Computerized neuropsychological testing in epilepsy: Overview of available tools

PURPOSE Neuropsychology has become an essential diagnostic tool for epilepsy-related cognitive comorbidities and treatment evaluation. However, a lack of resources may prevent routine neuropsychological assessments outside specialized epilepsy centers. Computerized testing appears to offer a time- and cost-effective approach to assess cognitive functions in patients with epilepsy. Moreover, the technical advances of computerized tests provide interesting tools to address specific diagnostic questions around epilepsy. This review is intended: (1) to outline the advantages and disadvantages of computerized testing, (2) to delineate its indications and fields of application, and (3) to give an overview of available tools that have been applied in epilepsy or antiepileptic drug research. METHOD Iterative review of computer-based neuropsychological assessment batteries previously applied in clinical epileptological settings or antiepileptic drug trials. RESULTS Among nine reviewed computer tests merely three were explicitly devised for epilepsy and showed sensitivity to clinical parameters like focus lateralization or localization or the presence/absence of epileptiform activity. Concurrent validity with established measures was demonstrated for two of these three tests. Some sensitivity to antiepileptic pharmacotherapy was reported for seven of all nine reviewed test batteries. CONCLUSION Additional studies are needed to demonstrate the sensitivity and specificity of computerized neuropsychological tests to epilepsy and treatment related variables. In most clinical scenarios exclusive computerized testing cannot substitute a thorough neuropsychological examination in patients with epilepsy at present.