Self-awareness and underestimation of cognitive abilities in patients with adult temporal lobe epilepsy after surgical treatment

Zimmermann, Nicolle; Castro-Pontes, Monique; Barqueta, Raphaela; Goes, Pedro Augusto de Assis; Gabriel, Marcin; Meira, Isabella D’Andrea; Fonseca, Róchele Paz; Prigatano, George P.

doi:10.1016/j.yebeh.2020.107463

Cited by 3 publications

(2 citation statements)

References 69 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…16 These reports both contain information on everyday life, whereas objective measures do not. Another study with a small sample on surgical subjects (n = 23) found 39% under-and overestimation, 51 indicating that differences in study populations may also influence the degree of concordance between SCI and OCI.…”

Section: Frequency Of Over-and Underestimation Of Cognitionmentioning

confidence: 99%

“…11 However, this procedure relies on the assumption that objective test results reflect "true" abilities and neglects that OCI and SCI may differ due to methodological reasons instead of misjudgments. In future studies, cognition may be additionally assessed via direct questions about the participants' perception of their objective test performance, proxy measures of relatives, 16,51 experimental tasks, or measurement tools that are more closely related to everyday performance. 62 Furthermore, we categorized quantitative variables, which decreases the resolution of information.…”

Section: Limitations and Directions For Further Researchmentioning

confidence: 99%

See 1 more Smart Citation

Domain‐specific relationships of subjective and objective cognition in epilepsy

et al. 2023

View full text Add to dashboard Cite

Objective: Many people with epilepsy report subjective cognitive impairment (SCI), i.e., problems with memory, attention, or executive functions, reducing quality of life. Nevertheless, overlap with objective cognitive impairment (OCI) is often weak. One reason may be a domain-specific mismatch between subjective reports and objective tests. We aimed to evaluate relations between SCI and OCI of corresponding domains and to assess whether these differ between persons who over-or underestimate their performance. Methods:In this prospective, cross-sectional sample of 104 adult inpatients with epilepsy, we performed multiple regression analyses predicting SCI in the domains attention, memory, and executive functions. We tested relationships with measures of psychomotor speed, short-term memory, verbal learning, verbal delayed recall, and word fluency while controlling for age, sex, seizure frequency, structural lesions, mono-versus polytherapy and adverse events of antiseizure medication (ASM), depressive and anxiety symptoms, level of education, and employment status. Furthermore, we tested whether these relationships differed between realistic raters and over-and underestimators. Results:We found domain-specific relations for attention and executive functions for the full sample, explaining a small proportion of variance of SCI (general dominance index = .03 and .004), whereas ASM adverse events and psychological variables were more important predictors. When dividing the sample according to the concordance of SCI and OCI, we found high frequencies of both over-(23%-46%) and underestimation (31%-35%) depending on the domain. The explanatory power of OCI for SCI was stronger within the subgroups compared to the full sample, suggesting nonlinear relationships and different underlying mechanisms for realistic raters, underestimators, and overestimators.Significance: Domain-specific SCI and OCI are related, and both should be assessed with standardized instruments. These relationships differ between overand underestimators as well as realistic raters. Based on the concordance of

show abstract

Section: Frequency Of Over-and Underestimation Of Cognitionmentioning

confidence: 99%

Section: Limitations and Directions For Further Researchmentioning

confidence: 99%

Domain‐specific relationships of subjective and objective cognition in epilepsy

et al. 2023

View full text Add to dashboard Cite

show abstract

Changes in overlap of subjective and objective cognition over time in epilepsy surgery candidates

Hohmann,

Jipping,

Oltmanns

et al. 2024

Seizure: European Journal of Epilepsy

View full text Add to dashboard Cite

Discrepancy between subjective and objective memory change after epilepsy surgery: Relation with seizure outcome and depressive symptoms

et al. 2022

View full text Add to dashboard Cite

Complaints pertaining to memory functioning are among the most often reported cognitive symptoms in patients with epilepsy. However, research suggests a considerable mismatch between patients' perception of memory functioning and the objective performance as measured with standardized neuropsychological tests. Depressive mood might be an important factor in explaining this discrepancy, though other variables have also occasionally been reported as relevant. There are mixed results as to which role these factors play in determining the overall quality of life of patients with epilepsy. The present study aimed to quantify the mismatch between subjective and objective memory functioning by taking into account the dynamic change of these factors as well as depressive symptoms after epilepsy surgery. Moreover, the influencing factors of subjective and objective memory change were investigated as well as their effects on the overall quality of life. Pre- and postoperative data from 78 patients with focal epilepsy were retrospectively analyzed. The results showed that (1) patients with clinically relevant postoperative depressive symptoms underestimate their actual memory performance; (2) for non-seizure-free patients, a postoperative decrease in depressive symptoms was associated with a tendency to underestimate memory decline; (3) the relationship between objective memory change and quality of life is mediated by the factors subjective memory change and depressive mood. Our data demonstrate a quantitative approximation of a pronounced depression-related negative biased self-perception of memory functioning of roughly 1 to 1.5 standard deviations. Moreover, it seems that when patients are relieved of having recurrent epileptic seizures, they may be less influenced by depressive symptoms when judging their memory change. Taken together, our study demonstrates the clinical relevance of incorporating subjective measures of memory functioning and mood that go beyond objective memory performance for the interpretation of how changes in memory functioning may affect patients' quality of life after epilepsy surgery.

show abstract

Self-awareness and underestimation of cognitive abilities in patients with adult temporal lobe epilepsy after surgical treatment

Cited by 3 publications

References 69 publications

Domain‐specific relationships of subjective and objective cognition in epilepsy

Domain‐specific relationships of subjective and objective cognition in epilepsy

Changes in overlap of subjective and objective cognition over time in epilepsy surgery candidates

Discrepancy between subjective and objective memory change after epilepsy surgery: Relation with seizure outcome and depressive symptoms

Contact Info

Product

Resources

About