EXECUTIVE DYSFUNCTION PROFILE IN MESIAL TEMPORAL LOBE EPILEPSY

Abstract

The aim of the study was a comprehensive assessment of the profile of executive dysfunctions in patients with MTLE and the search for associations between the results of neuropsychological tests and individual clinical variables.We examined 25 patients with MTLE and 25 healthy controls using the Montreal Cognitive Assessment (MoCA), Color Trails Test (CTT), Tower of London (ToL), Victoria Stroop Test (VLT) and Wisconsin Card Sorting Test (WCST).We considered the possible effects of seizure frequency and lateralization of the epileptogenic zone on various aspects of cognitive functioning. MTLE group scored significantly lower than controls in MoCA (p = 0.000) and needed significantly more time (p=0.000) in CTT-2. They also had lower scores in several parts of ToL (total correct, p=0.004; additional moves, p=0.038; execution time, p=0.001; problem-solving time, p=0.003) and WCST (error responses, p=0.003; conceptual level responses, p=0.000; com - pleted categories, p=0.007; perseverative responses, p=0.004; perseverative errors, p=0.009). There were no significant dif- ferences between the clinical and control group in VST and in other indicators of CTT, ToL and WCST. Neither the laterality of the epileptogenic focus nor the seizure frequency were sig- nificantly correlated with the results.Patients with MTLE exhibit a wide range of executive dysfunctions. Importantly, the disorders were present only in some aspects of functioning, such as: logical reasoning, planning, switching between tasks, cognitive flexibility and problem-solving, while others e.g. inhibition, remained normal. Our results constitute a significant enrichment of knowledge concerning the specificity of functioning of this group of patients which may help clinicians to introduce solutions to improve the functioning of these patients.