Abstracts

Rationale: People diagnosed with idiopathic generalized epilepsy (IGE) frequently exhibit cognitive deficits, which may be partially ameliorated by physical activity. We investigated the relationship between leisure time physical activity levels (PEL) and cognition in persons with IGE who have been seizure-free for at least 6 months (IGE-) as compared to those who are not seizure-free (IGE+) and healthy controls (HCs). We hypothesized greater physical activity levels in HCs than in both IGE groups, and that greater PEL would correlate with better cognitive functioning. We also expected IGE- to perform more like HCs than IGE+. Methods: We recruited 12 IGE-, 11 IGE+ and 28 HCs, ages 18-65. The SF-36 assessed quality of life (QOL), the International Physical Activity Questionnaire (IPAQ) categorized activity level, the Baecke questionnaire assessed PEL, the Montreal Cognitive Assessment (MoCA) assessed cognition, and a flanker task (FT) assessed executive attention. On the FT, subjects had to indicate the direction of the target stimulus (left or right) flanked by stimuli indicating the same (CON) or opposite (INC) direction; accuracy and response times were measured. Fisher’s exact test and analysis of variance were performed to examine group differences (significant at p<0.05). Correlation analysis examined relationship between PEL and cognitive performance for measures showing group differences (significant at p<0.05). Results: There were no significant group differences in age, the proportions of females, body mass indices, or SF-36 physical component and mental component scores. We showed group differences in proportions of high/low/moderate activity levels: 50/25/25% for IGE-, 27/45/27% for IGE+, and 64/4/32% for HCs (p=0.026). PEL was significantly different between groups (p=0.0002); PEL for HCs was greater than both IGE- and IGE+ (p<0.05) and no difference between IGE groups. Years of education were significantly different between groups (p=0.029); HCs had more years of education than IGE+ (p<0.05); there were no other group differences. We showed group differences in MoCA scores (p=0.0004); HCs and IGE- both performed better than IGE+ (p<0.05), and there was no difference between HCs and IGE-. FT accuracy for CON was significantly different between groups (p=0.0011); HCs and IGE- both were more accurate than IGE+ (p<0.05), and no difference between HCs and IGE-. FT response times for CON were also significantly different between groups (p=0.0041); HCs responded faster than IGE+ (p<0.05), and there were no other group differences. In the combined sample, PEL correlated with MoCA (Pearson’s r=0.32; p=0.023). Conclusions: HCs and IGE performed similarly, while IGE+ exhibited worse cognitive functioning than both HCs and IGE-. However, HCs are overall more active in their leisure time than persons with IGE, irrespective of seizure control. We show that there may be a relationship between being more physically active and cognitive performance. Future investigation into how level of physical activity interacts with cognitive functioning in persons with epilepsy who are and are not seizure-free is needed. Funding: UAB Civitan International Research Center and UAB Epilepsy Center