Relationships between cognitive function, seizure control, and self-reported leisure-time exercise in epilepsy

• Published in: Epilepsy & behavior 2021-05, Vol.118, p.107900-107900, Article 107900
• Main Authors: Popp, Johanna L., Szaflarski, Jerzy P., Kaur, Manmeet, Martin, Roy C., Brokamp, Gabrielle A., Terry, D. Mackensie, Diggs, M. David, Allendorfer, Jane B.
• Format: Article
• Language: English
• Subjects: Cognition; Executive attention; Idiopathic generalized epilepsy; MoCA; Physical exercise; Seizure
• ISSN: 1525-5050; 1525-5069
• DOI: 10.1016/j.yebeh.2021.107900

•Patients with IGE report less leisure-time exercise than HCs regardless of seizure control.•Cognition in patients with IGE with seizures is worse than in seizure-free IGE or HCs.•Leisure-time exercise level is positively correlated with MoCA performance.•Leisure-time exercise level is positively correlated with executive attention. Exercise may be a strategy for improvement of cognitive deficits commonly present in people with idiopathic generalized epilepsies (IGE). We investigated the relationship between cognition and level of physical exercise in leisure (PEL) in people with IGE who have been seizurefree for at least 6 months (IGE−) as compared to those who have not been seizurefree (IGE+) and healthy controls (HCs). We hypothesized that higher level of physical exercise is associated with better cognitive functioning in patients with IGE and HCs, and that seizure control affects both PEL levels and cognitive functioning in patients with IGE. We recruited 75 participants aged 18–65: 31 people with IGE (17 IGE−, 14 IGE+) and 44 HCs. Participants completed assessments of quality of life (SF-36), physical activity levels (Baecke questionnaire and International Physical Activity Questionnaire (IPAQ)) and cognition (Montreal Cognitive Assessment (MoCA), Hopkins Verbal Learning Test – Revised (HVLT), and flanker task). Group differences (HCs vs. IGE; HCs vs. IGE+ vs. IGE−) were assessed. Pearson correlations examined linear relationships between PEL and cognitive performance. Groups were similar in age and sex. Compared to HCs, patients with IGE had higher body mass index, fewer years of education, and consistently scored worse on all measures except flanker task accuracy on incongruent trials. When examining IGE− and IGE+ subgroups, compared to HCs, both had higher body mass index, and fewer years of education. Healthy controls scored significantly better than one or both of the IGE groups on SF-36 scores, PEL levels, IPAQ activity level, MoCA scores, HVLT learning and long-delay free-recall scores, and flanker task accuracy on congruent trials. Among patients with IGE, there were no significant differences between age of epilepsy onset, duration of epilepsy, number of anti-seizure drugs (ASDs) currently being used, or the group distribution of type of IGE. In the combined sample (IGE+, IGE− and HCs), PEL positively correlated with MoCA scores (Pearson’s r = 0.238; p = 0.0397) and with flanker task accuracy on congruent trials (Pearson’s r = 0.295; p = 0.0