Review| Volume 142, 109170, May 2023

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The relationship between physical activity and cognitive function in people with epilepsy: A systematic review


      • Studies examining how physical activity and cognition are related in PWE are rare.
      • There is a potential positive association between physical activity and cognition in PWE.
      • Known physical activity benefits suggest its promise as a cognitive treatment in PWE.
      • Large physical activity RCTs in PWE are needed to investigate the effects on cognition.



      This study aimed to systematically review the published literature evaluating the association between physical activity and cognitive function in people with epilepsy (PWE).


      A comprehensive search of PubMed, Cochrane, Embase, and PsychInfo was performed on June 20, 2022. Studies were excluded if they were not available in the English language, contained animal data only, did not include any original data, were not peer-reviewed, or did not include PWE as a discrete group. PRISMA guidelines were followed. The GRADE scale was used to assess the risk of bias.


      Six studies were identified with a total of 123 participants. These included one observational study and five interventional studies, only one of which was a randomized controlled trial. In all studies, there was a positive association between physical activity and cognitive function in PWE. Both interventional studies showed improvement in at least one domain of cognitive functioning, though there was heterogeneity in the outcome measures used.


      There is a potential positive association between physical activity and cognitive function in PWE, but available data is limited by heterogeneity, small sample size, and an overall lack of published studies in this area of research. There is a need for more robust studies to be performed in larger samples of PWE.



      PWE (people with epilepsy), PRISMA (Preferred Reporting Items for Systematic Review), GRADE (Grading of Recommendations Assessment Development and Evaluation), SF-36 (short form-36), PEL (physical exercise in leisure), BQ (Baecke Questionnaire of Habitual Physical Activity), IPAQ (international physical activity questionnaire), MoCA (Montreal Cognitive Assessment), HVLT (Hopkins verbal learning test), TMT (trails making test), DST (digit span test), SCWT (Stroop color and word test), CVLT-II (California verbal learning test – 2nd edition), POMS (profile of mood states), fMRI (functional magnetic resonance imaging), CAT (comprehensive attention test), CCTT (children’s color trails test), CSD (current source density), EEG (electroencephalography), WISC-III (Wechsler Intelligence Scales), CDI (children’s depression index), RCMAS (revised children’s manifest anxiety scale), CBCL (child behavior checklist), QOLCE (quality of life in childhood epilepsy)
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