Amiet Claire, Gourfinkel-An Isabelle, Bouzamondo Anissa, Tordjman Sylvie, Baulac Michel, Lechat Philippe, Mottron Laurent, Cohen David
Department of Child and Adolescent Psychiatry, Assistance Publique-Hospitaux de Paris, Groupe Hospitalier Pitié-Salpétrière, Université Pierre et Marie Curie, Paris, France.
Biol Psychiatry. 2008 Oct 1;64(7):577-82. doi: 10.1016/j.biopsych.2008.04.030. Epub 2008 Jun 20.
The association between epilepsy and autism is consistently reported, with a wide range of prevalence rates. This may be attributed to the heterogeneity of the samples with respect to age, comorbidity, sex, and intellectual disability (ID). We aimed to compare the prevalence of epilepsy 1) among autistic patients with ID versus autistic patients without ID and 2) among male versus female autistic patients.
We reviewed all data available from published reports (1963-2006) on autism and epilepsy and conducted a meta-analysis of 10 and 14 studies, respectively, to assess the relative risk (RR) of epilepsy in autism according to ID and gender. The pooled groups included 2112 (627 with IQ > or = 70, 1485 with IQ < 70) and 1530 (1191 male, 339 female) patients, respectively.
There was a strong discrepancy in relative risk (RR) according to IQ, with more autistic patients with ID having epilepsy (RR = .555; 95% confidence interval [CI]: .42-.73; p < .001). The pooled prevalence of epilepsy was 21.5% in autistic subjects with ID versus 8% in autistic subjects without ID. There was a strong discrepancy in RR according to sex, favoring comorbidity of epilepsy in autistic girls (RR = .549; 95% CI: .45-.66; p < .001). The male:female ratio of autism comorbid with epilepsy was close to 2:1 whereas the male:female ratio of autism without epilepsy was 3.5:1.
The results of this meta-analysis indicate that risk for epilepsy in autism is a function of ID severity and distinguishes autism associated with epilepsy as a subgroup of autism by its male-female ratio.
癫痫与自闭症之间的关联一直被报道，患病率范围很广。这可能归因于样本在年龄、合并症、性别和智力残疾（ID）方面的异质性。我们旨在比较癫痫的患病率：1）在有ID的自闭症患者与无ID的自闭症患者之间；2）在男性与女性自闭症患者之间。
我们回顾了已发表报告（1963 - 2006年）中关于自闭症和癫痫的所有可用数据，并分别对10项和14项研究进行荟萃分析，以评估根据ID和性别，自闭症患者患癫痫的相对风险（RR）。汇总组分别包括2112名（627名智商≥70，1485名智商＜70）和1530名（1191名男性，339名女性）患者。
根据智商，相对风险（RR）存在显著差异，更多有ID的自闭症患者患有癫痫（RR = 0.555；95%置信区间[CI]：0.42 - 0.73；p＜0.001）。有ID的自闭症患者中癫痫的汇总患病率为21.5%，而无ID的自闭症患者中为8%。根据性别，RR也存在显著差异，自闭症女孩患癫痫合并症的情况更常见（RR = 0.549；95% CI：0.45 - 0.66；p＜0.001）。自闭症合并癫痫的男女比例接近2:1，而无癫痫的自闭症男女比例为3.5:1。
这项荟萃分析的结果表明，自闭症患者患癫痫的风险是ID严重程度的函数，并通过其男女比例将与癫痫相关的自闭症作为自闭症的一个亚组区分开来。
