Elsevier

Seizure

Volume 83, December 2020, Pages 89-97
Seizure

Teleneuropsychology in the time of COVID-19: The experience of The Australian Epilepsy Project

https://doi.org/10.1016/j.seizure.2020.10.005Get rights and content
Under a Creative Commons license
open access

Highlights

  • TeleNP represents a medium through which clinical research and important clinical care can continue.

  • We discuss benefits, challenges, and practical considerations in the use of teleNP.

  • We describe how the Australian Epilepsy Project has adapted to the COVID-19 environment.

  • TeleNP data acquired to date reveals deficits typical of those observed in epilepsy.

  • TeleNP presents an opportunity to expand the reach and breadth of neuropsychological services.

Abstract

Purpose

Traditional neuropsychological testing carries elevated COVID-19 risk for both examinee and examiner. Here we describe how the pilot study of the Australian Epilepsy Project (AEP) has transitioned to tele-neuropsychology (teleNP), enabling continued safe operations during the pandemic.

Methods

The AEP includes adults (age 18–60) with a first unprovoked seizure, new diagnosis of epilepsy or drug resistant focal epilepsy. Shortly after launching the study, COVID-related restrictions necessitated adaptation to teleNP, including delivery of verbal tasks via videoconference; visual stimulus delivery via document camera; use of web-hosted, computerised assessment; substitution of oral versions for written tests; online delivery of questionnaires; and discontinuation of telehealth incompatible tasks.

Results

To date, we have completed 24 teleNP assessments: 18 remotely (participant in own home) and six on-site (participant using equipment at research facility). Five face-to-face assessments were conducted prior to the transition to teleNP. Eight of 408 tests administered via teleNP (1.9 %) have been invalidated, for a variety of reasons (technical, procedural, environmental). Data confirm typical patterns of epilepsy-related deficits (p < .05) affecting processing speed, executive function, language and memory. Questionnaire responses indicate elevated rates of patients at high risk of mood (34 %) and anxiety disorder (38 %).

Conclusion

Research teleNP assessments reveal a typical pattern of impairments in epilepsy. A range of issues must be considered when introducing teleNP, such as technical and administrative set up, test selection and delivery, and cohort suitability. TeleNP enables large-scale neuropsychological research during periods of social distancing (and beyond), and offers an opportunity to expand the reach and breadth of neuropsychological services.

Abbreviations

AEP
Australian Epilepsy Project
ASM
antiseizure medication
TeleNP
teleneuropsychology

Keywords

Cognitive assessment
Epilepsy surgery
Telehealth
Telepsychotherapy
Coronavirus
SARS-CoV-2

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