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新发癫痫患儿的简短认知与行为筛查:一项初步可行性试验

Brief cognitive and behavioral screening in children with new-onset epilepsy: a pilot feasibility trial.

作者信息

Triplett Regina L, Asato Miya R

机构信息

University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania.

Department of Pediatrics, Children's Hospital of Pittsburgh of the University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania; Department of Psychiatry, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

出版信息

Pediatr Neurol. 2015 Jan;52(1):49-55. doi: 10.1016/j.pediatrneurol.2014.09.020. Epub 2014 Nov 26.

Abstract

BACKGROUND

Minimal work has used psychometrically robust measures in a systematic fashion to identify and monitor children at risk for cognitive and behavioral comorbidities in current epilepsy care. We piloted a computerized cognitive battery and behavioral questionnaire for children with newly diagnosed epilepsy to determine clinical feasibility and acceptability to parents and patients.

METHODS

We recruited medication-naïve children (ages 8-17 years) with recent-onset seizures and typical developmental history from an outpatient child neurology clinic. Children completed the CNS Vital Signs computerized battery, whereas parents completed the Strengths and Difficulties Questionnaire. Post-test interviews with parents and patients were completed regarding the acceptability of the assessment procedures.

RESULTS

Forty-four families were eligible, and 39 agreed to participate (89%). All assessments were completed in less than 45 minutes. Parents rated testing in clinic as convenient and important, expressing strong interest in the cognitive and behavioral impact of epilepsy and medication. Children also rated the testing procedure as acceptable and agreed that they would recommend it to peers.

CONCLUSIONS

Our brief battery was tolerated and well received by children and their parents. Computerized testing of children along with a parent questionnaire is a psychometrically viable approach that is acceptable to families. Our protocol is time efficient for clinical use with the potential to detect early cognitive and behavioral difficulties related to epilepsy. Ongoing longitudinal study will provide further information regarding the success of our screening methods in monitoring for disease- or treatment-related changes.

摘要

背景

在当前癫痫治疗中,很少有研究系统地使用心理测量学上可靠的方法来识别和监测有认知和行为共病风险的儿童。我们对新诊断癫痫患儿试用了计算机化认知测试组合和行为问卷,以确定其临床可行性以及家长和患儿的接受程度。

方法

我们从一家门诊儿童神经科诊所招募了新近发病、未服用过药物且发育史正常的8至17岁儿童。儿童完成了CNS Vital Signs计算机化测试组合,而家长则完成了优势与困难问卷。就评估程序的可接受性对家长和患儿进行了测试后访谈。

结果

44个家庭符合条件,39个家庭同意参与(89%)。所有评估均在不到45分钟内完成。家长认为在诊所进行测试方便且重要,对癫痫和药物治疗对认知和行为的影响表现出浓厚兴趣。儿童也认为测试程序可以接受,并同意会向同龄人推荐。

结论

我们简短的测试组合得到了儿童及其家长的接受和好评。对儿童进行计算机化测试并结合家长问卷是一种在心理测量学上可行且为家庭所接受的方法。我们的方案在临床使用中效率高,有可能检测出与癫痫相关的早期认知和行为困难。正在进行的纵向研究将提供更多信息,说明我们的筛查方法在监测疾病或治疗相关变化方面的成功情况。

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The neuropsychological and academic substrate of new/recent-onset epilepsies.新发/近期癫痫的神经心理学和学术基础。
J Pediatr. 2013 May;162(5):1047-53.e1. doi: 10.1016/j.jpeds.2012.10.046. Epub 2012 Dec 5.
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Epilepsy: maximizing cognitive outcomes in epilepsy.癫痫:优化癫痫患者的认知预后
Nat Rev Neurol. 2012 Aug;8(8):416-7. doi: 10.1038/nrneurol.2012.143. Epub 2012 Jul 10.

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