Assessment of psychosocial adjustment in patients with temporal lobe epilepsy using a standard measure

Abstract

Despite the growing evidence of poor psychosocial adjustment, at present there is no formal method of assessment of social adjustment in patients with temporal lobe epilepsy (TLE). First, we assessed social adjustment in patients with TLE using a self-report questionnaire and compared the results with those from quality-of-life (QOL) scales. Second, we verified the influence of cognitive performance and clinical variables of epilepsy on social adjustment and QOL. We evaluated 35 people with TLE and 38 healthy controls. Patients had worse social adjustment, and it was correlated with worse perception of cognitive function. Attention and verbal memory dysfunctions were negatively correlated with social adjustment. However, there was no significant correlation between cognitive performance and QOL. Regarding clinical variables, persons with left TLE showed worse social adjustment and patients with frequent seizures showed worse QOL. These findings indicate the relevance of evaluating social adjustment and emphasize the importance of cognitive rehabilitation to improved social adjustment.

Autistic characteristics in adults with epilepsy

“…has not yet been determined how many years of seizure-freedom are related to a significant improvement, and the pattern of recovery from epilepsy in terms of social cognitive ability has not Previous evidence has suggested worse psychosocial adjustment in certain epilepsy types such as TLE and mTLE (Gois et al, 2011;Jokeit, 2010). However, Experiment 1 suggested that autistic traits were common to all adults with epilepsy and therefore not exclusive to any single epilepsy type.…”

“…This is most surprising, given that animal studies have related TLE to functional changes in social behaviours that manifest as ASD, and consistent with such evidence, a number of studies have shown that those with TLE have worse social adjustment (Gois et al, 2011;Marin et al, 2008). On one hand, early onset is a consistent factor for impaired advanced social cognition (Shaw et al, 2004;Hlobil et al, 2008).…”

“…At present there is little evidence to demonstrate that imagination or attention-switching is impaired in epilepsy. However, there is evidence for poor social functioning and psychosocial adjustment in epilepsy (Gois et al, 2011;Marin et al, 2008;McCagh et al, 2009). Some researchers have suggested that functional connectivity differences in individuals with epilepsy indicate that seizures may reorganise the networks important for understanding the social world with severe negative consequences (Wang et al, 2011).…”

“…Poor psychosocial adjustment has been associated with the social isolation and social stigma of having epilepsy. Where poor psychosocial adjustment has been identified, it has been found to occur more frequently in certain focal epilepsies such as TLE (Gois et al, 2011;Jokeit, 2010, p.582). As highlighted by Schacher and colleagues (2006), studies of advanced social cognition have not been extensively researched in epilepsy, and are therefore neglected.…”

Learning and memory and its relationship with the lateralization of epileptic focus in subjects with temporal lobe epilepsy

“…In MTLE, the primary brain network involved includes structures of the limbic system, mainly the hippocampus and amygdala that are crucially implicated in learning and memory processes. Epileptogenic foci are most often localized in one brain hemisphere, although epileptogenic medial temporal lesions are bilateral in many cases 1,2 . Neuropsychological assessment of MTLE patients is important to document cognitive impairments in specific domains, such as episodic memory 3,4 and linguistic and nonlinguistic functions 5,6 .…”