Temporal lobe epilepsy with or without hippocampal sclerosis: Different neuropsychological profiles and associated clinical factors

Abstract

Objective: To elucidate the neurocognitive profiles in temporal lobe epilepsy with or without hippocampal sclerosis (TLE-HS vs TLE-noHS) and ascertain clinical factors associated with the different scores of neurocognitive tests.

Methods: TLE patients who underwent neuropsychological tests (NPTs) in our center were recruited. The NPTs included the Wisconsin Card Sorting Test, Stroop Color-Word Test, Trail Making Test, the Wechsler Adult Intelligence Scale - fourth edition and the Wechsler Memory Scale - fourth edition. Student t-test or Mann–Whitney U test was used to assess the difference in scores between groups. Univariate and multivariate linear regression analyses were also used to assess clinical factors associated with statistically significant NPT scores.

Results: Among 109 recruited patients, 81 were TLE-HS, and 28 were TLE-noHS. NPT score results showed that verbal comprehension index (VCI) and auditory memory index (AMI) were significantly lower in TLE-HS. A lower VCI score was associated with earlier onset, longer duration of epilepsy, presence of generalized tonic-clonic seizure, history of febrile seizure, and some antiseizure medication uses. HS was an independent factor associated with lower VCI, whereas, in addition to HS, some clinical factors, i.e., history of status epilepticus, lower highest years of education or psychiatric comorbidities, were also independently associated with lower AMI.

Conclusions: Our findings suggest that TLE-HS had unique clinical characteristics and different NPT scores from TLE-noHS. In clinical practice, we should be aware that NPT scores might be affected by some clinical factors, and only VCI is a promising test that can help differentiate these two conditions.