Cross-cultural validation of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) in Chinese-speaking people with epilepsy.

AIM: The International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) has been validated for cross-cultural applicability in many populations, but data from Chinese-speaking cohorts remain lacking. This study aimed to examine the utility of IC-CoDE in Chinese people with epilepsy and characterize localized cognitive phenotypic patterns.

METHOD: A total of 335 Chinese people with epilepsy (mean age 27.41 ± 8.03 years; 53.7% male) and 90 healthy local controls were enrolled. All participants underwent comprehensive neuropsychological assessments covering five cognitive domains, with at least two standardized. Test scores were converted to Z-scores using local control data for standardization. IC-CoDE phenotypes were classified at the -1.5 SD threshold (intact, single-domain impairment, bidomain impairment, generalized impairment).

RESULTS

Application of IC-CoDE (-1.5 SD) revealed 44% (n = 149) of the Chinese sample had intact cognitive function, 27% (n = 90) had single-domain impairment, 16% (n = 53) had bidomain impairment, and 13% (n = 43) had generalized impairment. Memory was the most extensively impaired domain. Age, years of education, disease duration, number of antiseizure medications, and seizure side were associated with phenotypic classification (all ps < 0.05).

CONCLUSION

This study demonstrates the cross-cultural adaptability of IC-CoDE in Chinese-speaking people with epilepsy, filling a gap in global IC-CoDE validation.