Epilepsy Clinical Trial
Official title:
COMET Study Effectiveness of a Cognitive Remediation Program of Memory in Patients With Temporal Lobe Epilepsy
Studies on the cognitive function have highlighted promising results concerning attention. In
contrast, in the field of memory, the single cohort study that has been carried out, has not
been randomised, with non comparable groups, the significant outcomes are therefore to be
balanced.
In this study, patients with focal and structural temporal lobe epilepsy will be randomised
in 2 groups : the COMETE group where patients will attend a specific rehabilitation programme
of memory and the control group where patients will benefit from a standard treatment.
Epilepsy is a chronic neurological disease among the most frequent ones. It causes cognitive
disorders in 20 to 50 percent of patients with structural epilepsy, that is to say in
connexion with an identified or presumed cerebral lesion. Compared to seizures, these
cognitive disorders are a major additional factor of professional, social or family
disability. They are particularly prevalent (50%) in temporal lobe epilepsy and
preferentially affect language memory and abilities. These disorders are well described, they
are multifactorial but no (drug and/or non drug) therapy has been validated yet.
Recently, techniques of cognitive rehabilitation have shown benefits in some neurological
diseases, like multiple sclerosis.
Concerning adulthood epilepsy, the few cognitive rehabilitation studies that have been
conducted present huge methodological gaps limiting the scope of theirs results.
Studies on the cognitive function have highlighted promising results concerning attention. In
contrast, in the field of memory, the single cohort study that has been carried out, has not
been randomised, with non comparable groups, the significant outcomes are therefore to be
balanced.
Thus, in this study, patients with focal and structural temporal lobe epilepsy will be
randomised in 2 groups : the COMETE group where patients will attend a specific
rehabilitation programme of memory and the control group where patients will benefit from a
standard treatment.
Work's hypothesis would be that patients undergoing the rehabilitation programme would
present improved learning abilities (with impact on their memory performances) compared to
patients with standard treatment.
This hypothesis is based on underlying theories of cognitive rehabilitation. This method
predicts that by reinforcing some cognitive abilities that transfer to others, the improved
learning abilities will also result in improved abilities in immediate memory, work memory,
but will have no effect on verbal inhibition abilities, which will constitute a specific
marker/indicator ? for the intervention. Moreover, patient care may have an impact on their
quality of life and mood which are predictive factors for a good social and professional
integration: that's why these indexes/criteria have to be measured.
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