The effects of computer-based rehabilitation on the cognitive functions of Epilepsy patients
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Objective: The aim of this study was to examine the effects of computerized cognitive rehabilitation programs conducted with the purpose of slowing down cognitive losses and developing coping strategies in patients diagnosed with cryptogenic and symptomatic focal epilepsy, with participants' cognitive functions being evaluated through neuropsychological tests prior to and after rehabilitation. Method: Of 32 patients who were receiving treatment at the Istanbul University, Cerrahpasa Faculty of Medicine Hospital, Department of Neurology Epilepsy Clinic, 9 patients who met the inclusion criteria underwent an 8-consecutive-week computer-assisted cognitive rehabilitation program conducted by a psychologist once a week. The effectiveness of the program was tested with a comprehensive neuropsychological assessment both before the rehabilitation program and 3 months after its completion. Results: Test scores of patients before and after the rehabilitation were found as follows: Stroop-1 12.22 +/- 2.72; 11.55 +/- 4.36, Stroop-2 14.55 +/- 4.95; 15.55 +/- 9.20, Stroop-3 34.11 +/- 15.59; 26.44 +/- 12.25, Spatial Recall Test-1 14.22 +/- 5.99; 15.88 +/- 6.79, Spatial Recall Test-2 4.22 +/- 2.94; 6.88 +/- 2.93, Selective Reminding Test-1 55.88 +/- 11.95; 56.0 +/- 7.0, Selective Reminding Test-2 8.77 +/- 3.83; 8.77 +/- 2.72, Digit Symbol Substitution Test 38.33 +/- 19.31; 37.66 +/- 24.35, Lexical Verbal Fluency Test 25.77 +/- 11.3; 33.66 +/- 14.47, Semantic Verbal Fluency Test 15.77 +/- 4.52; 17.88 +/- 5.88. The pre- and post-rehabilitation scores of Stroop-3, Spatial Recall Test (SRT)-2 and Lexical Verbal Fluency tests were significantly different (p<0.05). The Beck Depression Inventory scores of patients were significantly reduced following the rehabilitation program (p<0.05). Conclusion: An improvement in attention/vigilance, executive functions, information-processing, verbal fluency, and spatial memory were observed with cognitive rehabilitation; however, there was no improvement in verbal learning. The study showed that implementation of rehabilitation programs might assist in developing different cognitive function impairments witnessed in patients with epilepsy. There is need for more comprehensive research on this matter.
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