Neuropsychological Rehabilitation (NR) helps manage cognitive deficits in epilepsy. As internationally developed programs have limited applicability to resource-limited countries, we developed a program to bridge this gap. This 6-week caregiver-assisted, culturally suitable program has components of (1) psychoeducation, (2) compensatory training, and, (3) cognitive retraining and is called EMPOWER (Indignized Hoe Based Attention and Memory Rehabilitation rogram fr Adult Patients ith Drug Rfactory Epilepsy). Its efficacy needs to be determined. We carried out an open-label parallel randomized controlled trial. Adults aged 18–45 years with Drug Refractory Epilepsy (DRE), fluency in Hindi and or English, with impaired attention or memory (n = 28) were randomized to Intervention Group (IG) and Control Group (CG). The primary outcomes were objective memory (Auditory Verbal Learning Test), patient and caregiver reported everyday memory difficulties (Everyday Memory Questionnaire-Revised), number of memory aids in use, depression (Hamilton Depression Rating Scale), anxiety (Hamilton Anxiety Rating Scale) and quality of life (Quality of Life in Epilepsy-31). Intention to treat was carried out for group analysis. In the absence of norms necessary for computing Reliable Change Indices (RCIs), a cut-off of +1.0 Standard Deviation (SD) was utilized to identify clinically meaningful changes in the individual analysis of objective memory. A cut-off of 11.8 points was used for quality of life. Feedback and program evaluation responses were noted. The majority of the sample comprised DRE patients with temporal lobe epilepsy who had undergone epilepsy surgery. Group analysis indicated improved learning (p = 0.013), immediate recall (p = 0.001), delayed recall (p < 0.001), long-term retention (p = 0.031), patient-reported everyday memory (p < 0.001), caregiver-reported everyday memory (p < 0.001), anxiety (p = 0.039) and total quality of life (p < 0.001). Individual analysis showed improvement in 50 %, 64 %, 71 %, 57 %, and 64 % of patients on learning, immediate recall, delayed recall, long-term retention, and total quality of life respectively. Despite improvements, themes indicative of a lack of awareness and understanding of cognitive deficits were identified. Overall, the program was rated favorably by patients and caregivers alike. NR shows promise for patients with DRE, however larger studies are warranted. The role of cognition in epilepsy needs to be introduced at the time of diagnosis to help lay the foundation for education and acceptance.

中文翻译：

---

印度癫痫的神经心理康复：超越基础知识

神经心理康复 (NR) 有助于控制癫痫患者的认知缺陷。由于国际开发的计划对资源有限的国家的适用性有限，我们制定了一项计划来弥补这一差距。这个为期 6 周、由护理人员协助、适合文化的计划包含 (1) 心理教育、(2) 补偿训练和 (3) 认知再训练，称为 EMPOWER（基于 Indignized Hoe 的注意力和记忆康复计划，适用于成人患者使用药物） R工厂癫痫）。其功效需要确定。我们进行了一项开放标签平行随机对照试验。年龄 18-45 岁、患有药物难治性癫痫 (DRE)、能流利印地语和/或英语、注意力或记忆力受损的成年人 (n = 28) 被随机分为干预组 (IG) 和对照组 (CG)。主要结果是客观记忆（听觉言语学习测试）、患者和护理人员报告的日常记忆困难（修订版日常记忆问卷）、使用的记忆辅助工具的数量、抑郁（汉密尔顿抑郁评定量表）、焦虑（汉密尔顿焦虑评定量表）和生活质量（癫痫的生活质量-31）。进行意向治疗进行分组分析。在缺乏计算可靠变化指数 (RCI) 所需的规范的情况下，使用 +1.0 标准差 (SD) 的截止值来识别客观记忆个体分析中具有临床意义的变化。生活质量的分界线为 11.8 分。记录了反馈和计划评估答复。大多数样本包括接受过癫痫手术的颞叶癫痫 DRE 患者。组分析表明学习能力提高 (p = 0.013)、立即回忆 (p = 0.001)、延迟回忆 (p < 0.001)、长期记忆 (p = 0.031)、患者报告的日常记忆 (p < 0.001)、护理人员-报告日常记忆（p < 0.001）、焦虑（p = 0.039）和总体生活质量（p < 0.001）。个体分析显示，50%、64%、71%、57% 和 64% 的患者在学习、即时回忆、延迟回忆、长期记忆和总体生活质量方面分别有所改善。尽管有所改善，但仍发现了对认知缺陷缺乏认识和理解的主题。总体而言，该计划受到患者和护理人员的一致好评。 NR 对 DRE 患者显示出希望，但需要进行更大规模的研究。需要在诊断时介绍认知在癫痫中的作用，以帮助奠定教育和接受的基础。