Paradigm Shifts in the Neuropsychology of Epilepsy

This article reviews the major paradigm shifts that have occurred in the area of the application of clinical and experimental neuropsychology to epilepsy and epilepsy surgery since the founding of the International Neuropsychological Society. The five paradigm shifts discussed include: 1) The neurob...

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Bibliographic Details
Published in:Journal of the International Neuropsychological Society 2017-10, Vol.23 (9-10), p.791-805
Main Authors: Hermann, Bruce, Loring, David W., Wilson, Sarah
Format: Article
Language:English
Subjects:
Behavior
Brain research
Cognition & reasoning
Cognition Disorders - diagnosis
Cognition Disorders - etiology
Cognitive ability
Epilepsy
Epilepsy - complications
Epilepsy - psychology
Humans
Life span
Localization
Medical imaging
Memory
Nervous system
Neural networks
Neurobiology
Neurology
Neuropsychological Tests
Neuropsychology
Neurosciences
Quality of life
Reviews
Risk factors
Section 2 – Neurological Disorders
Seizures
Surgery
Terminology
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Summary:This article reviews the major paradigm shifts that have occurred in the area of the application of clinical and experimental neuropsychology to epilepsy and epilepsy surgery since the founding of the International Neuropsychological Society. The five paradigm shifts discussed include: 1) The neurobiology of cognitive disorders in epilepsy – expanding the landscape of syndrome-specific neuropsychological impairment; 2) pathways to comorbidities: bidirectional relationships and their clinical implications; 3) discovering quality of life: The concept, its quantification and applicability; 4) outcomes of epilepsy surgery: challenging conventional wisdom; and 5) Iatrogenic effects of treatment: cognitive and behavioral effects of antiepilepsy drugs. For each area we characterize the status of knowledge, the key developments that have occurred, and how they have altered our understanding of the epilepsies and their management. We conclude with a brief overview of where we believe the field will be headed in the next decade which includes changes in assessment paradigms, moving from characterization of comorbidities to interventions; increasing development of new measures, terminology and classification; increasing interest in neurodegenerative proteins; transitioning from clinical seizure features to modifiable risk factors; and neurobehavioral phenotypes. Overall, enormous progress has been made over the lifespan of the INS with promise of ongoing improvements in understanding of the cognitive and behavioral complications of the epilepsies and their treatment. (JINS, 2017, 23, 791–805)
ISSN:1355-6177
1469-7661
DOI:10.1017/S1355617717000650