Affective and Cognitive Vulnerability Under Chronic Stress: Insights From Patients With Left Temporal Lobe Epilepsy and Caregivers

BACKGROUND: Temporal lobe epilepsy (TLE) is a chronic stress condition characterized by affective and cognitive deficits. This study analyzed differences in affective and cognitive functioning between patients with TLE and another chronically stressed population - caregivers of patients with epilepsy - as well as the relationships between affective and cognitive outcomes. METHODS: In this cross-sectional study, 40 adults (20 with left TLE and 20 caregivers; mean age 48.43 ± 8.86 years) underwent a neuropsychological assessment evaluating affectivity, attention, executive function, language, and memory. RESULTS: Patients with TLE and caregivers did not differ in anxiety, depression, attention, executive functions, or visual memory. However, patients with TLE had poorer semantic verbal fluency (p = 0.02), naming (p < 0.0001), short-term verbal recall (p = 0.027), long-term verbal recall with semantic cues (p = 0.005), long-term verbal recognition (p = 0.017), and verbal discriminability (p = 0.001). The group (epilepsy vs. caregiver) significantly moderated the association between depression and long-term verbal recognition (B = -0.12, standard error (SE) = 0.05, p = 0.03, 95% confidence interval (CI) [-0.23, -0.01]), with higher depression scores being associated with poorer verbal recognition in patients with epilepsy (p = 0.001) but not in caregivers (p = 0.74). CONCLUSIONS: These findings suggest a specific pattern of verbal dysfunction and increased cognitive vulnerability to depression in patients with TLE, compared to another chronically stressed group. Although the present study cannot determine the mechanisms underlying these associations, the results underscore the clinical relevance of assessing these variables together and may inform the development of tailored interventions.