Clinical Validity of NIH Cognitive Toolbox Tasks in Drug-resistant Epilepsy Compared to Gold Standard Neuropsychological Testing
Abstract number :
3.523
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2024
Submission ID :
1608
Source :
www.aesnet.org
Presentation date :
12/9/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Matthew Kreinbrink, BS – University of Maryland School of Medicine
Amir Srour, BS – University of Maryland School of Medicine
Leila Gachechiladze, MD – University of Oklahoma
Anjeli Inscore, PsyD – University of Maryland School of Medicine
Stephanie Chen, MD – University of Maryland School of Medicine
Rationale:
Drug-resistant epilepsy (DRE) is a prevalent debilitating neurological disorder for which resective surgery can be one of the most effective choices for achieving seizure freedom and a higher quality of life. Cognitive decline is a very common morbidity associated with epilepsy surgery, so assessing and predicting postsurgical cognitive outcomes have become core tenets of presurgical evaluation in these patients. Currently, cognitive testing is only done as part of a comprehensive presurgical workup. The NIH Toolbox Cognition Battery (NIHTB-CB) was developed to provide an accessible, quick, and standardized way of examining cognitive function. Despite this, it has not been widely explored or used in most clinical populations. Previously, NIHTB-CB was validated as an adjunct neuropsychological test sensitive enough to discern cognitive differences between patients with drug-resistant temporal lobe epilepsy and age/gender-matched controls in our population. In this study, we aim to evaluate the clinical validity of the NIHTB-CB tasks compared to the gold standard neuropsychological measures performed as part of a comprehensive presurgical evaluation.Methods:
Patients with DRE undergoing presurgical evaluation at our Level IV NAEC Epilepsy Center and who received gold standard neuropsychological testing were recruited. All patients continued to have seizures despite trials of two or more antiseizure medications. All participants underwent NIHTB-CB testing. NIHTB-CB and gold standard tests were grouped into 1 of 5 cognitive domains. Age-corrected scores from each test were converted into normalized z-scores and then averaged to form a composite score for each of the cognitive domains. Correlation between NIH-TB and gold standard composite domain scores was assessed using a Pearson correlation coefficient.
Results:
24 subjects (mean age=38.0, range 23-62) were recruited: 20 patients with temporal lobe epilepsy and 4 patients with extra-temporal epilepsy. There were strong correlations (r > 0.5) between NIHTB-CB and gold standard composite scores in episodic memory (p = 0.0013), attention and executive functioning (p= 0.0097) domains, and a particularly strong correlation in the language domain (p < 0.0001). There was no significant correlation in working memory (p = 0.0954) or processing speed (p = 0.4154) domains.
Behavior