Epilepsy & behavior : E&B · 2026
Cognitive phenotypes in adults with temporal lobe epilepsy from South Africa - A contribution to the international classification of cognitive disorders in epilepsy (IC-CoDE).
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Ives-Deliperi Victoria, Butler James T, Hermann Bruce P, Shah Urvashi, Busch Robyn M, Reyes Anny, McDonald Carrie R, ILAE IC-CoDE Task Force
Аннотация
OBJECTIVES: The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) provides a systematic framework to identify cognitive phenotypes in patients with various epilepsy syndromes and assess their consistency across diverse cultures and regions. Evidence-based consensus on cognitive profiles will enhance diagnostic processes and foster collaborative epilepsy research. This study evaluated the applicability of the IC-CoDE in adults with temporal lobe epilepsy (TLE) in South Africa.
METHODS: Neuropsychology data from 301 adults with TLE were analysed and the IC-CoDE taxonomy was applied to derive cognitive phenotypes. Cognitive phenotype distributions, along with demographic and clinical characteristics, were evaluated and compared to findings from cohorts in the US and Mumbai, India.
RESULTS: Sixty-six percent of our sample was cognitively intact, 19% had single-domain impairment, 9% bidomain and 6% generalized impairment. Adults with mesial temporal lobe sclerosis (MTS) had higher rates of impairment in all cognitive domains, compared to those without MTS. Significantly more adults with TLE were cognitively intact in our sample than in the US and Mumbai cohorts (p < 0.001) and significantly more presented with single-domain impairment in language. Bidomain impairment most commonly involved language and memory, consistent with the US cohort.
SIGNIFICANCE: Differences between our findings and those from other cohorts may be related to varying clinical characteristics, particularly the significantly greater proportion of adults with normal MRIs in our cohort. These results reveal nuanced patterns of cognitive phenotypes in South African adults with TLE but overall provide further support for the cross-cultural application of the IC-CoDE.
METHODS: Neuropsychology data from 301 adults with TLE were analysed and the IC-CoDE taxonomy was applied to derive cognitive phenotypes. Cognitive phenotype distributions, along with demographic and clinical characteristics, were evaluated and compared to findings from cohorts in the US and Mumbai, India.
RESULTS: Sixty-six percent of our sample was cognitively intact, 19% had single-domain impairment, 9% bidomain and 6% generalized impairment. Adults with mesial temporal lobe sclerosis (MTS) had higher rates of impairment in all cognitive domains, compared to those without MTS. Significantly more adults with TLE were cognitively intact in our sample than in the US and Mumbai cohorts (p < 0.001) and significantly more presented with single-domain impairment in language. Bidomain impairment most commonly involved language and memory, consistent with the US cohort.
SIGNIFICANCE: Differences between our findings and those from other cohorts may be related to varying clinical characteristics, particularly the significantly greater proportion of adults with normal MRIs in our cohort. These results reveal nuanced patterns of cognitive phenotypes in South African adults with TLE but overall provide further support for the cross-cultural application of the IC-CoDE.