Utility of NIH Toolbox Cognitive Battery in Patients with Medically Refractory Epilepsy
Abstract number :
2.28
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2021
Submission ID :
1826393
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Nicole Hartmann, DO, MBS - University of Maryland Medical Center; Christina Spadafora – University of Maryland Medical Center; Stephanie Chen – University of Maryland Medical Center
Rationale: Neuropsychiatric (NP) testing is paramount during the surgical workup for medically refractory epilepsy (MRE). Typical neuropsychiatric testing is a lengthy battery of testing that typically takes many hours to perform. The information provided assists in surgical planning to predict the post-surgical cognitive outcomes (Baumgartner, et al. 2019). The NIH Toolbox for the assessment of Neurologic and Behavioral Function (NIHTB) measures 4 domains including cognition, motor, sensory and emotional functioning. The purpose of the development of this battery is for use in a longitudinal fashion and as a “common currency” between researchers (Weintraub, et al. 2013). NIHTB is much shorter in duration, taking approximately 30 minutes per each domain. The shorter duration and easy execution make replication and trending over time a simpler process. Validity for use of the NIHTB in epilepsy has not yet been established, but a recent study by Hwang, et al in 2020 did use portions of the NIHTB cognitive battery (NIHTB-CB) in a comparison of cognition, particularly processing speed, in non-surgical TLE patients to controls. The NIHTB-CB has also been used in 2016 by Glynn, et al to trend interventions in childhood absence epilepsy.
In this study, we aim to show that NIHTB-CB across multiple domains is sensitive enough to differentiate between those with MRE and age-education adjusted controls.
Methods: MRE patients were recruited from our University practice. Medically refractory defined as continued seizures despite use of two or more anti-seizure medications (ASM) and undergoing the workup for or have already undergone epilepsy surgery. Healthy controls also recruited and underwent NIHTB-CB testing. The results of the toolbox testing were compared between the two groups.
Results: Five test subjects with MRE and five age and education-similar controls underwent NIHTB-CB testing. The MRE population consisted of three patients with left FLE, one left anterior TLE, and one patient with bitemporal epilepsy. Average number of ASM for MRE group is four (range 2-6). In all NIHTB tests performed, the control group scored higher than the MRE group. T testing was performed for statistical significance and p < 0.05 in 4 of 7 tests as well as in total composite test scoring.
Behavior