title: Interictal epileptiform discharges were associated with poorer cognitive performance in adult epileptic patients.
abstract: Cognitive impairment is one of the major consequences of epilepsy and has been shown to reduce quality of life. Interictal epileptiform discharges (IEDs) were associated with poorer cognitive performance in children, and the aim of this study was to determine whether there was a similar association in adults.
  
  
  
  A prospective cohort of 167 seizure-free adult patients underwent EEG recording and extensive cognitive evaluations. Global cognition was evaluated using Addenbrooke's Cognitive Examination-Revised (ACE-R), while sub-dimensions of cognition were evaluated using the Auditory Verbal Learning Test (AVLT), Trial Making Test (TMT)-A and -B, and the 5 constitutive subscales of ACE-R.
  
  
  
  Performance in ACER, but not AVLT or TMT, was significantly lower in patients with general IEDs. Furthermore, the five subscale scores of ACE-R were significantly lower in patients with general IEDs, and verbal fluency and language scores contributed in a major way to the low scores. Stratified analysis showed that sleep-phase IEDs were also associated with lower performance in ACE-R and its subscales. Finally, non-rapid eye movement (NREM)-IEDs were found to be associated with visuospatial and memory impairment, and IEDs while awake, with poorer performance in TMT-B.
  
  
  
  The results of this study demonstrate that cognitive performance is associated with IEDs in adult epilepsy patients, and could serve as a springboard for further research into reducing IEDs to bring about better cognitive performance.
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China.
authors.forename: Xiao-Ying
authors.initials: XY
authors.lastname: Liu
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China.
authors.forename: Tao
authors.initials: T
authors.lastname: Shi
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China.
authors.forename: Wei-Na
authors.initials: WN
authors.lastname: Yin
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China.
authors.forename: Zhen-Yu
authors.initials: ZY
authors.lastname: Ren
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China.
authors.forename: Yu-Lei
authors.initials: YL
authors.lastname: Deng
authors.affiliation: Department of Neurology, Ruijin Hospital (affiliated with Shanghai Jiaotong University School of Medicine), Shanghai, China. Electronic address: chen_sd@medmail.com.cn.
authors.forename: Sheng-Di
authors.initials: SD
authors.lastname: Chen
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology*; D003071:Cognition / Q000502:physiology*; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology; D004569:Electroencephalography; D004827:Epilepsy / Q000175:diagnosis / Q000503:physiopathology* / Q000523:psychology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008297:Male; D009483:Neuropsychological Tests; D011446:Prospective Studies; D012890:Sleep / Q000502:physiology