Assessment of patients with Psychogenic Nonepileptic Seizures using Czech version of Neuropsychological Assessment Battery Screening Module
Abstract
Objective: Differential diagnosis of Psychogenic Non-epileptic Seizures (PNES) can be sometimes difficult to make and requires a multidisciplinary approach. Neuropsychological assessment is an indispensable part of such diagnostics.
Neuropsychological Assessment Battery (NAB) is a relatively new and complex neuropsychological tool that tests five cognitive domains. The aim of the present study is to verify the usefulness of NAB in the differential diagnosis of PNES.
Participants and methods: The sample was comprised of 15 PNES patients (38.2y, 14w/1m) and 50 healthy controls. PNES diagnosis was based on video EEG monitoring (one week) with normal EEG findings, habitual seizure capture, suggestive seizure provocation, and patients' history.
All participants of this study were tested by the NAB Screening module (NAB-SM), which assesses five cognitive domains - attention, language, memory, spatial and executive functions. Demographic and medical information was also collected. 15 patients and 15 controls (38.2y, 14w/1m) were matched according to the age, gender and years of education.
Results: Psychometric data were analyzed using paired-sample t-tests. Compared to the control group, patients with PNES obtained significantly lower scores in following domains: Memory, Spatial and Total scale (p< .001) and Attention (p<.0,05).
Despite variability in neuropsychological findings, studies suggest that patients with PNES have abnormalities of neurocognitive processing (Willment et al., 2015). The literature mostly reports altered attention, memory and executive functions (O'Brien et al., 2015, Ozer Celik et al., 2015).
However, visuospatial skills have not been systematically studied (Willment et al., 2015). Results of this study are consistent with previous findings with regard to attention and memory.
Also mean scores of one subtest of Executive function domain (i.e. Mazes) were significantly lower in patient group.
Conclusions: This study attempted to assess the clinical utility of the Neuropsychological Assessment Battery (NAB) within a PNES population. Although the sample size was small, the analysis discovered a statistically significant difference between the clinical group and the control group.
Results suggest that NAB-SM can be used in differential diagnosis of PNES as a screening test of cognitive performance. Future research with the Czech version of NAB is warranted to more definitively determine its utility within clinical population.