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

Seizure. 2020 Dec:83:89-97. doi: 10.1016/j.seizure.2020.10.005. Epub 2020 Oct 16.

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.

Keywords: Cognitive assessment; Coronavirus; Epilepsy surgery; SARS-CoV-2; Telehealth; Telepsychotherapy.

MeSH terms

  • Australia
  • COVID-19 / complications
  • COVID-19 / virology*
  • Epilepsy / complications
  • Epilepsy / virology*
  • Executive Function / physiology*
  • Humans
  • Neuropsychological Tests
  • Neuropsychology / methods
  • Pilot Projects
  • SARS-CoV-2 / metabolism*
  • Surveys and Questionnaires
  • Telemedicine* / methods