Influence of cognitive reserve on neuropsychological performance in epileptic patients

Background and objective: Our goal was to determine the influence of the cognitive reserve (CR) on the neuropsychological performance of patients with temporal lobe epilepsy (TLE). Patients and method: Twenty-eight patients with TLE from a program of epilepsy surgery were assessed with a neuropsychological battery that included standard clinical measures of memory, attention, visual-construction skills and language. Raw scores adjusted according normative data were transformed to z scores. CR scores were based on a combination of educational level, occupational attainment and estimated premorbid intelligence. Results: There were no significance differences in socio-demographic and clinical features between the 2 groups. Epileptic patients with low CR showed significantly lower scores than patients with high CR, with regard to measures of verbal memory (p<0.039), attention (p<0.001), visual-construction skills (p<0.019), and phonetic (p<0.003) and semantic (p<0.005) fluency. Conclusions: Epileptic patients with low CR showed greater neuropsychological morbidity than patients with high CR. These findings suggest that higher CR may decrease vulnerability or delay the clinical manifestation related to cognitive deficits following TLE. (C) 2007 Elsevier Espana, S.L. All rights reserved.