02/16/2024
01:45 PM - 03:15 pm
Room: West Side Ballroom - Salon 3
Symposia 12
Beyond Assessment: Integrating Rehabilitation Models into the Neuropsychology of Epilepsy Across the Lifespan and Around the Globe
Chair:
Anny Reyes
University of California, San Diego, San Diego, CA, United States
Discussant:
Cady Block
Emory University, Atlanta, United States
Category: Epilepsy/Seizures
Keyword 1: cognitive rehabilitation Keyword 2: cognitive functioning Keyword 3: quality of life
Summary Abstract:
Epilepsy is the fourth most common neurological condition, with over 3.4 million people living with active epilepsy in the U.S., many of whom experience significant economic burden due to the treatment of epilepsy and related comorbidities. It is estimated that approximately 50% of people with epilepsy (PWE) have at least one comorbid condition, with psychiatric and cognitive dysfunction the most prevalent. The rates of these comorbidities are even higher in treatment-resistant epilepsy, presenting a barrier to surgery. Importantly, epilepsy comorbidities are associated with poor prognosis and quality of life, impacting education, employment, and other social outcomes. Despite a growing appreciation of the impact of these comorbid conditions, the epilepsy literature has historically been descriptive in nature (i.e., describing the scope of the problem), with less research attention being paid to developing interventions aimed at preventing and treating epilepsy-related comorbidities. In 2003, the Center for Disease Control and Prevention (CDC) held the second National Conference on Public Health and Epilepsy focused on developing recommendations for epilepsy research and care. Recommendations included the development and testing of self-management models for epilepsy care and understanding, mitigating, and preventing the impact of seizures and epilepsy on cognition, mood, and quality of life. These recommendations also reflect the 2021 American Epilepsy Society (AES) and National Institute of Neurological Disorders and Stroke (NINDS) Epilepsy Research Benchmark Area IV: Limit, treat, or prevent co-occurring conditions associated with epilepsy across the lifespan in general and special epilepsy populations.
In response to these research benchmarks and recommendations, several research and clinical initiatives have been developed integrating rehabilitation principles into epilepsy care management models that include preoperative counseling, cognitive rehabilitation, and psychiatric interventions. This symposium will cover research efforts on prevention and effective interventions for epilepsy comorbidities with the goal of informing the neuropsychology community of the recent advances in rehabilitation science and practice in epilepsy. First, Dr. Bruce Hermann will provide a historical overview of the epilepsy neurobehavioral comorbidities and recent trends in the provision of nonpharmacological interventions in clinical neuropsychology. Second, Dr. Sallie Baxendale will discuss a predictive model for postoperative cognitive decline that offers the opportunity to provide pre-rehabilitation to surgical candidates. Third, Dr. Elaine Kiriakopoulos will provide an overview of HOBSCOTCH (Home-Based Self-Management and Cognitive Training Changes Lives), a behavioral cognitive training program designed to address memory and attention problems in adults with epilepsy. Fourth, Dr. Aaron Fobian will discuss a novel intervention for the treatment of pediatric functional seizures. Lastly, Dr. Cady Block will lead a discussion on this recent paradigm shift in the neuropsychology of epilepsy and the ways that researchers and clinicians can expand on the traditional role of neuropsychology in epilepsy. Together, these presentations will provide an overview of the recent efforts to prevent and treat the neurobehavioral complications of the epilepsies, raising awareness of the critical need to expand in this area of research.
