ABSTRACT
@#Epilepsy is one of the main health problems in neurology that can lead to cognitive decline. Generally, the epilepsy-associated cognitive decline is influenced by demographic, clinical, and treatment characteristics. This study aimed to determine the characteristics of cognitive status of epilepsy patients who received monotherapy using first-generation antiepileptic drugs (AEDs), namely phenytoin, carbamazepine, and valproic acid. It involved 93 epilepsy patients of Mutiara Sukma Mental Hospital (n=38) and Mataram General Hospital (n=55). Besides, 93 healthy patients were assigned as healthy control group (HC) subjects (n=93). Demographic characteristics collected from epilepsy and HC groups were age, gender, and years of education. Clinical characteristics taken from both groups were MoCA-Ina score. Clinical characteristics taken from epilepsy group were age at epilepsy onset, type of seizure (partial vs generalized), etiology (idiopathic vs structural), first-generation AED used, years of treatment, and cognitive status. The result of the study revealed that there were no significant different between the two groups in the means of age and years of education as well as the frequency of male gender (p>0.05). The mean of MoCA-Ina score of epilepsy group was significantly lower compared with HC group (p<0.05). The frequency of cognitive decline among epilepsy patients was 75.3%. The cognitive functions of epilepsy patients using monotherapy with carbamazepine, phenytoin, or valproic acid was significantly lower compared with healthy subjects. We conclude that there was high prevalence of epilepsy-associated cognitive impairment which was associated with male gender.
ABSTRACT
Background: ASCO Phenotype classification is a new classification of stroke based on phenotypic system. ASCO classification can evaluate the etiology of ischemic stroke comprehensively to characterize patients using different grade of evidence for the subtype of ischemic stroke. ASCO classification can predict post ischemic stroke cognitive decline. This Study purpose to evaluate the association between ASCO classification with the executive function in post ischemic stroke patients.Methods: This cross sectional study followed by 28 post ischemic stroke patients (men 16, women 12) over 3 months. Mean age 52.82±8.66. Cognitive function was assessed by Montreal Cognitive Assessment Indonesia (MoCA INA).Results: There were 17 patients with grade 1 atherosclerosis (ASCO A1), ten patients with grade 1 small vessel disease (ASCO S1), one patient with grade 1 cardioembolism (ASCO C1) in post ischemic stroke. Grade 1 atherosclerosis (ASCO A1) was significantly associated with executive function decline (p=0.002), naming decline (p=0.05), abstraction decline (p=0.001), memory decline (p=0.002) and orientation decline (p=0.016)). Grade 1 small vessel disease (ASCO S1) was significantly associated with executive function decline (p=0.001) and memory decline (p = 0.001) and abstraction (p=0.001). Grade 1 cardioembolism 1 (ASCO C1) was not significantly associated with cognitive decline.Conclusions: There was significant association between ASCO classification with the executive function of Montreal Cognitive Assestment Indonesia (MoCA INA) in post ischemic stroke patients.