title: Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge.
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.
  
  
  CONCLUSIONS
  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.
authors: The Chicago School of Professional Psychology, Chicago, Illinois, U.S.A.|Alberta Children's Hospital, Calgary, Alberta, Canada.
authors: Anya
authors: A
authors: Mazur-Mosiewicz
authors: Alberta Children's Hospital, Calgary, Alberta, Canada.|Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.
authors: Helen L
authors: HL
authors: Carlson
authors: Alberta Children's Hospital, Calgary, Alberta, Canada.
authors: Cailey
authors: C
authors: Hartwick
authors: Foothills Medical Centre, Calgary, Alberta, Canada.
authors: Jonathan
authors: J
authors: Dykeman
authors: Alberta Children's Hospital, Calgary, Alberta, Canada.
authors: Taryn
authors: T
authors: Lenders
authors: Alberta Children's Hospital, Calgary, Alberta, Canada.|Alberta Children's Hospital Research Institute, Calgary, Alberta, Canada.|University of Calgary, Calgary, Alberta, Canada.
authors: Brian L
authors: BL
authors: Brooks
authors: Foothills Medical Centre, Calgary, Alberta, Canada.|University of Calgary, Calgary, Alberta, Canada.
authors: Samuel
authors: S
authors: Wiebe
mesh_terms: D003072:Cognition Disorders / Q000209:etiology* / Q000534:rehabilitation*; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004827:Epilepsy / Q000534:rehabilitation / Q000601:surgery; D006801:Humans; D009493:Neurosurgery / Q000379:methods; D011183:Postoperative Complications / Q000534:rehabilitation*
keywords: Cognitive remediation; Epilepsy; Learning; Memory; Neuropsychological outcome; Rehabilitation; Resection; Strategies; Surgery