title: Current standards of neuropsychological assessment in epilepsy surgery centers across Europe.
abstract: We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.
authors.affiliation: Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany.
authors.forename: Viola Lara
authors.initials: VL
authors.lastname: Vogt
authors.affiliation: Epilepsy Center/Neurocenter, Kuopio University Hospital, Kuopio, Finland.|School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Äikiä
authors.affiliation: Department of Neurology, Epilepsy Program, Hospital Ruber International, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Del Barrio
authors.affiliation: Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium.
authors.forename: Paul
authors.initials: P
authors.lastname: Boon
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Csaba
authors.initials: C
authors.lastname: Borbély
authors.affiliation: Department of Clinical Neurosciences, Pediatric Neurology Clinic, Carol Davila University of Medicine, Bucharest, Romania.|Alexandu Obregia Clinical Psychiatric Hospital, Pediatric Neurology Clinic, Bucharest, Romania.
authors.forename: Ema
authors.initials: E
authors.lastname: Bran
authors.affiliation: Department of Child Neurology, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Kees
authors.initials: K
authors.lastname: Braun
authors.affiliation: Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium.
authors.forename: Evelien
authors.initials: E
authors.lastname: Carette
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Maria
authors.initials: M
authors.lastname: Clark
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Judith Helen
authors.initials: JH
authors.lastname: Cross
authors.affiliation: Clinic of Child Neurology, St Naum University Hospital of Neurology and Psychiatry, Sofia, Bulgaria.
authors.forename: Petia
authors.initials: P
authors.lastname: Dimova
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Daniel
authors.initials: D
authors.lastname: Fabo
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Foroglou
authors.affiliation: Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Francione
authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.|Department of Neurology and Neurosurgery of the Russian National Research Medical University, Moscow, Russia.
authors.forename: Anna
authors.initials: A
authors.lastname: Gersamia
authors.affiliation: Department of Neurology, Epilepsy Program, Hospital Ruber International, Madrid, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Gil-Nagel
authors.affiliation: Moscow Research and Clinical Center for Neuropsychiatry, Moscow, Russia.|Department of Neurology and Neurosurgery of the Russian National Research Medical University, Moscow, Russia.
authors.forename: Alla
authors.initials: A
authors.lastname: Guekht
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Sue
authors.initials: S
authors.lastname: Harrison
authors.affiliation: Department of Neurology, Zagreb Epilepsy Center, University Hospital, Zagreb, Croatia.
authors.forename: Hrvoje
authors.initials: H
authors.lastname: Hecimovic
authors.affiliation: National Center for Epilepsy (SSE), Oslo University Hospital, Oslo, Norway.
authors.forename: Einar
authors.initials: E
authors.lastname: Heminghyt
authors.affiliation: University Departement of Neurology, Strasbourg, France.
authors.forename: Edouard
authors.initials: E
authors.lastname: Hirsch
authors.affiliation: 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
authors.forename: Alena
authors.initials: A
authors.lastname: Javurkova
authors.affiliation: School of Medicine, University of Eastern Finland, Kuopio, Finland.
authors.forename: Reetta
authors.initials: R
authors.lastname: Kälviäinen
authors.affiliation: EEG & Epilepsy Unit, Hospital of Geneva & Functional Neurology and Neurosurgery Program, University Hospitals of Geneva and Lausanne, Geneva, Switzerland.
authors.forename: Nicole
authors.initials: N
authors.lastname: Kavan
authors.affiliation: National Institute of Clinical Neurosciences, Budapest, Hungary.
authors.forename: Anna
authors.initials: A
authors.lastname: Kelemen
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Vasilios K
authors.initials: VK
authors.lastname: Kimiskidis
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Margarita
authors.initials: M
authors.lastname: Kirschner
authors.affiliation: University Departement of Neurology, Strasbourg, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Kleitz
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Teia
authors.initials: T
authors.lastname: Kobulashvili
authors.affiliation: Aristotle University of Thessaloniki, Thessaloniki, Greece.
authors.forename: Mary H
authors.initials: MH
authors.lastname: Kosmidis
authors.affiliation: Division of Clinical Electro-Neurophysiology, Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Selin Yagci
authors.initials: SY
authors.lastname: Kurtish
authors.affiliation: Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.
authors.forename: Mathieu
authors.initials: M
authors.lastname: Lesourd
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Sofia
authors.initials: S
authors.lastname: Ljunggren
authors.affiliation: National Center for Epilepsy (SSE), Oslo University Hospital, Oslo, Norway.
authors.forename: Morten Ingvar
authors.initials: MI
authors.lastname: Lossius
authors.affiliation: Department of Clinical Neuroscience and Rehabilitation, Institute of Neuroscience and Physiology, Sahlgrenska University Hospital, The Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden.
authors.forename: Kristina
authors.initials: K
authors.lastname: Malmgren
authors.affiliation: Faculty of Medicine, Clinic of Neurology and Neurosurgery, Vilnius University, Vilnius, Lithuania.|Department of Neurology, Vilnius University Hospital Santariškių klinikos, Vilnius, Lithuania.
authors.forename: Ruta
authors.initials: R
authors.lastname: Mameniskiené
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Patricia
authors.initials: P
authors.lastname: Martin-Sanfilippo
authors.affiliation: 2nd Faculty of Medicine, Motol University Hospital, Charles University in Prague, Prague, Czech Republic.
authors.forename: Petr
authors.initials: P
authors.lastname: Marusic
authors.affiliation: Department of Neurology, Center for Refractory Epilepsy, University Hospital Ghent, Ghent, Belgium.
authors.forename: Marijke
authors.initials: M
authors.lastname: Miatton
authors.affiliation: Division of Clinical Electro-Neurophysiology, Department of Neurology, Cerrahpaşa Medical Faculty, Istanbul University, Istanbul, Turkey.
authors.forename: Çiğdem
authors.initials: Ç
authors.lastname: Özkara
authors.affiliation: Claudio Munari Epilepsy Surgery Center, Niguarda Hospital, Milan, Italy.
authors.forename: Federica
authors.initials: F
authors.lastname: Pelle
authors.affiliation: Danish Epilepsy Center, Filadelfia/University of Copenhagen, EEMA (European Epilepsy Monitoring Unit Association), Dianalund, Denmark.|Epilepsy Institute, IDEE, Lyon, France.
authors.forename: Guido
authors.initials: G
authors.lastname: Rubboli
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Sarah
authors.initials: S
authors.lastname: Rudebeck
authors.affiliation: Department of Clinical Neurosciences, CHUV, Lausanne, Switzerland.|Epilepsy Institute, IDEE, Lyon, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Ryvlin
authors.affiliation: Department of Pediatric Psychology, Sector of Neuropsychology, University Medical Center Utrecht, Utrecht, The Netherlands.
authors.forename: Monique
authors.initials: M
authors.lastname: van Schooneveld
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Schmid
authors.affiliation: Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany.
authors.forename: Pia-Magdalena
authors.initials: PM
authors.lastname: Schmidt
authors.affiliation: EEG & Epilepsy Unit, Hospital of Geneva & Functional Neurology and Neurosurgery Program, University Hospitals of Geneva and Lausanne, Geneva, Switzerland.
authors.forename: Margitta
authors.initials: M
authors.lastname: Seeck
authors.affiliation: Epilepsiezentrum Kork, Kehl-Kork, Germany.
authors.forename: Bernhard J
authors.initials: BJ
authors.lastname: Steinhoff
authors.affiliation: University College London Institute of Child Health & Great Ormond Street Hospital for Children, NHS Foundation Trust, London, United Kingdom.
authors.forename: Sara
authors.initials: S
authors.lastname: Shavel-Jessop
authors.affiliation: Department of Clinical Neurosciences, Pediatric Neurology Clinic, Carol Davila University of Medicine, Bucharest, Romania.|Alexandu Obregia Clinical Psychiatric Hospital, Pediatric Neurology Clinic, Bucharest, Romania.
authors.forename: Oana
authors.initials: O
authors.lastname: Tarta-Arsene
authors.affiliation: Department of Neurology, Christian Doppler Klinik, Paracelsus Medical University Salzburg, Salzburg, Austria.
authors.forename: Eugen
authors.initials: E
authors.lastname: Trinka
authors.affiliation: Department of Pediatrics, Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
authors.forename: Gerd
authors.initials: G
authors.lastname: Viggedal
authors.affiliation: Epilepsiezentrum Kork, Kehl-Kork, Germany.
authors.forename: Anne-Sophie
authors.initials: AS
authors.lastname: Wendling
authors.affiliation: Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany.
authors.forename: Juri-Alexander
authors.initials: JA
authors.lastname: Witt
authors.affiliation: Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany.
authors.forename: Christoph
authors.initials: C
authors.lastname: Helmstaedter
mesh_terms: D003072:Cognition Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D004827:Epilepsy / Q000150:complications / Q000453:epidemiology / Q000601:surgery*; D005060:Europe / Q000453:epidemiology; D019538:Health Care Surveys / Q000706:statistics & numerical data; D006801:Humans; D007391:International Cooperation; D059906:Neuroimaging; D009483:Neuropsychological Tests / Q000592:standards*
keywords: Consensus; Diagnostic; Epilepsy surgery; Europe; Neuropsychology