Reduced Subjective Cognitive Concerns With Neurobehavioral Therapy in Functional Seizures and Traumatic Brain Injury.

Functional seizures are common among people with traumatic brain injury (TBI). Subjective cognitive concerns refer to a person's own perception of problems with cognitive functioning in everyday life. The authors investigated the presence and correlates of subjective cognitive concerns and the response to neurobehavioral therapy among adults with TBI and functional seizures (TBI+FS group). In this observational study, participants in the TBI+FS group (N=47) completed a 12-session neurobehavioral therapy protocol for seizures, while participants in the comparison group (TBI without seizures) (N=50) received usual treatment. Subjective cognitive concerns, objective cognition, mental health, and quality of life were assessed before and after treatment. Data collection occurred from 2018 to 2022. Baseline subjective cognitive concerns were reported for 37 (79%) participants in the TBI+FS group and 20 (40%) participants in the comparison group. In a multivariable regression model in the TBI+FS group, baseline global mental health (β=-0.97) and obsessive-compulsive symptoms (β=-1.01) were associated with subjective cognitive concerns at baseline. The TBI+FS group had fewer subjective cognitive concerns after treatment (η Subjective cognitive concerns are common among people with TBI and functional seizures and may be related to general mental health and obsessive-compulsive symptoms. Evidence-based neurobehavioral therapy for functional seizures is a reasonable treatment option to address such concerns in this population, although additional studies in culturally diverse samples are needed. In addition, people with functional seizures would likely benefit from rehabilitation specifically targeted toward cognitive functioning.

Déclaration de conflit d'intérêts

Dr. Van Patten engages in profit sharing with the International Neuropsychological Society for continuing education proceeds and receives royalties from Springer. Dr. Altalib has received research funding from Cerevel, Congressionally Directed Medical Research Programs, Eisai, the Epilepsy Study Consortium, the Epilepsy Research Program, and UCB Pharma. Dr. Gaston has received a consulting fee from GW Biosciences and an honorarium from the American Academy of Neurology, and he serves on the advisory board for Neurelis. Dr. Grayson serves on the board of the Epilepsy Foundation of Western North Carolina and receives speakers bureau fees from Jazz Pharmaceuticals. Dr. Allendorfer has received funding from the Evelyn F. McKnight Brain Institute, LivaNova, and the State of Alabama Carly’s Law; she has served as Associate Editor for