Relationship between Cognitive Performance and Subjective Symptoms in Patients with Newly Diagnosed Focal Epilepsy (S21.003)

Objective: Demonstrate the relationship between objective cognitive performances and subjective symptoms/perceptions in newly diagnosed focal epilepsy. Background: The Human Epilepsy Project (HEP) is a prospective, observational study seeking to identify clinical characteristics and biomarkers predictive of disease treatment response, progression, and outcome in newly diagnosed focal epilepsy. As part of this investigation, neuropsychological data are collected to determine if they predict treatment outcome, and to delineate adverse cognitive/behavioral effects of antiepileptic drug treatment and ongoing seizures. Here, we examine the relationship between neuropsychological measures and subjective experiences (symptoms and perceptions) in newly diagnosed patients at enrollment, hypothesizing that objective/subjective measures will be poorly correlated. Design/Methods: Patients enrolled in the HEP study underwent cognitive testing with Cogstate (online computerized test battery assessing functions like attention, memory, and processing speed), which is sensitive to disease and drug effects. Participants in HEP completed testing following enrollment and every 3 months thereafter for the duration of their participation. Cognitive tasks included: Detection (DET), Identification (IDN), One Back Memory (ONB), One Card Learning (OCL), and Groton Maze Learning (GML). Outcome variables were speed for DET, IDN and ONB; accuracy for OCL; and total errors for GML. Subjective measures included: Quality of Life in Epilepsy 10-patient (QOLIE-10p), Neurological Disorders Depression Inventory for Epilepsy (NDDI-E), Center for Epidemiological Studies-Depression (CES-D), AB Neuropsychological Assessment Scale (ABNAS), and Adverse Events Profile (AEP). Pearson correlations were assessed across measures at enrollment. Results: There were 304 patients. Significant correlations were present between all subjective measures (r=− .706 to .761). Each Cogstate measure was related to 1–3 other Cogstate measures (r=−.307 to .578). Only two significant correlations existed between subjective and cognitive measures (QOLIE-10p to ONB, r=−.175 and CES-D to OCL, r=−.166). Conclusions: Subjective experiences (i.e., QOL, mood, side effects) and cognitive performance measures display little relation to each other in this cohort with newly diagnosed focal epilepsy. Study Supported by: The Epilepsy Study Consortium (ESCI) is a non-profit organization dedicated to accelerating the development of new therapies in epilepsy to improve patient care. The funding provided to ESCI to support HEP comes from industry, philanthropy and foundations (Eisai, Lundbeck, Pfizer, Sunovion, UCB Pharma, Finding A Cure for Epilepsy and Seizures, The Andrews Foundation, Friends of Faces, and others). Disclosure: Dr. Meador has received personal compensation for activities with the Epilepsy Study Consortium as a consultant. Dr. Meador has received research support from Sunovion. Dr. Kanner has received personal compensation for activities with Medscape. Dr. Morrision has nothing to disclose. Dr. Schembri has received personal compensation for activities with Cogstate as an employee. Dr. Hesdorffer has received personal compensation for activities with Cyberonics, Mount Sinai Injury Prevention Center, and Upsher Smith. Dr. Hesdorffer has received personal compensation in an editorial capacity for Epilepsia. Dr. Hesdorffer has received research support from the Epilepsy Study Consortium. Dr. O9Brien has received personal compensation for activities with UCB Pharma and Eisai Inc. Dr. O9Brien has received research support from Eisai Inc., UCB Pharma, Sanofi-Aventis Pharmaceuticals, Inc., SciGen, Marinus and UPS. Dr. Penovich has received personal compensation for activities with Lundbeck, Sunovion and UCB, Inc. as a member of the speaker9s bureau. Dr. Sperling has received personal compensation for activities with Medscape and Medtronic as a consultant. Dr. Sperling has received research support from UCB Pharma, Eisai, Sunovion, GlaxoSmithKline, SK Life Science, Upsher Smith, Neurelis, Accorda, Medtronic, and Brain Sentinel. Dr. Darby has received personal compensation for activities with CogState. Dr. McKenna has nothing to disclose. Dr. Winawer has nothing to disclose. Dr. Cristofaro has nothing to disclose.