Department of Epileptology, University of Bonn, Bonn, Germany.
Epilepsy Behav. 2010 Sep;19(1):55-64. doi: 10.1016/j.yebeh.2010.06.042. Epub 2010 Aug 17.
Maximum seizure control, preservation of cognition, and prevention of developmental hindrance are major aims of the pharmacological treatment of children and adolescents with epilepsy. Herewith we introduce the junior version of EpiTrack, a 12- to 15-minute screening test for monitoring the cognitive effects of antiepileptic drug treatment in children and adolescents aged 6 to 18.
The test, which comprises six subtests (Speed, Flexibility, Planning, Response Inhibition, Word Fluency, Working Memory), was administered to 277 children and adolescents aged 6-18 years, 111 of whom were retested after an interval of 3 months. For the first clinical validation, 155 patients (46% idiopathic/benign, 62% seizure free) were evaluated.
Standardization and correction for age resulted in a mean score of 33 ± 2 points, which was no longer correlated with age (r=0.005). The retest practice effect was 0.7 ± 2 points, and the reliability r(tt)=0.78. Factor analysis indicated one executive factor in controls and patients. In the epilepsy group, 50% of the patients were impaired (controls 14%). Number of antiepileptic drugs, use/no use of individual drugs, type of epilepsy, earlier age at onset, generalized tonic-clonic seizures, and history of febrile seizures made a difference in test performance. For patients and controls, EpiTrack scores reflected parents' performance ratings and the children's needs for extra education.
The junior version of EpiTrack appears to be a valid and reliable screening tool for the assessment of executive functions in children and adolescents. Future studies with a repeated measurement design must show how well this tool is suited for the tracking of cognitive effects of antiepileptic drug treatment.
最大限度地控制癫痫发作、保护认知功能、预防发育障碍是儿童和青少年癫痫药物治疗的主要目标。在此，我们介绍 EpiTrack 青少年版，这是一种 12-15 分钟的筛查测试，用于监测 6 至 18 岁儿童和青少年抗癫痫药物治疗的认知影响。
该测试包括六个子测试（速度、灵活性、计划、反应抑制、词汇流畅性、工作记忆），共对 277 名 6-18 岁的儿童和青少年进行了测试，其中 111 名在 3 个月后进行了复测。在首次临床验证中，对 155 名患者（46%为特发性/良性，62%无发作）进行了评估。
标准化和年龄校正后平均得分为 33 ± 2 分，与年龄不再相关（r=0.005）。重测练习效应为 0.7 ± 2 分，可靠性 r(tt)=0.78。因子分析表明，对照组和患者组都存在一个执行功能因素。在癫痫组中，有 50%的患者存在障碍（对照组为 14%）。抗癫痫药物的数量、是否使用个别药物、癫痫类型、发病年龄较早、全面强直阵挛发作和热性惊厥史都会影响测试表现。对于患者和对照组，EpiTrack 评分反映了家长的表现评分和孩子额外教育的需求。
EpiTrack 青少年版似乎是一种有效的、可靠的筛查工具，可用于评估儿童和青少年的执行功能。未来需要采用重复测量设计的研究来表明该工具在跟踪抗癫痫药物治疗的认知影响方面的适用性。
