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Objective: Cenobamate is a recently approved antiseizure medication that proved to be safe and effective in randomized controlled trials. However, little is known about its impact on some areas frequently affected by epilepsy. For this reason, we explored the effects of cenobamate on cognitive performance, as well as on negative affectivity and quality of life in a sample of patients with drug-resistant epilepsy., Methods: Two prospective cohort studies were carried out. In Study 1, 32 patients (22 men and 10 women) underwent a baseline (T0) and a short-term (T1) neuropsychological assessment after 3 months of cenobamate administration. In Study 2, 22 patients (16 men and 6 women) from the T1 sample also underwent a baseline and a follow-up evaluation (T2) 6 months after T0., Results: No significant differences were found in cognitive variables, negative affectivity, and quality of life either in Study 1 or Study 2. Similarly, based on the reliable change index, it was found that most patients showed no changes in these variables., Significance: These results suggest that cenobamate is a safe antiseizure medication in terms of cognition, negative affectivity, or quality of life since no adverse events have been found after 3 and 6 months of treatment., Plain Language Summary: Cenobamate is a new antiseizure medication. In patients with epilepsy, cenobamate seems to not affect cognition, anxiety, depression, or quality of life., (© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)

Introduction: Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life., Methods: 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration., Results: Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life., Discussion: These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Catalán-Aguilar, González-Bono, Lozano-García, Tormos-Pons, Hampel, Villanueva and Cano-López.)

Introduction: Academic and employment insertion is one of the issues that most concern people with epilepsy, but little is known about its relationship with quality of life., Aim: We aimed to analyze the effects of the academic and employment insertion on quality of life, anxiety, depression, social support, and executive functions, and the relationships among these variables in patients with drug-resistant epilepsy., Patients and Methods: Fifty-nine patients with drug-resistant temporal lobe epilepsy were classified into two groups: with academic or employment insertion (n = 25) and without insertion (n = 34) and underwent a neuropsychological evaluation., Results: Patients with insertion had a significantly better quality of life, lower trait anxiety, and higher social support, and tended to have a lower percentage of errors and higher percent conceptual level responses than those without insertion. Academic/employment insertion had indirect effects on quality of life through its relationship with global social support and trait anxiety., Conclusions: Our findings provide a model for understanding the quality of life in patients with temporal lobe epilepsy for an integral perspective of the patient and points out the key role of increased social support and reduced anxiety associated with academic and employment insertion to improve quality of life. These results could favor the implementation of programs that promote academic or employment reinsertion, considering the relevance of socio-emotional domains.

Chronic exposure to seizures in patients with left hemisphere (LH) epileptic focus could favor higher activation in the contralateral hemisphere during language processing, but the cognitive effects of this remain unclear. This study assesses the relationship between asymmetry in hemispheric activation during language fMRI and performance in verbal and non-verbal tasks. Whereas prior studies primarily used fMRI paradigms that favor frontal lobe activation and less prominent activation of the medial or superior temporal lobes, we used a verbal comprehension paradigm previously demonstrated to activate reliably receptive language areas. Forty-seven patients with drug-resistant epilepsy candidates for surgery underwent a multidisciplinary assessment, including a comprehensive neuropsychological evaluation and an fMRI verbal comprehension paradigm. Patients were distributed in two groups depending on laterality indexes (LI): typical hemispheric asymmetry (unilateral left activation preponderance; n = 23) and atypical hemispheric asymmetry (bilateral or unilateral right preponderance; n = 24). Right-handedness and right hemisphere (RH) focus were significant predictors of typical asymmetry. Patients with typical activation pattern presented better performance intelligence quotient and verbal learning than patients with atypical hemispheric asymmetry (for all, p < 0.014). Patients with LH focus had more frequently atypical hemispheric asymmetry than patients with RH focus (p = 0.05). Specifically, they showed lower LI and this was related to worse performance in verbal and non-verbal tasks. In conclusion, an increased activation of homologous RH areas for verbal comprehension processing could imply a competition of cognitive resources in the performance of the same task, disrupting cognitive performance., (Copyright © 2018 The Authors. Published by Elsevier Inc. All rights reserved.)

Background: Negative affect (NA) and chronic stress are separately associated with health imbalances, and the interaction between the two aspects remains unclear. Care of relatives with long-term pathologies could be a likely model in the study of this issue, as caregivers frequently report chronic stress and health complaints. The aim of this study is examine the role of NA on psychophysiological stress-induced response and health in schizophrenia caregivers., Method: Forty-one caregivers were distributed into two groups accordingly to their scores in NA. Thirteen non-caregivers were included as a control group. Participants were exposed to a repeated acute psychosocial stress while salivary cortisol, immunoglobulin A (IgA), and skin conductance level (SCL) were measured before, during, and after stress. Mood, state-anxiety, care conditions and perceived general health were also assessed., Results: Caregivers with higher NA reported negative perceptions, worse health, and greater decreases in cortisol and IgA response than caregivers with low NA and than non-caregivers., Conclusions: NA could reduce the capability to develop adaptive psychophysiological stress responses. From a preventive view, the evaluation of NA could be useful to detect and assist high-risk individuals in potentially chronically stressed populations.

Several ethological reports have indicated that cooperative behaviors play an adaptive role. However, research has focused on competition in men, and there have been few studies on cooperation. This study aims to analyze the cortisol and psychological responses in women to a cooperative situation compared with a competitive situation in a laboratory context. The sample was distributed into four groups depending on the task and the outcome obtained: Positive cooperation, negative cooperation, competition with victory, and competition with defeat. Our results show that, in comparison with competition, cooperation produces different effects in cortisol, but not in psychological states. Nevertheless, these effects occur only when the task outcome and its appraisal are considered. Only the participants who cooperated and obtained a positive outcome and those who competed and lost showed significant decrements of cortisol. Internal attribution was higher in groups with more stable cortisol levels, suggesting a possible modulator effect of controllability in the way the situation was experienced. These results could be generalized to situations in which negotiation, mediation, and cooperative strategies are relevant for making decisions and/or solving problems.