The Effects of Computer- Based Rehabilitation on the Cognitive Functions of Epilepsy Patients

Bilgisayar temelli rehabilitasyonun epilepsi hastalarının bilişsel işlevlerine etkileri Amaç: Kriptojenik ve semptomatik fokal epilepsi tanısı almış olgularda, bilişsel kayıpların yavaşlatılması ve başa çıkma stratejilerinin geliştirilebilmesi için yürütülen bilişsel rehabilitasyon programlarının uygulanması ve rehabilitasyon öncesi ve sonrasında bilişsel işlevleri, nöropsikolojik testler aracılığıyla değerlendirilerek, uygulanan rehabilitasyon programının etkilerinin test edilmesi amaçlanmıştır. Yöntem: İstanbul Üniversitesi Cerrahpaşa Tıp Fakültesi Hastanesi Nöroloji Anabilim Dalı Epilepsi Polikliniği'nde tedavi gören 32 hasta arasından, çalışma kriterlerine uygun olan 9 hastaya ardışık 8 hafta boyunca, haftada bir kez psikolog eşliğinde bilgisayar destekli bilişsel rehabilitasyon programı uygulanmıştır. Programın etkisi, rehabilitasyondan önce ve 3 ay sonra uygulanan nöropsikolojik değerlendirme puanlarının karşılaştırılmasıyla değerlendirilmiştir.Bulgular: Yaş ortalaması 36.2±10.7 olan hastaların rehabilitasyon öncesi ve sonrası test skorları sırasıyla; Stroop-1 12.22±2.72; 11.55±4.36, Stroop-2 14.55±4.95; 15.55±9.20, Stroop-3 34.11±15.59; 26.44±12.25, Uzamsal Hatırlama Testi-1 14.22±5.99; 15.88±6.79, Uzamsal Hatırlama Testi-2 4.22±2.94; 6.88±2.93; Seçici Hatırlama Testi-1 55.88±11.95; 56.0±7.0, Seçici Hatırlama Testi-2 8.77±3.83; 8.77±2.72, Sayı Sembolleri Testi 38.33±19.31; 37.66±24.35, Leksikal Sözel Akıcılık 25.77±11.3; 33.66±14.47, Semantik Sözel Akıcılık 15.77±4.52; 17.88±5.88 olarak bulunmuştur. Yapılan analizler sonucunda, Stroop-3, Uzamsal Hatırlama Testi-2 ve Leksikal Sözel Akıcılık testlerinin bilişsel rehabilitasyon öncesi ve sonrası puanları arasında istatistiksel olarak anlamlı farklılık gözlenmiştir (p

Bilgisayar temelli rehabilitasyonun epilepsi hastalarının bilişsel işlevlerine etkiler

The effects of computer-based rehabilitation on the cognitive functions of epilepsy patientsObjective: The aim of this study was to examine the effects of computerized cognitive rehabilitation programs conducted with the purpose of slowing down cognitive losses and developing coping strategies in patients diagnosed with cryptogenic and symptomatic focal epilepsy, with participants’ cognitive functions being evaluated through neuropsychological tests prior to and after rehabilitation.Method: Of 32 patients who were receiving treatment at the Istanbul University, Cerrahpasa Faculty of Medicine Hospital, Department of Neurology Epilepsy Clinic, 9 patients who met the inclusion criteria underwent an 8-consecutive-week computer-assisted cognitive rehabilitation program conducted by a psychologist once a week. The effectiveness of the program was tested with a comprehensive neuropsychological assessment both before the rehabilitation program and 3 months after its completion.Results: Test scores of patients before and after the rehabilitation were found as follows: Stroop-1 12.22±2.72; 11.55±4.36, Stroop-2 14.55±4.95; 15.55±9.20, Stroop-3 34.11±15.59; 26.44±12.25, Spatial Recall Test-1 14.22±5.99; 15.88±6.79, Spatial Recall Test-2 4.22±2.94; 6.88±2.93, Selective Reminding Test-1 55.88±11.95; 56.0±7.0, Selective Reminding Test-2 8.77±3.83; 8.77±2.72, Digit Symbol Substitution Test 38.33±19.31; 37.66±24.35, Lexical Verbal Fluency Test 25.77±11.3; 33.66±14.47, Semantic Verbal Fluency Test 15.77±4.52; 17.88±5.88. The pre- and post-rehabilitation scores of Stroop-3, Spatial Recall Test (SRT)-2 and Lexical Verbal Fluency tests were significantly different (p

___

  • 1. Kwan P, Brodie MJ. Neuropsychological effects of epilepsy and antiepileptic drugs. Lancet 2001; 357:216-222. [CrossRef]
  • 2. Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology 2002; 58(Suppl 5):S21-26. [CrossRef]
  • 3. Medvedev AV. Temporal binding at gamma frequencies in the brain: paving the way to epilepsy? Australas Phys Eng Sci Med 2001; 24:37-48. [CrossRef]
  • 4. Smith DB, Craft BR, Collins J, Mattson RH, Cramer JA. Behavioral characteristics of epilepsy patients compared with normal controls. Epilepsia 1986; 27:760-768. [CrossRef]
  • 5. Elger CE, Helmstädter C, Kurthen M. Chronic epilepsy and cognition. Lancet Neurol 2004; 3:663-672. [CrossRef]
  • 6. Gomceli YB, Bilir E. The cognitive disorder caused by epilepsy. Demans Dergisi 2003; 3:41-47. (Turkish)
  • 7. Hermann B, Meador KJ, Gaillard WD, Cramer JA. Cognition across the lifespan: antiepileptic drugs, epilepsy, or both? Epilepsy Behav 2010; 17:1-5. [CrossRef]
  • 8. Helmstädter C, Kemper B, Elger CE. Neuropsychological aspects of frontal lobe epilepsy. Neuropsychologia 1996; 34:399-406. [CrossRef]
  • 9. Ponds R, Hendriks M. Cognitive rehabilitation of memory problems in patients with epilepsy. Seizure 2006; 15:267-273. [CrossRef]
  • 10. Ylvisaker M, Szekeres SF, Henry K, Sullivan DM, Wheeler P. Topics in Cognitive Rehabilitation Therapy. In: Ylvisaker M, Gobble EMR (editors). Community re-entry for head injured adults. Boston: Butterworth-Heinemann; 1995, 137-220.
  • 11. Helmstaedter C, Loer B, Wohlfahrt R, Hammen A, Saar J, Steinhoff BJ, Quiske A, Schulze-Bonhage A. The effects of cognitive rehabilitation on memory outcome after temporal lobe epilepsy surgery. Epilepsy Behav 2008; 12:402-409. [CrossRef]
  • 12. Hendriks MPH. Neuropsychological compensatory strategies for memory deficits in patients with epilepsy. In: Pfäfflin M, Fraser RT, Thorbecke R, Specht U, Wolf P (editors). Comprehensive care for people with epilepsy. London: John Libbey, 2001, 87-94.
  • 13. Engelberts NH, Klein M, Ader HJ, Heimans JJ, Trenite DG, van der Ploeg HM. The effectiveness of cognitive rehabilitation for attention deficits in focal seizures: a randomized controlled study. Epilepsia 2002; 43:587-595. [CrossRef]
  • 14. Stroop JR. Studies of interference in serial verbal reaction. J Exp Psychol Gen 1935; 18:643-662. [CrossRef]
  • 15. Golden CS. The stroop color and word test: a manual for clinical and experimental uses. Chicago: Stroelting Go, 1978.
  • 16. MacLeod CM. Half a centry of research on the Stroop effect: an integrative review. Psychol Bull 1991; 109:162-203. [CrossRef]
  • 17. Ehrenreich JH. Normative data for adults on a short form of the Selective Reminding Test. Psychol Rep 1995; 76:387-390. [CrossRef]
  • 18. Bingol A, Yildiz S, Topcular B, Tutuncu M, Demirci NO. Brief repeatable battery (BRB)- Turkish normative data. Eur J Neurol 2012; 19(Supp 1): 558.
  • 19. Boringa JB, Lazeron RH, Reuling IE, Adèr HJ, Pfennings L, Lindeboom J, de Sonneville LM, Kalkers NF, Polman CH. The brief repeatable battery of neuropsychological tests: normative values allow application in multiple sclerosis clinical practice. Mult Scler 2001; 7:263-267. [CrossRef] Icellioglu S, Bingol A, Kurt E, Yeni SN Dusunen Adam The Journal of Psychiatry and Neurological Sciences, Volume 30, Number 4, December 2017 363
  • 20. Lezak MD, Howieson DB, Loring DW. Neuropsychological assessment. 4th edition. New York, USA: Oxford University Press, 2004.
  • 21. Beck AT, Ward C, Mendelson M. Beck Depression Inventory (BDI). Arch Gen Psychiatry 1961; 4:561-571. [CrossRef]
  • 22. Hisli N. A study on the validity of Beck Depression Inventory. Turkish Journal of Psychology 1987; 6:118-122. (Turkish)
  • 23. Gillham RA, Williams N, Wiedmann KD, Butler E, Larkin JG, Brodie MJ. Cognitive function in adult epileptic patients established on anticonvulsant monotherapy. Epilepsy Res 1990; 7:219-225. [CrossRef]
  • 24. Eddy CM, Rickards HE, Cavanna AE. The cognitive impact of antiepileptic drugs. Ther Adv Neurol Disord 2011; 4:385-407. [CrossRef]
  • 25. Lodh S, Agrawal N. Neurocognitive problems in epilepsy. BJPsych Adv 2012; 18:232-240. [CrossRef]
  • 26. Chung YT, Hsieh IC, Lai MC, Huang CW. The potential role of neurocognitive rehabilitation in epilepsy. Int J Neurorehabil 2014; 1:125.
  • 27. Radford K, Lah S, Thayer Z, Millera LA. Effective group-based memory training for patients with epilepsy. Epilepsy Behav 2011; 22:272-278. [CrossRef]
  • 28. Mazur-Mosiewicz A, Carlson HL, Hartwick C, Dykeman J, Lenders T, Brooks BL, Wiebe S. Effectiveness of cognitive rehabilitation following epilepsy surgery: current state of knowledge. Epilepsia 2012; 56:735-744. [CrossRef]
  • 29. Alvarez-Alamilla J, Velasco AL, Río-Portilla YD. Conflict processing and response inhibition in patients with temporal lobe epilepsy: fMRI study. Epilepsy Journal 2016; 2:113-118.
  • 30. Metternich B, Buschmann F, Wagner K, Schulze-Bonhage A, Kriston L. Verbal fluency in focal epilepsy: a systematic review and meta-analysis. Neuropsychol Rev 2014; 24:200-218. [CrossRef]
  • 31. Farinaa E, Ragliob A, Giovagnolic AR. Cognitive rehabilitation in epilepsy: an evidence-based review. Epilepsy Res 2015; 109:210- 218. [CrossRef]
  • 32. Blake RV, Wroe SJ, Breen EK, McCarthy RA. Accelerated forgetting in patients with epilepsy: Evidence for an impairment in memory consolidation. Brain 2000; 123:472-483. [CrossRef]
  • 33. Andersson-Roswall L, Engman E, Samuelsson H, SjöbergLarsson C, Malmgren K. Verbal memory decline and adverse effects on cognition in adult patients with pharmacoresistant partial epilepsy: a longitudinal controlled study of 36 patients. Epilepsy Behav 2004; 5:677-686. [CrossRef]
  • 34. Selwa LM, Berent S, Giordani B, Henry TR, Buchtel HA, Ross DA. Serial Cognitive Testing in Temporal Lobe Epilepsy: Longitudinal Changes with Medical and Surgical Therapies. Epilepsia 1994; 35:743-749. [CrossRef]
  • 35. Holmes MD, Dodrill CB, Wilkus RJ, Ojemann LM, Ojemann GA. Is partial epilepsy progressive? Ten-year follow-up of EEG and neuropsychological changes in adults with partial seizures. Epilepsia 1998; 39:1189-1193. [CrossRef]
  • 36. Hermann BP, Seidenberg M, Dow C, Jones J, Rutecki P, Bhattacharya A, Bell B. Cognitive prognosis in chronic temporal lobe epilepsy. Ann Neurol 2006; 60:80-87. [CrossRef]
  • 37. Gupta A, Naorem T. Cognitive retraining in epilepsy. Brain Inj 2003; 17:161-174. [CrossRef]
Düşünen Adam - Psikiyatri ve Nörolojik Bilimler Dergisi-Cover
  • ISSN: 1018-8681
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1984
  • Yayıncı: Kare Yayıncılık
Sayıdaki Diğer Makaleler

The Effects of Computer- Based Rehabilitation on the Cognitive Functions of Epilepsy Patients

Ayhan BİNGÖL, ELİF KURT, SEHER NAZ YENİ, Serra ICELLİOGLU

ECT Practices in a Psychiatry Clinic at a Training and Research Hospital

Seda KİRAZ, Alisan Burak YASAR, Tugrul DOGAN, Meliha Zengin EROĞLU

The Relationship of The Type of Alleged Crime with Self-Esteem and Depressive Symptoms in Juvenile Delinquents

Selma Tural HESAPÇIOĞLU

Üniversite öğrencilerinde riskli davranışların yaygınlığı ve riskli davranışların madde kullanımı ile ilişkisi

EBRU ALDEMİR, A. Ender ALTINTOPRAK, DEMET HAVAÇELİĞİ ATLAM

A Call to Action for the Prevention of Hepatitis C Infection Among Intravenous Drug Users in Turkey

Cüneyt EVREN, Rabia BİLİCİ, Enver ÜÇBİLEK, Dilara İNAN

The Effect of Psychoeducation on the Anger Management of Adolescents Diagnosed with Conduct Disorder

Leyla Baysan ARABACİ, Gülçin UZUNOĞLU

A Case of Type II Citrullinemia Misdiagnosed as Conversion Disorder

Esin ÖZATALAY, Seda Aybüke SARI

Assessment of Pain Symptoms Experienced in Major Depressive Disorder and Anxiety Disorder

Ramazan KOKSAL, M Kemal YAZİCİ, EDA ASLAN

The Seroprevalence of Antibodies to Toxoplasma Gondii Among Children with Autism

Esra Yancar DEMİR, YELİZ ÇETİNKOL, Mustafa Kerem ÇALGIN, Abdullah ERDİL, EMİNE YURDAKUL ERTÜRK, Abdullah DAĞLI, ERMAN ESNAFOĞLU

The Psychometric Properties of the Turkish Version of the Internet Gaming Disorder Scale

Cüneyt EVREN, Merve TOPÇU, Nilay KUTLU, Bilge EVREN, Ercan DALBUDAK