Vogt Viola Lara, Äikiä Marja, Del Barrio Antonio, Boon Paul, Borbély Csaba, Bran Ema, Braun Kees, Carette Evelien, Clark Maria, Cross Judith Helen, Dimova Petia, Fabo Daniel, Foroglou Nikolaos, Francione Stefano, Gersamia Anna, Gil-Nagel Antonio, Guekht Alla, Harrison Sue, Hecimovic Hrvoje, Heminghyt Einar, Hirsch Edouard, Javurkova Alena, Kälviäinen Reetta, Kavan Nicole, Kelemen Anna, Kimiskidis Vasilios K, Kirschner Margarita, Kleitz Catherine, Kobulashvili Teia, Kosmidis Mary H, Kurtish Selin Yagci, Lesourd Mathieu, Ljunggren Sofia, Lossius Morten Ingvar, Malmgren Kristina, Mameniskiené Ruta, Martin-Sanfilippo Patricia, Marusic Petr, Miatton Marijke, Özkara Çiğdem, Pelle Federica, Rubboli Guido, Rudebeck Sarah, Ryvlin Philippe, van Schooneveld Monique, Schmid Elisabeth, Schmidt Pia-Magdalena, Seeck Margitta, Steinhoff Bernhard J, Shavel-Jessop Sara, Tarta-Arsene Oana, Trinka Eugen, Viggedal Gerd, Wendling Anne-Sophie, Witt Juri-Alexander, Helmstaedter Christoph
Department of Epileptology, Medical Center, University of Bonn, Bonn, Germany.
Epilepsy Center/Neurocenter, Kuopio University Hospital, Kuopio, Finland.
Epilepsia. 2017 Mar;58(3):343-355. doi: 10.1111/epi.13646. Epub 2017 Jan 9.
We explored the current practice with respect to the neuropsychological assessment of surgical epilepsy patients in European epilepsy centers, with the aim of harmonizing and establishing common standards. Twenty-six epilepsy centers and members of "E-PILEPSY" (a European pilot network of reference centers in refractory epilepsy and epilepsy surgery), were asked to report the status of neuropsychological assessment in adults and children via two different surveys. There was a consensus among these centers regarding the role of neuropsychology in the presurgical workup. Strong agreement was found on indications (localization, epileptic dysfunctions, adverse drugs effects, and postoperative monitoring) and the domains to be evaluated (memory, attention, executive functions, language, visuospatial skills, intelligence, depression, anxiety, and quality of life). Although 186 different tests are in use throughout these European centers, a core group of tests reflecting a moderate level of agreement could be discerned. Variability exists with regard to indications, protocols, and paradigms for the assessment of hemispheric language dominance. For the tests in use, little published evidence of clinical validity in epilepsy was provided. Participants in the survey reported a need for improvement concerning the validity of the tests, tools for the assessment of everyday functioning and accelerated forgetting, national norms, and test co-normalization. Based on the present survey, we documented a consensus regarding the indications and principles of neuropsychological testing. Despite the variety of tests in use, the survey indicated that there may be a core set of tests chosen based on experience, as well as on published evidence. By combining these findings with the results of an ongoing systematic literature review, we aim for a battery that can be recommended for the use across epilepsy surgical centers in Europe.
我们探讨了欧洲癫痫中心对癫痫手术患者进行神经心理学评估的当前做法，目的是统一并建立共同标准。我们邀请了26个癫痫中心以及“E-PILEPSY”（欧洲难治性癫痫和癫痫手术参考中心试点网络）的成员，通过两项不同的调查来报告成人和儿童神经心理学评估的现状。这些中心在神经心理学在术前检查中的作用方面达成了共识。在评估指征（定位、癫痫功能障碍、药物不良反应和术后监测）以及要评估的领域（记忆、注意力、执行功能、语言、视觉空间技能、智力、抑郁、焦虑和生活质量）方面，大家达成了强烈共识。尽管这些欧洲中心使用了186种不同的测试，但可以识别出一组反映中等程度共识的核心测试。在评估半球语言优势的指征、方案和范式方面存在差异。对于所使用的测试，几乎没有发表关于其在癫痫中的临床有效性的证据。调查参与者报告称，在测试有效性、日常功能评估工具、快速遗忘、国家常模和测试共同标准化方面需要改进。基于本次调查，我们记录了关于神经心理学测试指征和原则的共识。尽管使用的测试种类繁多，但调查表明，可能存在一组基于经验以及已发表证据而选择的核心测试。通过将这些发现与正在进行的系统文献综述结果相结合，我们旨在形成一套可推荐给欧洲各癫痫手术中心使用的测试组合。
