TOPLINE:

Among people with epilepsy, more severe depressive symptoms were linked to greater cognitive burden on the EpiTrack — a validated tool for screening cognitive impairment in epilepsy, and the association persisted after adjusting for frequencies of seizures and interictal epileptiform abnormalities and anti-seizure medication burden.

METHODOLOGY:

• Researchers conducted a single-centre, prospective, cross-sectional observational study to evaluate the association of depressive symptoms with cognitive burden in people with epilepsy.
• They included 100 people with epilepsy (mean age, 42 years; 50 women) seen at an outpatient epilepsy centre in Italy from 2022 to 2025; of them, 55 had cognitive impairment assessed using EpiTrack.
• Cognitive impairment was defined as an age-corrected EpiTrack score of 31 points or less and no cognitive impairment as a score of 32 points or more.
• Analyses examined associations between EpiTrack scores, depressive symptoms evaluated using Beck Depression Inventory-II (BDI-II) scores, and epilepsy-related variables including frequencies of seizures and interictal epileptiform abnormalities, pharmacologic burden, and the number of anti-seizure medications.

TAKEAWAY:

• Lower EpiTrack scores correlated with higher BDI-II scores (ie, more severe depressive symptoms; correlation coefficient [r], -0.33), a higher seizure frequency (r, -0.34), a higher frequency of interictal epileptiform abnormalities (r, -0.34), greater pharmacologic burden (r, -0.21), and a higher number of anti-seizure medications (r, -0.38; P < .05 for all).
• People with epilepsy with EpiTrack-defined cognitive impairment had higher BDI-II scores than those without cognitive impairment, even after adjusting for age, seizure frequency, the frequency of interictal epileptiform abnormalities, and pharmacologic burden (P < .05 for all).
• BDI-II scores remained significantly associated with EpiTrack performance when accounting for the effect of seizure frequency (P = .004).
• The addition of BDI-II scores improved EpiTrack's prediction scores and the classification of cognitive impairment in people with epilepsy.

IN PRACTICE:

"Screening for depressive symptoms and cognitive dysfunctions should be strongly recommended for global clinicians caring for PwE [people with epilepsy]," the authors of the study wrote.

SOURCE:

This study was led by Biagio Maria Sancetta, Università Campus Bio-Medico di Roma, Rome, Italy. It was published online on January 28, 2026, in Epilepsia.

LIMITATIONS:

The study was limited by the lack of a complete neurocognitive and neuropsychological assessment, potential sample bias due to the high proportion of patients with drug-resistant epilepsy, a heterogeneous sample, and the self-reported nature of the BDI-II scale. Additionally, the cross-sectional design limited generalisability and the ability to draw causal inferences.

DISCLOSURES:

The funding source of the study was not explicitly reported. The authors declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.