Posters
2013AES #: 2.205 NEUROPSYCHOLOGICAL FUNCTIONING IN PATIENTS WITH PSYCHOGENIC NON-EPILEPTIC SEIZURES (PNES): THOSE WITH COMORBID PTSD COMPARED TO THOSE WITH NO TRAUMA
Date: December 8, 2013
L. Myers, M. E. Lancman, S. Szuster, K. Lebeau, R. Trobliger, M. E. Lancman
Rationale: The aim of this study was to compare neuropsychological functions in patients diagnosed with psychogenic non-epileptic seizures (PNES) and comorbid PTSD to those diagnosed with PNES and who deny any traumatic history. PTSD has been repeatedly associated with memory impairments. Subtle executive deficits have also been reported although results have been mixed. Our hypothesis was that those with a diagnosis of PNES and PTSD would exhibit a different cognitive profile than that seen in patients with PNES who deny a history of psychological trauma.
Methods: We studied 14 patients with PNES and PTSD and 14 with PNES who did not report trauma. The diagnosis of PNES was confirmed through video-EEG monitoring. All patients had a complete neuropsychological evaluation. A diagnosis of PTSD was obtained using the Trauma Scale Inventory-2 A clinical interview was conducted in which general history as well as trauma exposure and details were collected.
Results: All subjects were female. Within the PTSD/PNES group mean age at the time of study was 42.50, 2.992 years and mean education was 13.79, .69. Of non-traumatized PNES patients, mean age was 35.43, 3.42 and mean education was 14.07, .62. Significant differences were found between those with PTSD versus non-traumatized individuals. Those with co-morbid PTSD were more likely to have a history of substance abuse (p<.037) and to carry a diagnosis of depression (p<.001). In addition, on the Wechsler Memory Scale subtests of narrative verbal memory, those with PTSD showed a trend towards a diminished score on Logical Memory I (.064) and significantly lower scores on Logical Memory II (p<.003). No other statistically significant differences were found on other cognitive tests.
Conclusions: Our findings regarding verbal memory and clinical history are consistent with previous reports in patients with PTSD. We did not find any evidence of significant weaknesses on any executive tasks. This is however not inconsistent with other reports regarding executive (frontal) functions and PTSD. Substance abuse and mood disorders are frequently observed concomitantly with PTSD. These findings contribute to our understanding intragroup differences in what is increasingly being appreciated as a heterogenous condition. Patients with PNES who have comorbid PTSD represent a distinguishable subgroup within the PNES globality.
