Psycho-behavioural and Neurocognitive Aspects of Epilepsy in Hong Kong Chinese Adults

Patients with epilepsy (PWEs) experienceextensivepsychological and cognitive disturbances. Increasing emphasis has been placed on the bidirectional interaction between seizure and psychological states, couples withaccumulating evidences suggesting the potential effects of psycho-behavioural therapy on improving well-being and seizure control in PWEs.;This study has three levels of objectives. First, it aims to establish the neurocognitive and psychological profiles of PWEswith different drug-responsiveness in Hong Kong Chinese adults. Second, the effect of a mindfulness-based therapy (MBT) in people with drug-resistant epilepsy is examined against an attention-placebo control, social support (SS) groupusing a prospectiveassessor-blinded randomized controlled trial. Third, the neuropsychologicaleffects of neurosurgery are explored.;A total of 186 PWEs were recruited. In the 84 patients with drug-resistant epilepsy, 39.3% and 29.8% reported moderate to severe level of anxiety and depression, respectively; versus 15.7% and 6.9% in patients with drug-responsive epilepsy (n = 102). Neurocognitive deficits were prevalent, particularlyin verbal recall memory, visual attention, auditory attention and working memory. The effects of the psycho-behavioural therapy were demonstrated. Specifically, patients received MBT (n = 30) showedsignificantly more improvement at post-intervention compared to the SS group (n=30) in terms of psychological well-being, seizure control and delayed memory function. For patients who underwent neurosurgery (n=14), those who received operation on their non-language dominant hemisphere and those who enjoyedpost-operative seizure freedom reported significantly higher quality of life compared to their counterparts whose received operation on their language-dominant hemisphere and those whose seizure persisted.;Our findings established the neuropsychological and cognitive profiles of PWEs and revealed particular vulnerabilities in patients who were resistant to pharmacological treatment. We demonstrated the effects of short-term psycho-behavioural intervention in terms of improving psychological well-being, seizure control and neurocognitive function. Finally, our exploratory study on patients who underwent neurosurgery enhanced our understanding towards post-operative psycho-behavioural conditions on different types of patients, which was clinically important for pre-operative decision making.;Further research in local population focusing on neuro-psycho-behavioural aspects of epilepsy is crucial. The sustainability of the positive effects associated with the psycho-behavioural intervention should be carefully addressed in later study.