Exploration of Neuroprotective Therapy

Table 3. Cognitive performance

Cognitive screening tools		Patients n = 25	Controls n = 25	P-value
3a. MoCA and ACE-II total scores
MoCA	Mean	20.76	24.28	0.044
	Standard deviation	3.491	4.505
	Standard error mean	0.698	0.901
ACE-III	Mean	69.08	81.32	0.206
	Standard deviation	11.979	9.4919
	Standard error mean	2.396	1.882
3b. MoCA and ACE-III screening results for cognitive impairment
MoCA	No cognitive impairment	4 (16%)	12 (48%)	0.015
MoCA	Cognitive impairment	21 (84%)	13 (52%)	0.015
ACE-III	No cognitive impairment	4 (16%)	16 (64%)	< 0.001
ACE-III	Cognitive impairment	21 (84%)	9 (36%)	< 0.001
3c. Verbal and semantic fluency performance
Verbal fluency	< 11 per minute	16 (64%)	7 (28%)	0.011
Verbal fluency	≥ 11 per minute	9 (36%)	18 (72%)	0.011
Semantic fluency	< 17 per minute	19 (76%)	11 (44%)	0.027
Semantic fluency	≥ 17 per minute	6 (24%)	14 (56%)	0.027

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3a. MoCA and ACE-III total scores: Displays the total scores for Montreal Cognitive Assessment (MoCA) and Addenbrooke’s Cognitive Examination (ACE-III). Statistical analysis was performed using the Student’s T-test. 3b. MoCA and ACE-III screening results for cognitive impairment: The dichotomous analysis of cognitive impairment using MoCA and ACE-III is presented as a 2 × 2 Chi-square table. 3c. Verbal and semantic fluency performance: This section displays verbal and semantic fluency results, analyzed as a 2 × 2 Chi-square table. P-values are reported to indicate statistical significance

Declarations

Acknowledgments

The authors thank all participants who volunteered for this study and the staff at the Central Hospital “Dr. Ignacio Morones Prieto” for their support during data collection. The resources for this study were provided by the authors and participating institutions.

Author contributions

RGRM: Conceptualization, Methodology, Investigation, Formal analysis, Writing—original draft, Writing—review & editing. RMR: Conceptualization, Investigation, Writing—original draft, Writing—review & editing. IRL: Conceptualization, Methodology, Supervision, Writing—review & editing, Project administration. CMT, LMMC, JLRC, LDMF, DMG, DGMR, MOHB, SFG, MGG, GAMS, and ISDH: Investigation, Data curation. HGHR: Validation, Formal analysis. All authors read and approved the submitted version.

Conflicts of interest

The authors declare that there are no conflicts of interest.

Ethical approval

The study was approved by the Research Ethics Committee (Approval No. 17–24) in the Central Hospital “Dr. Ignacio Morones Prieto”, in San Luis Potosí, Mexico, which complies with the ethical standards of the Declaration of Helsinki (Geneva, 2024 revision).

Consent to participate

Informed consent to participate in the study was obtained and signed by all participants.

Consent to publication

Informed consent to publication was obtained from participants. The paper does not involve privacy issues, such as displaying individual details (images or videos).

Availability of data and materials

The data supporting this study’s findings are available from the corresponding author upon reasonable request.

Funding

Not applicable.

Copyright

Publisher’s note

Open Exploration maintains a neutral stance on jurisdictional claims in published institutional affiliations and maps. All opinions expressed in this article are the personal views of the author(s) and do not represent the stance of the editorial team or the publisher.

References

Fisher RS, Acevedo C, Arzimanoglou A, Bogacz A, Cross JH, Elger CE, et al. ILAE Official Report: A practical clinical definition of epilepsy. Epilepsia. 2014;55:475–82. [DOI] [PubMed]

Witt JA, Helmstaedter C. Cognition in epilepsy: current clinical issues of interest. Curr Opin Neurol. 2017;30:174–9. [DOI] [PubMed]

Kanner AM, Helmstaedter C, Sadat-Hossieny Z, Meador K. Cognitive disorders in epilepsy I: Clinical experience, real-world evidence and recommendations. Seizure. 2020;83:216–22. [DOI] [PubMed]

Paredes-Aragón E, Ruiz-Garcia R, Burneo JG. Depression in patients with epilepsy. Pathophysiological and clinical concepts and therapeutic strategies. Rev Neurol. 2023;76:137–46. Spanish. [DOI] [PubMed] [PMC]

Fiest KM, Dykeman J, Patten SB, Wiebe S, Kaplan GG, Maxwell CJ, et al. Depression in epilepsy: A systematic review and meta-analysis. Neurology. 2013;80:590–9. [DOI] [PubMed] [PMC]

Yang Y, Yang M, Shi Q, Wang T, Jiang M. Risk factors for depression in patients with epilepsy: A meta-analysis. Epilepsy Behav. 2020;106:107030. [DOI] [PubMed]

Operto FF, Pastorino GMG, Viggiano A, Dell’Isola GB, Dini G, Verrotti A, et al. Epilepsy and Cognitive Impairment in Childhood and Adolescence: A Mini-Review. Curr Neuropharmacol. 2023;21:1646–65. [DOI] [PubMed] [PMC]

Arslan G, Demir B. Cognitive impairment in epilepsy patients and its correlations. Appl Neuropsychol Adult. 2024;31:1405–10. [DOI] [PubMed]

Tabibian F, Mehvari Habibabadi J, Maracy MR, Kahnouji H, Rahimi M, Rezaei M. Evaluation of Cognitive Impairment in Refractory Temporal Lobe Epilepsy Patients Concerning Structural Brain Lesions. Basic Clin Neurosci. 2023;14:385–95. [DOI] [PubMed] [PMC]

10.

Bogut L, Andersen K, Grejsen J, Gimenez-Rico MJM, Debes NMM. Decreased Cognitive Function in Danish Children with Epilepsy. Neuropediatrics. 2023;54:328–34. [DOI] [PubMed]

11.

Galioto R, Thamilavel S, Blum AS, Tremont G. Awareness of cognitive deficits in older adults with epilepsy and mild cognitive impairment. J Clin Exp Neuropsychol. 2015;37:785–93. [DOI] [PubMed]

12.

Reséndiz-Aparicio JC. Guías clínicas del Programa Prioritario de Epilepsia del Sector Salud, México. Rev Mex Neuroscience. 2023;20:2376. [DOI]

13.

Padrós Blázquez F, Montoya Pérez KS, Bravo Calderón MA, Martínez Medina MP. Propiedades psicométricas del Inventario de Ansiedad de Beck (BAI, Beck Anxiety Inventory) en población general de México. Ansiedad Estrés. 2020;26:181–7. [DOI]

14.

Levis B, Benedetti A, Thombs BD; DEPRESsion Screening Data (DEPRESSD) Collaboration. Accuracy of Patient Health Questionnaire-9 (PHQ-9) for screening to detect major depression: individual participant data meta-analysis. BMJ. 2019;365:l1476. [DOI] [PubMed] [PMC]

15.

Montaño-Lozada JM, López N, Espejo-Zapata LM, Soto-Añari M, Ramos-Henderson M, Caldichoury-Obando N, et al. Cognitive changes in patients with epilepsy identified through the MoCA test during neurology outpatient consultation. Epilepsy Behav. 2021;122:108158. [DOI] [PubMed]

16.

Novak A, Vizjak K, Gacnik A, Rakusa M. Cognitive impairment in people with epilepsy: Montreal Cognitive Assessment (MoCA) as a screening tool. Acta Neurol Belg. 2023;123:451–6. [DOI] [PubMed]

17.

Adaptación cultural, validez aparente y confiabilidad del instrumento Addenbookr’s Cognitive Examination III para el tamizaje del trastorno neurocognitivo mayor en pacientes del programa GERIATRIMSS del Hospital General de Zona No. 1 del IMSS de Aguascalientes [Internet]. c2002–2012 [cited 2020 Feb 13]. Available from: http://hdl.handle.net/11317/1850

18.

Schlesselman JJ. SAMPLE SIZE REQUIREMENTS IN COHORT AND CASE-CONTROL STUDIES OF DISEASE. Am J Epidemiol. 1974;99:381–4. [DOI]

19.

Manole AM, Sirbu CA, Mititelu MR, Vasiliu O, Lorusso L, Sirbu OM, et al. State of the Art and Challenges in Epilepsy—A Narrative Review. J Pers Med. 2023;13:623. [DOI] [PubMed] [PMC]

20.

Celiker Uslu S, Yuksel B, Tekin B, Sariahmetoglu H, Atakli D. Cognitive impairment and drug responsiveness in mesial temporal lobe epilepsy. Epilepsy Behav. 2019;90:162–7. [DOI] [PubMed]

21.

Poch C, Toledano R, García-Morales I, Prieto A, García-Barragán N, Aledo-Serrano Á, et al. Mnemonic discrimination in patients with unilateral mesial temporal lobe epilepsy relates to similarity and number of events stored in memory. Neurobiol Learn Mem. 2020;169:107177. [DOI]

22.

Batchelor R, Taylor MD. Young adults with epilepsy: Relationships between psychosocial variables and anxiety, depression, and suicidality. Epilepsy Behav. 2021;118:107911. [DOI] [PubMed]

23.

Badawy RA, Johnson KA, Cook MJ, Harvey AS. A mechanistic appraisal of cognitive dysfunction in epilepsy. Neurosci Biobehav Rev. 2012;36:1885–96. [DOI] [PubMed]

24.

Holmes GL. Cognitive impairment in epilepsy: the role of network abnormalities. Epileptic Disord. 2015;17:101–16. [DOI] [PubMed] [PMC]

25.

Zhang Z, Lu G, Zhong Y, Tan Q, Yang Z, Liao W, et al. Impaired attention network in temporal lobe epilepsy: A resting FMRI study. Neurosci Lett. 2009;458:97–101. [DOI] [PubMed]

26.

Holmes GL, Lenck-Santini PP. Role of interictal epileptiform abnormalities in cognitive impairment. Epilepsy Behav. 2006;8:504–15. [DOI] [PubMed]

27.

Jefferys JGR, Jiruska P, de Curtis M, Avoli M. Limbic Network Synchronization and Temporal Lobe Epilepsy. In: Noebels JL, Avoli M, Rogawski MA, Olsen RW, Delgado-Escueta AV, editors. Jasper’s Basic Mechanisms of the Epilepsies. 4th ed. Bethesda (MD): National Center for Biotechnology Information (US); 2012. [PubMed]

28.

Piper RJ, Richardson RM, Worrell G, Carmichael DW, Baldeweg T, Litt B, et al. Towards network-guided neuromodulation for epilepsy. Brain. 2022;145:3347–62. [DOI] [PubMed] [PMC]

29.

Hüsser AM, Vannasing P, Tremblay J, Osterman B, Lortie A, Diadori P, et al. Brain language networks and cognitive outcomes in children with frontotemporal lobe epilepsy. Front Hum Neurosci. 2023;17:1253529. [DOI] [PubMed] [PMC]

30.

Landi S, Petrucco L, Sicca F, Ratto GM. Transient Cognitive Impairment in Epilepsy. Front Mol Neurosci. 2019;11:458. [DOI] [PubMed] [PMC]

31.

Kramer MA, Cash SS. Epilepsy as a Disorder of Cortical Network Organization. Neuroscientist. 2012;18:360–72. [DOI] [PubMed] [PMC]

32.

Besag FMC, Vasey MJ. Neurocognitive Effects of Antiseizure Medications in Children and Adolescents with Epilepsy. Paediatr Drugs. 2021;23:253–86. [DOI] [PubMed]

33.

Mukhtar I. Unravelling the critical role of neuroinflammation in epilepsy-associated neuropsychiatric comorbidities: A review. Prog Neuropsychopharmacol Biol Psychiatry. 2025;136:111135. [DOI] [PubMed]

34.

Aliyianis TS, Winston GP. The impact of cognitive impairment due to epilepsy on quality of life: What do we know? Epilepsy Res. 2025;215:107592. [DOI] [PubMed]