IEC 2025 | Sex differences in cognition among patients with epilepsy: insights from the literature

Yes, so yeah, I think it’s an interesting topic to look at sex differences, particularly because the session I presented was related to the neurobiology of epilepsy. So first, I dig into the literature to sort of understand what the clinical literature says about sex differences in behavioral comorbidities because as many people appreciate epilepsy is not all about seizures and the comorbidities are as important to patients if not more in some cases. So one of the things that I look in the literature whether there’s any differences in cognitive deficits. And what I what I found is that there were a few papers from Bruno and Quinn from back in 2015 and 2020, respectively, where they look at the cognitive deficit in women with temporal lobe epilepsy. And they show that they had more severe cognitive impairments, particularly when they were evaluated in the mini mental state, verbal learning, but also working memory. In contrast, males with temporal lobe epilepsy, they had an impairment only in the visuospatial short-term memory, which was actually quite interesting. However, not many of these studies have been done in regards to cognitive deficits. And one of the issues that I sort of found during my literature search is that most of the studies, they are either just considering a small population or a small sample size. So I think it’s something that we need to investigate further in the clinical space. When I look at the literature now on the cognitive deficits in preclinical models, so the evidence even then was a bit more, or there was less evidence of cognitive deficits in preclinical models. And there were a couple of papers that I found where they showed that the male mice exhibited worse cognitive performance in comparison to female mice. And that was in a model where you induce epilepsy by injecting kainic acid, which is a proconvulsant. And in a modern model that this model uses pilocarpine, they found that both sexes had problems in cognition, but they did not see any sex differences. And if we look at other models, such as the lateral fluid percussion model of TBI and then post-traumatic epilepsy or the controlled cortical impact model of TBI and post-traumatic epilepsy, there’s no sex differences at all that were reported.

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