Brain Sciences最新文献

{"title":"Long-Term Treatment Retention of Levetiracetam Monotherapy in Adults with Epilepsy: A 10-Year Retrospective Cohort Study Using Time-to-Treatment-Failure Analysis.","authors":"Waad Hasan Alkathiri, Saeed Ali Alqahtani, Abdlatif Ahmed Alghaiheb, Bandar Nasser Aljafen, Bander Balkhi","doi":"10.3390/brainsci16101110","DOIUrl":"https://doi.org/10.3390/brainsci16101110","url":null,"abstract":"<p><strong>Background: </strong>This study aimed to estimate treatment retention rates for levetiracetam monotherapy in patients with epilepsy and to characterize treatment failure in this population.</p><p><strong>Methods: </strong>A retrospective cohort study included 769 adult patients with epilepsy between 2015 and 2024 at a tertiary hospital in Saudi Arabia who initiated levetiracetam monotherapy. The date of levetiracetam initiation was designated as the index date, and patients were followed from that point until treatment failure or censoring. Treatment failure was defined as either discontinuation of levetiracetam because of adverse events or the addition of another antiseizure medication due to insufficient seizure control. Kaplan-Meier survival analysis was used to estimate the probability of remaining on levetiracetam monotherapy over the follow-up period. Differences in patient characteristics were assessed between the treatment-failure and success groups using Student's <i>t</i>-test for continuous variables and either the chi-square test or Fisher's exact test for categorical variables.</p><p><strong>Results: </strong>Of the 769 patients who initiated levetiracetam monotherapy, 143 (18.55%) experienced treatment failure during the 10-year follow-up period. The overall mean time to levetiracetam treatment failure was 93.58 months. The 25th percentile time to treatment failure was 95 months (95% CI: 60.167-103.133). The median time to treatment failure was not reached. Females comprised 50.3% of the cohort, with no significant difference in sex distribution between groups (<i>p</i> = 0.136). Patients in the treatment-failure group were younger (39.85 ± 16.88 vs. 45.76 ± 19.48, <i>p</i> = 0.0003), had higher estimated Creatinine clearance (CrCl) (132.19 ± 57.83 vs. 118.50 ± 61.15, <i>p</i> = 0.0150), and had predominantly generalized seizure onset (40.56% vs. 33.71%, <i>p</i> = 0.0182) compared with the treatment-success group.</p><p><strong>Conclusions: </strong>Levetiracetam monotherapy demonstrated sustained long-term treatment retention when used as first-line therapy in adults with epilepsy.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262563","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Proprioception-Centered Hypothesis Linking Sensorimotor Function, Respiration, and Sleep Across the Day-Night Cycle in Developmental Dyslexia.","authors":"Patrick Quercia, Steeve Morin","doi":"10.3390/brainsci16101106","DOIUrl":"https://doi.org/10.3390/brainsci16101106","url":null,"abstract":"<p><p><b>Objectives:</b> Developmental dyslexia is a heterogeneous neurodevelopmental condition in which motor, perceptual, attentional, respiratory, and sleep-related differences have been reported alongside reading difficulties. This Perspective proposes a proprioception-centered sensorimotor coherence framework to consider potential interactions among these domains across the day-night cycle. <b>Methods:</b> This hypothesis-generating narrative Perspective traces the progressive development of the proposed framework from clinical observations to experimental investigations and subsequent refinement of a clinical examination based on functional responses to sensory modulation. No systematic review or new cohort analysis was undertaken. The examination explores three principal domains-tonic-motor regulation, spatial localization, and multisensory integration-together with respiratory and sleep-related factors. Sensorimotor modulation includes ocular, oral, plantar, respiratory, manual, and ergonomic approaches selected according to their observed functional effects across domains. A clinical case illustrates the application of this approach. <b>Results:</b> Experimental studies conducted over nearly two decades in our INSERM laboratory objectively investigated postural regulation, proprioceptive acuity, spatial localization, multisensory processing, and action representation in developmental dyslexia. More recent exploratory clinical studies extended the investigation to respiration and sleep. Taken together, these observations suggest that proprioception-centered sensorimotor coherence may represent one functional level through which motor, perceptual, respiratory, attentional, and learning-related processes interact across the day-night cycle as learning develops and continues. <b>Conclusions:</b> The proposed framework is a working hypothesis rather than an established causal model or a validated treatment for developmental dyslexia. It provides a complementary embodied perspective and identifies clinically observable and experimentally testable relationships that warrant further investigation, including through controlled studies examining the contributions of individual sensory and functional components.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Daily Life Impacts and Desired Support for Mothers of Children with Sensory Integration Differences, with and Without Autism.","authors":"Susan Allen, Fiona Knott, Amanda Branson, Shelly J Lane","doi":"10.3390/brainsci16101105","DOIUrl":"https://doi.org/10.3390/brainsci16101105","url":null,"abstract":"<p><p><b>Background/Objectives</b>: To address the needs of mothers of children with sensory integration differences, we need a greater understanding of their experience and what they find helpful. This study aimed to explore the impact of child sensory integration differences on daily activities and relationships and to identify the relationships, media, and parent interventions mothers regard as helpful and further support that is desired. It compared perceptions of mothers of autistic and non-autistic children. <b>Methods</b>: A single cohort descriptive observational survey study. Questions were generated from previous in-depth interviews. <b>Results</b>: Mothers of autistic children versus non-autistic children both with sensory integration differences reported greater impact on school and community activities and on some relationships. No differences were observed in factors mothers identified as helpful, such as media resources and relationships. Most mothers in the full cohort reported that child sensory integration differences had a pervasive impact on everyday activities and relationships for both mother and child. Supportive relationships, media, social media, and direct interventions to mothers were helpful. Mothers wanted more practical and emotional support for themselves, education of others, and specialist support for their child. <b>Conclusions</b>: Mothers of children with sensory integration differences identified social and professional relationships, media, and parent intervention as helpful, supporting a variety of intervention strategies.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262634","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Selected Cognitive Abilities and Temperamental Traits Among Young Adults Playing Video Games.","authors":"Justyna Krzepota, Krzysztof Wrześniewski, Joanna Basiaga-Pasternak, Marek Cieśluk, Aneta Łuć, Tomasz Sacewicz, Dorota Sadowska","doi":"10.3390/brainsci16101109","DOIUrl":"https://doi.org/10.3390/brainsci16101109","url":null,"abstract":"<p><p><b>Objectives</b>: The aim of this study was to analyse cognitive functioning and temperamental traits among young adults differing in their level of engagement in video gaming. <b>Methods</b>: The analysis included 67 male students from the Józef Piłsudski University of Physical Education in Warsaw, Branch Campus in Biała Podlaska. Based on average daily gaming time, participants were classified as frequent players (n = 22; mean age 22.45 ± 2.40 years; 6.29 ± 6.07 h/day) or casual players (n = 45; mean age 21.60 ± 1.96 years; 0.94 ± 0.95 h/day). Cognitive functioning was assessed using the Reaction Test (RT), Signal Test (ST), and Determination Test (DT) from the Vienna Test System. Temperament was measured with the Formal Characteristics of Behaviour-Temperament Inventory. <b>Results</b>: Frequent players showed a trend toward shorter reaction time in RT/S3 (U = 356; <i>p</i> = 0.064). In the Signal Test, they demonstrated significantly fewer omitted reactions, more correct responses, higher focused attention, and better total results (all <i>p</i> < 0.01). Regarding temperament, frequent players scored significantly lower on briskness (<i>p</i> = 0.034) and rhythmicity (<i>p</i> = 0.021) than casual players. <b>Conclusions</b>: The present exploratory study suggests a nuanced relationship between media engagement, specific cognitive performance, and temperamental traits. Frequent players demonstrated a robust advantage in parameters of sustained attention, alongside a marginal descriptive trend toward faster psychomotor responses compared to casual players. Regarding temperament, frequent players were characterised by significantly lower self-reported briskness and rhythmicity, while no statistically significant between-group differences were detected for endurance, activity, or emotional reactivity. Crucially, because our data are cross-sectional and the frequent players group comprised exclusively esports students, these differences cannot be interpreted as definitive causal effects or direct consequences of gaming intensity alone.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neglected Posterior Cervical Myelomeningocele in Adults: Systematic Review of the Literature and Illustrative Case.","authors":"Adi Ahmetspahic, Razim Mahmutagic, Bekir Rovcanin, Ibrahim Omerhodzic, Edina Dozic, Deniz Bulja, Mirza Pojskic, Kenan I Arnautović","doi":"10.3390/brainsci16101107","DOIUrl":"https://doi.org/10.3390/brainsci16101107","url":null,"abstract":"<p><p><b>Objectives</b>: Adult posterior cervical spinal dysraphism, including meningocele (MC), myelomeningocele (MMC), and myelocystocele (MyCC) is exceptionally rare and remains insufficiently characterised. This study aimed to conduct the first systematic review of the literature on adult cases and report an additional illustrative case. <b>Methods</b>: A PRISMA 2020 systematic review of PubMed/MEDLINE, Web of Science and Scopus was conducted (PROSPERO CRD420261426944). Data were extracted at case level, grouped by the lesion label used by the original authors, and synthesised narratively. <b>Results</b>: Nineteen studies (18 case reports and one case series) described 23 adults (median age 24 years; 19 male): 16 MC, one MyCC and six MMC. An objective neurological abnormality was documented in 14 of 21 examined patients. Nineteen patients were operated on; among 17 with a classified outcome, ten improved, five were intact and two were stable, and none were reported worse (median follow-up 12 months). The additional case was a 62-year-old man with a radiologically diagnosed C4-C5 lesion most consistent with MMC and no objective neurological deficit, managed by observation (3 months of follow-up). <b>Conclusions</b>: The evidence is sparse, heterogeneous and prone to publication bias, and it is insufficient to establish natural history, optimal management or the relative merits of surgery and observation. Standardised terminology, multicentre registries and long-term follow-up are needed.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Exposure Model to the Generative Brain: Art, Creativity, and the Case for Cultural Vitality as Health Infrastructure.","authors":"Claudio Lucchiari, Maria Elide Vanutelli","doi":"10.3390/brainsci16101104","DOIUrl":"https://doi.org/10.3390/brainsci16101104","url":null,"abstract":"<p><p>A quarter-century of neuroaesthetics and cultural epidemiology has established that engagement with art is broadly and durably health-bearing, yet the finding sits awkwardly within the paradigm through which it is usually read: a tacit exposure model, in which art is beneficial input, the person is its recipient, and benefit is modelled on the dose received. Translated into practice as social prescribing, now expanding on an evidence base that the field's own systematic reviews describe as weak, this model inherits the grammar of the receptor and the individual patient, and leaves an anomaly it cannot explain. The epidemiological signature of cultural engagement is that of a cultivated capacity distributed across a coupled system rather than of an administered agent; it survives adjustment for socioeconomic position, health status, health behaviours, and social connectedness, though not the residual confounding we treat as its most serious rival explanation. We advance the hypothesis that aesthetic reception and creative production are two directions of a single generative regime of brain function: neurally instantiated but neither neurally nor individually bounded, scaling from a transient individual state to dyadic and group-level creativity and to the enactive coupling of organism and environment. Cultural vitality thereby becomes a candidate infrastructural determinant of health, adjudicated by three stated criteria and tested through seven falsifiable predictions. Whether the reclassification holds is an empirical question, and one that neuroscience is morally compelled to help resolve before policy commitments harden.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"CSPT-SleepNet: An Automatic Sleep Staging Framework Integrating Center-Driven Sequence Supervision and Multimodal Pyramid Token Encoding.","authors":"Xiaoqin Lian, Peiyi Wang, Chao Gao, Yelan Wu","doi":"10.3390/brainsci16101108","DOIUrl":"https://doi.org/10.3390/brainsci16101108","url":null,"abstract":"<p><p><b>Background:</b> Automatic sleep staging is fundamental to sleep architecture analysis and the diagnosis of sleep disorders. Sleep staging requires jointly modeling complementary information across modalities, multi-scale physiological features, and temporal relationships across consecutive epochs. In target epoch prediction from consecutive epochs, non-target epochs primarily provide contextual information, but their ground-truth labels remain underused as auxiliary supervision. <b>Methods:</b> We propose CSPT-SleepNet, an automatic sleep staging framework integrating center-driven sequence supervision with multimodal pyramid token encoding. A Multimodal Pyramid Token Encoder extracts hierarchical multi-scale features from electroencephalogram, electrooculogram, and electromyogram signals, followed by intra-modal, cross-modal, and inter-epoch modeling for center-epoch classification. During training, the center epoch receives primary classification supervision, while non-center epochs receive weaker auxiliary supervision based on their ground-truth labels, providing stage-informed contextual support for the prediction target. <b>Results:</b> In subject-independent cross-validation on Sleep-EDF-20, Sleep-EDF-78, and ISRUC-S3, CSPT-SleepNet achieved accuracy (ACC)/macro F1 (MF1) scores of 87.93%/83.53%, 85.81%/80.87%, and 84.06%/82.86%, respectively. In a separate controlled comparison on Sleep-EDF-20, center-driven sequence supervision improved ACC and MF1 by 0.60 and 0.91 percentage points, respectively, over equal-weight sequence supervision. The full model has 3.418 million trainable parameters and requires 397.10 million floating-point operations for an input sequence of nine 30-s epochs. <b>Conclusions:</b> CSPT-SleepNet provides an effective framework for center-epoch sleep staging from consecutive multimodal inputs. Nevertheless, N1 recognition remains challenging, with F1 scores ranging from 55.3% to 62.7% across the three datasets.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Microsurgical Outcomes of Third-Ventricle Colloid Cysts Treated via an Interhemispheric Transcallosal Approach: A Single-Center Retrospective Series.","authors":"Abdulkadir Kankılıç, İbrahim Başar, Ferhat Kurtoğlu, Ali Fahir Özer","doi":"10.3390/brainsci16101101","DOIUrl":"https://doi.org/10.3390/brainsci16101101","url":null,"abstract":"<p><strong>Background/objectives: </strong>Third-ventricle colloid cysts are benign but can cause obstructive hydrocephalus and sudden deterioration, and the role of microsurgical transcallosal resection in the endoscopic era remains debated. We evaluated clinical, radiological, and functional outcomes of microscope-assisted interhemispheric transcallosal resection and the effect of preoperative hydrocephalus on recovery.</p><p><strong>Methods: </strong>This retrospective, observational, single-center study analyzed 30 patients with symptomatic, histopathologically confirmed colloid cysts operated on between June 2015 and February 2021, divided into hydrocephalus (<i>n</i> = 16) and non-hydrocephalus (<i>n</i> = 14) groups. Functional outcomes were assessed using the Karnofsky Performance Status (KPS) scale.</p><p><strong>Results: </strong>Mean KPS improved from 65.3 ± 21.0 to 92.0 ± 11.0 (<i>p</i> < 0.001). Patients with hydrocephalus had lower preoperative Glasgow Coma Scale (GCS; <i>p</i> = 0.022) and KPS (<i>p</i> = 0.048) scores, comparable postoperative KPS (<i>p</i> = 0.208), and greater KPS improvement (<i>p</i> = 0.012). Four patients (13.3%) needed external ventricular drainage; none required a permanent shunt. Four patients (13.3%) developed new persistent neurological events (seizures, <i>n</i> = 3; memory impairment, <i>n</i> = 1). No recurrence occurred over a median follow-up of 7.0 years.</p><p><strong>Conclusions: </strong>Microscope-assisted interhemispheric transcallosal microsurgical resection was associated with significant KPS improvement, no permanent shunt requirement, and no recurrence. Despite the increasing use of endoscopic techniques, microsurgical approaches remain valuable due to direct visualization, bimanual dissection, and the potential for durable gross-total resection; however, neurocognitive outcomes were not assessed, and prospective studies are needed.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262659","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twins Discordant for Parkinson's Disease: A 10-Year Longitudinal Follow-Up of Mortality, Clinical and Lifestyle Features, Nutritional Status, and Dietary Habits.","authors":"Michela Barichella, Antonio Natale, Elena Contaldi, Luca Magistrelli, Emanuele Cereda, Carlotta Bolliri, Maria Carmela Macchione, Federica Invernizzi, Daniela Calandrella, Ioannis Ugo Isaias, Gianni Pezzoli","doi":"10.3390/brainsci16101102","DOIUrl":"https://doi.org/10.3390/brainsci16101102","url":null,"abstract":"<p><p><b>Background/Objectives</b>: Twins discordant for Parkinson's disease (PD) share genetic background and early-life exposures, offering a model for non-genetic determinants of disease. We aimed to evaluate longitudinally the mortality, clinical and lifestyle features, nutritional status and dietary habits of a cohort of PD-discordant twins, with specific attention to the monozygotic (MZ) subgroup. <b>Methods</b>: One hundred and eight subjects from 54 PD-discordant twin pairs (26 MZ, 28 dizygotic [DZ]), with genetically confirmed zygosity, were assessed at baseline (T0) and after 10 years by telephone interview (T1; 33 pairs), using Kaplan-Meier/Cox survival analyses, a clinical and lifestyle history questionnaire, body mass index (BMI), and a food frequency questionnaire (FFQ). <b>Results</b>: Ten-year mortality was markedly higher in PD (31.5% vs. 5.6%; HR 6.83), with all MZ deaths occurring in the affected twin. Constipation was more frequent in PD at both time points (T0 <i>p</i> = 0.004; T1 <i>p</i> = 0.011). Comorbidities, smoking, weight and BMI did not differ within pairs. Preserved-fish intake was stably lower in PD (T0 <i>p</i> = 0.021; T1 <i>p</i> = 0.004); fruit intake was lower in PD at baseline (MZ, <i>p</i> = 0.001) but higher at follow-up (<i>p</i> = 0.029). <b>Conclusions</b>: The mortality difference persisted despite no detected within-pair differences in BMI and comorbidities, consistent with a major contribution of PD itself. Preserved-fish intake remained stably lower in affected twins, whereas increased fruit intake at follow-up may reflect adaptation to constipation; these exploratory dietary findings warrant confirmation.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262724","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Impairment in Drug-Resistant Epilepsy: A Multidomain Systematic Review.","authors":"Mateusz Bargielski, Edyta Adamska-Patruno, Adam Krętowski, Jan Kochanowicz, Alina Kułakowska, Monika Chorąży","doi":"10.3390/brainsci16101103","DOIUrl":"https://doi.org/10.3390/brainsci16101103","url":null,"abstract":"<p><p><b>Background</b>: Drug-resistant epilepsy (DRE) is frequently accompanied by cognitive impairment across multiple neuropsychological domains. <b>Objectives</b>: We aimed to synthesize contemporary evidence on cognitive impairment, neurobiological correlates, potentially modifiable clinical factors, and treatment-related cognitive outcomes in predominantly adult populations with DRE. <b>Methods</b>: PubMed/MEDLINE and Web of Science were searched for studies published between January 2017 and September 2026, supplemented by citation searching. Twenty-two studies comprising 2359 participants were included, of whom 1616 (68.5%) had confirmed DRE. Eligibility was independently verified by a second reviewer, and risk of bias was assessed independently by two reviewers using design-specific Joanna Briggs Institute tools. Owing to substantial clinical and methodological heterogeneity, a structured qualitative synthesis was performed. <b>Results</b>: Cognitive impairment involved memory, executive function, attention, language, and processing- or psychomotor-speed-related performance. Cognitive performance was associated with distributed neurobiological abnormalities and with clinical factors including sleep quality, antiseizure medication exposure, and seizure burden. Treatment- and surgery-related cognitive outcomes varied across studies. The predominantly observational evidence and substantial heterogeneity limited causal inference. <b>Conclusions</b>: Cognitive impairment in DRE is heterogeneous and extends beyond memory dysfunction. Current evidence supports multidomain neuropsychological assessment and is compatible with a distributed network framework, although causal mechanisms remain uncertain.</p>","PeriodicalId":9095,"journal":{"name":"Brain Sciences","volume":"16 10","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149262582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}