Cognitive impairment in persons with drug resistant epilepsy and correlation with homocysteine, pyridoxine, folic acid, cyanocobalamine and BDNF levels.

Cognitive decline is a major disability comorbidity in persons with epilepsy. This is particularly true in patients with drug epilepsy on multiple anti seizure drugs. It has been hypothesised that neuroinflammation can be a contributor to epilepsy development, as well as epilepsy related comorbidities. Besides inflammatory pathways, other potential causes are oxidative stress, hyperhomocysteinemia , and BDNF.  Hyperhomocysteinemia leads to the development of neurotoxicity. BDNF is an important regulatory protein in neurodevelopment, synaptogenesis and neurogenesis. Altered BDNF and homocysteine levels can be causative factors in refractory seizures and cognitive decline. Since group B vitamins like pyridoxine, folic acid and cyanocobalamine are cofactors for homocysteine metabolism, disturbance in homocysteine will be associated with changes in their levels. These can serve as potential targets for therapeutic intervention.

This study is planned to explore the extent of cognitive impairment in persons with drug resistant epilepsy on anti-seizure drugs, as well as correlation with BDNF, homocysteine, pyridoxine, folic acid and cyanocobalamine. Eligible participants will be enrolled for the study on the basis of inclusion and exclusion criteria. Participants will undergo cognitive evaluation to assess cognitive domains using cognitive assessment scales like MoCA, ACEIII, MMSE and MINI. Also, blood samples of the participants will be taken for the estimation of BDNF, homocysteine, pyridoxine, folic acid and cyanocobalamine. These will then be correlated with cognitive impairment using statistical tools.