Abstract
Objective: People with functional seizures (FS) have frequent and disabling cognitive dysfunction and mental health symptoms, with low quality of life. However, interrelationships among these constructs are poorly understood. In this meta-analysis, we examined associations between objective (i.e. performance-based) cognitive testing and self-reported (i) mental health, (ii) cognition, and (iii) quality of life in FS. Method: We searched MEDLINE, Embase, PsycINFO, and Web of Science, with the final search on June 10, 2024. Inclusion criteria were studies documenting relationships between objective cognitive test scores and self-reported (i.e. subjective) mental health, cognition, and/or quality of life in adults with FS. Exclusion criteria were mixed FS/epilepsy samples. A modified Newcastle-Ottawa Scale evaluated risk of bias. This project is registered as CRD42023392385 in PROSPERO. Results: Initially, 4,054 unique reports were identified, with the final sample including 24 articles of 1,173 people with FS. Mean age was 35.9 (SD = 3.9), mean education was 12.6 (SD = 1.3), and proportion of women was 73.9%. Risk of bias was moderate, due in part to inconsistent reporting of confounding demographic variables. Significant relationships were found between global objective cognition and global self-reported mental health (k = 21, Z = −0.23 [0.04], 95% CI = −0.30, −0.16), depression (k = 11, Z = −0.13 [0.05], 95% CI = −0.21, −0.04), cognition (k = 5, Z = −0.16 [0.05], 95% CI = −0.26, −0.06), and quality of life (k = 5, Z = −0.17 [0.05], 95% CI = −0.24, −0.10). Exploratory analyses showed associations between select cognitive and mental health constructs. Conclusions: Objective cognition is reliably associated with self-reported mental health, cognition, and quality of life in people with FS. Scientific and clinical implications are discussed.
| Original language | English (US) |
|---|---|
| Journal | Clinical Neuropsychologist |
| DOIs | |
| State | Accepted/In press - 2024 |
Funding
R. Van Patten receives funding from VA Providence, RR&D Center for Neurorestoration and Neurotechnology. He engages in profit sharing with the International Neuropsychological Society for Continuing Education proceeds from the Navigating Neuropsychology podcast. He also receives royalties from publication of the book, Becoming a Neuropsychologist: Advice and Guidance for Students and Trainees (Springer, 2021). The research reported/outlined here was supported by the Department of Veterans Affairs, Veterans Health Administration, VISN 1 Career Development Award to R. Van Patten. M. Lu is supported by the NIH funds R01HL164405 and R35GM139659, and receives the Relief Funding Award from the University of Miami Office of the Vice Provost for Research and Scholarship and Office of Faculty Affairs. T. A. Austin is supported by a Career Development Award (1IK2RX004764) from the VA Rehabilitation Research and Development Service. E. Cotton receives grant funding from the Women\u2019s Board of Northwestern, and is on the Medical Advisory Board for the Epilepsy Foundation of Chicago. L. Chan reports no disclosures. J. Bellone engages in profit sharing with the International Neuropsychological Society for Continuing Education proceeds from the Navigating Neuropsychology podcast. He also receives royalties from publication of the book, Becoming a Neuropsychologist: Advice and Guidance for Students and Trainees (Springer, 2021). K. Mordecai reports no disclosures. E.W. Twamley reports no disclosures. She gratefully acknowledges the support of a VA Rehabilitation Research and Development Research Career Scientist Award. K. Sawyer reports no disclosures. W. Curt LaFrance Jr. receives funding from the DoD CDMRP Epilepsy Research Program (W81XWH-17-0169, PI), co-editor royalties for Gates and Rowan\u2019s Nonepileptic Seizures, and co-author royalties from Oxford University Press for Taking Control of Your Seizures: Workbook and for Treating Nonepileptic Seizures: Therapist Guide.
Keywords
- cognitive functioning
- functional neurological disorder
- Functional seizures
- integrative care
- mental health
- meta-analysis
- neuropsychology
- nonepileptic seizures
ASJC Scopus subject areas
- Neuropsychology and Physiological Psychology
- Developmental and Educational Psychology
- Arts and Humanities (miscellaneous)
- Clinical Psychology
- Psychiatry and Mental health