibitory Control and Attention test vs Frontal Assessment Battery (FAB) and WAIS-IV Digit Span Forward Score);Episodic memory (Picture Sequence Test vs WMS-IV Immediate Memory Index and WMS-IV Delayed Memory Index);Working memory (List Sorting Test vs WAIS-IV Letter-Number Sequencing Test and WAIS-IV Digit Span Test); Processing speed (Pattern Comparison Test vs Trails Making Test Part B) and Language (Picture Vocabulary Test vs MAE Visual Naming Test and MAE Aural Comprehension Test).Relationships between NIHTB-CB and neuropsychological assessment measures were examined using Pearson correlations (r)

Results: 12 patients ages 28-65 completed all measures of interest.Attention and executive function: Flanker Inhibitory Control and Attention demonstrated moderate correlation with FAB (r = 0.46), and low correlation with Digit Span Forward (r=0.2) and Backward Tests(r= 0.3). Episodic Memory:Picture Sequence demonstrated a very high correlation with WAIS-IV Immediate and Delayed Memory Index(r = 0.9 and 0.7,respectively).Working memory: List Sorting demonstrated a very high correlation with the WAIS-IV Letter-Number Sequencing(r=0.84) and a moderate correlation with the WAIS-IV Digit Span(r=0.4).Processing Speed:Pattern Comparison correlated highly with Trails Making Test Part B (r=-0.7). Language:Picture Vocabulary Test demonstrated high correlation with the MAE Visual Naming (r=0.8) and moderate correlation with MAE Aural Comprehension Test (r=0.5)

Conclusions: The NIH Toolbox-Cognition Battery demonstrated variable correlation with specific neuropsychological battery tests.Tests with high and very high correlations might provide an accurate assessment of functioning within the same cognitive domain in patients with drug-resistant TLE.The NIHTB-CB may prove useful as an adjunct assessment tool in this patient population (e.g. to track outcomes)


Funding: 1UL1TR003098-01; UMB ICTR