Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge

Anya Mazur-Mosiewicz, Helen L. Carlson, Cailey Hartwick, Jonathan Dykeman, Taryn Lenders, Brian L. Brooks, Samuel Wiebe

Research output: Contribution to journalArticle

18 Citations (Scopus)

Abstract

Objective Cognitive rehabilitation (CR) is a well-researched therapeutic option for a variety of neurocognitive problems. Recently, CR has been proposed as an option for patients who experience cognitive difficulties following epilepsy surgery (ES). However, there is inconsistency in reporting the efficacy of CR in this population. We appraise existing evidence regarding CR approaches in patients undergoing resective ES and review effectiveness of specific CR strategies. Methods A comprehensive literature search using MEDLINE, Embase, CINAHL, PsycINFO, and EBM Reviews (including the Cochrane database) identified studies in English published before September 2014, without age restriction, related to CR in patients who underwent resective ES. We included studies focused on patients who underwent ES and who received at least one type of cognitive rehabilitation. Results Of 2,059 citations identified, four fulfilled eligibility criteria (n = 577), and all investigated the effectiveness of specific CR strategies in patients with either left or right temporal lobe resections. CR strategies used included internal compensatory strategies, external memory aids, psychoeducation, verbal and visual memory training, and exercises of attention and executive functions. None were randomized trials, and only one study involved standardized methods or described the procedures in detail. Evidence suggests that CR may contribute to improvements in aspects of verbal memory, with particular benefit of visual imagery techniques; CR aimed at verbal memory functions may be less effective for patients with hemispheric-dominant resections, and figural memory may not be improved by CR. Furthermore, CR may improve functional and life outcomes, but its timing does not appear to influence its effectiveness. Significance We demonstrate that CR interventions are overwhelmingly under researched or underreported, and there is a need for a systematic evaluation of CR in this patient population. CR should be given greater attention after ES to determine its efficacy and role in the management of these patients.

Original languageEnglish
Pages (from-to)735-744
Number of pages10
JournalEpilepsia
Volume56
Issue number5
DOIs
StatePublished - 1 May 2015

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Epilepsy
Rehabilitation
Imagery (Psychotherapy)
Executive Function
Temporal Lobe
MEDLINE
Population
Learning
Databases
Exercise

Keywords

  • Cognitive remediation
  • Epilepsy
  • Learning
  • Memory
  • Neuropsychological outcome
  • Rehabilitation
  • Resection
  • Strategies
  • Surgery

Cite this

Mazur-Mosiewicz, A., Carlson, H. L., Hartwick, C., Dykeman, J., Lenders, T., Brooks, B. L., & Wiebe, S. (2015). Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge. Epilepsia, 56(5), 735-744. https://doi.org/10.1111/epi.12963
Mazur-Mosiewicz, Anya ; Carlson, Helen L. ; Hartwick, Cailey ; Dykeman, Jonathan ; Lenders, Taryn ; Brooks, Brian L. ; Wiebe, Samuel. / Effectiveness of cognitive rehabilitation following epilepsy surgery : Current state of knowledge. In: Epilepsia. 2015 ; Vol. 56, No. 5. pp. 735-744.
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Mazur-Mosiewicz, A, Carlson, HL, Hartwick, C, Dykeman, J, Lenders, T, Brooks, BL & Wiebe, S 2015, 'Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge', Epilepsia, vol. 56, no. 5, pp. 735-744. https://doi.org/10.1111/epi.12963

Effectiveness of cognitive rehabilitation following epilepsy surgery : Current state of knowledge. / Mazur-Mosiewicz, Anya; Carlson, Helen L.; Hartwick, Cailey; Dykeman, Jonathan; Lenders, Taryn; Brooks, Brian L.; Wiebe, Samuel.

In: Epilepsia, Vol. 56, No. 5, 01.05.2015, p. 735-744.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Effectiveness of cognitive rehabilitation following epilepsy surgery

T2 - Current state of knowledge

AU - Mazur-Mosiewicz, Anya

AU - Carlson, Helen L.

AU - Hartwick, Cailey

AU - Dykeman, Jonathan

AU - Lenders, Taryn

AU - Brooks, Brian L.

AU - Wiebe, Samuel

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N2 - Objective Cognitive rehabilitation (CR) is a well-researched therapeutic option for a variety of neurocognitive problems. Recently, CR has been proposed as an option for patients who experience cognitive difficulties following epilepsy surgery (ES). However, there is inconsistency in reporting the efficacy of CR in this population. We appraise existing evidence regarding CR approaches in patients undergoing resective ES and review effectiveness of specific CR strategies. Methods A comprehensive literature search using MEDLINE, Embase, CINAHL, PsycINFO, and EBM Reviews (including the Cochrane database) identified studies in English published before September 2014, without age restriction, related to CR in patients who underwent resective ES. We included studies focused on patients who underwent ES and who received at least one type of cognitive rehabilitation. Results Of 2,059 citations identified, four fulfilled eligibility criteria (n = 577), and all investigated the effectiveness of specific CR strategies in patients with either left or right temporal lobe resections. CR strategies used included internal compensatory strategies, external memory aids, psychoeducation, verbal and visual memory training, and exercises of attention and executive functions. None were randomized trials, and only one study involved standardized methods or described the procedures in detail. Evidence suggests that CR may contribute to improvements in aspects of verbal memory, with particular benefit of visual imagery techniques; CR aimed at verbal memory functions may be less effective for patients with hemispheric-dominant resections, and figural memory may not be improved by CR. Furthermore, CR may improve functional and life outcomes, but its timing does not appear to influence its effectiveness. Significance We demonstrate that CR interventions are overwhelmingly under researched or underreported, and there is a need for a systematic evaluation of CR in this patient population. CR should be given greater attention after ES to determine its efficacy and role in the management of these patients.

AB - Objective Cognitive rehabilitation (CR) is a well-researched therapeutic option for a variety of neurocognitive problems. Recently, CR has been proposed as an option for patients who experience cognitive difficulties following epilepsy surgery (ES). However, there is inconsistency in reporting the efficacy of CR in this population. We appraise existing evidence regarding CR approaches in patients undergoing resective ES and review effectiveness of specific CR strategies. Methods A comprehensive literature search using MEDLINE, Embase, CINAHL, PsycINFO, and EBM Reviews (including the Cochrane database) identified studies in English published before September 2014, without age restriction, related to CR in patients who underwent resective ES. We included studies focused on patients who underwent ES and who received at least one type of cognitive rehabilitation. Results Of 2,059 citations identified, four fulfilled eligibility criteria (n = 577), and all investigated the effectiveness of specific CR strategies in patients with either left or right temporal lobe resections. CR strategies used included internal compensatory strategies, external memory aids, psychoeducation, verbal and visual memory training, and exercises of attention and executive functions. None were randomized trials, and only one study involved standardized methods or described the procedures in detail. Evidence suggests that CR may contribute to improvements in aspects of verbal memory, with particular benefit of visual imagery techniques; CR aimed at verbal memory functions may be less effective for patients with hemispheric-dominant resections, and figural memory may not be improved by CR. Furthermore, CR may improve functional and life outcomes, but its timing does not appear to influence its effectiveness. Significance We demonstrate that CR interventions are overwhelmingly under researched or underreported, and there is a need for a systematic evaluation of CR in this patient population. CR should be given greater attention after ES to determine its efficacy and role in the management of these patients.

KW - Cognitive remediation

KW - Epilepsy

KW - Learning

KW - Memory

KW - Neuropsychological outcome

KW - Rehabilitation

KW - Resection

KW - Strategies

KW - Surgery

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