Neuropsychological Features, Social Functioning, and Their Relationship in Patients with Temporal Lobe Epilepsy
Date Issued
2013
Date
2013
Author(s)
Wang, Wei-Han
Abstract
Background: A growing body of evidence has suggested that patients with temporal lobe epilepsy (TLE) exhibit not only an impaired memory but also a worse performance across measures of intelligence, language, executive function, and psychomotor speed. Nevertheless, in Taiwan, the literature on this subject is sparse. Moreover, Maintaining or improving social functioning has been a long-standing goal for patients with epilepsy, their families, and clinicians. However, because of the lack of functional-based social functioning scale for epilepsy, to date it is still unclear to what extent cognitive impairment or other relevant factors, such as social cognitive deficit, can have a direct influence on social functioning in patients with TLE. Methods: This dissertation comprises four original studies. The first retrospective study characterized the neuropsychological features in patients with TLE and identified the relative contributions of seizure-related variables on neuropsychological function. The second study aimed to develop a functional-based social functioning scale for epilepsy to test its psychometric properties. The third study was conducted to identify the relative contributions of cognitive function and seizure-related variables on social functioning in TLE patients. Finally, the fourth study in this dissertation was then conducted to explore social cognitive function and its relationship to social functioning in patients with TLE.
Results and Conclusions: Cognitive impairments in multiple domains are evident in most patients with TLE and are dependent on age at seizure onset, number of antiepileptic drugs used, frequency of seizures, and duration of epilepsy. Moreover, a new epilepsy-specific social functioning scale, namely, the “Social and Occupational Functioning Scale for Epilepsy (SOFSE),” was developed. It is a brief, psychometrically sound, and easy-to-administer measure of social functioning for use in busy clinical settings. By using the SOFSE, the study 3 showed that cognitive impairment in multiple domains significantly contributed to social dysfunction in patients with TLE. In addition, advanced impairment of theory of mind, psychiatric disturbances, and other cognitive (verbal) impairments can also contribute to social and occupational functioning in TLE patients. These findings have implications for the targeted improvement of complex social cognitive skills in epilepsy, that can lead to enhancement of patients’ social functioning.
Subjects
顳葉癲癇
神經心理功能
社會功能
社會認知功能
心智理論
Type
thesis
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