Yang Bin, Wang Xiaocui, Shen Liwei, Ye Xiaofei, Yang Guang-e, Fan Jin, Hu Panpan, Wang Kai
The First Affiliated Hospital of Anhui Medical University, PR China; Department of Neurology, Anhui Provincial Children's Hospital, Anhui Medical University, PR China.
Department of Neurology, Anhui Provincial Children's Hospital, Anhui Medical University, PR China.
Epilepsy Behav. 2015 Dec;53:78-82. doi: 10.1016/j.yebeh.2015.09.034. Epub 2015 Oct 30.
Benign epilepsy affecting children with normal mental development often occurs at a particular age, responds well to medication, and could be resolved completely by puberty. Although several studies have shown neuropsychological disabilities of children with benign epilepsy with centrotemporal spikes (BECTS), there is no clear evidence about the impairment of attentional systems and the comorbidity of attentional problems. Our research was based on the attention network model and assessed the characteristics of three anatomically defined subnetworks (alerting, orienting, and executive control) of 90 children with BECTS and 90 healthy children. All the subjects enrolled in the study participated in the attention network test (ANT) with assessment of both the reaction time (RT) and accuracy of the test. The results indicated that the performance of healthy controls was significantly better in orienting of attentional system (P<0.001) and the accuracy of attention network test (P<0.001), compared with that of children affected by BECTS. The grand mean effect (higher score worse) was significantly higher (P<0.001) in the patient group than that in the control group. The multiple linear regression analysis revealed a positive correlation between the age of onset and the accuracy of attention network test results, and a negative correlation between the age of onset and the results of grand mean effect. A negative correlation was observed between spike index (SI) of the non-REM sleep stage and the accuracy of attention network test results. We found no relationship between the grand mean effect and clinical factors such as gender, duration of clinical course, duration of seizures, total number of seizures, severity of seizures (seizure frequency), hemispheric lateralization of electroencephalograph (EEG), and the awake SI. Furthermore, no relationship was observed between the clinical factors and the accuracy of the test results. The findings showed that BECTS is associated with impaired attentional networks, and impairments are greater at younger ages of onset.
良性癫痫影响精神发育正常的儿童，通常在特定年龄发病，对药物治疗反应良好，到青春期可完全缓解。尽管多项研究显示了伴有中央颞区棘波的儿童良性癫痫（BECTS）患儿存在神经心理障碍，但关于注意力系统受损及注意力问题共病情况尚无明确证据。我们的研究基于注意力网络模型，评估了90例BECTS患儿和90例健康儿童三个解剖学定义子网络（警觉、定向和执行控制）的特征。所有纳入研究的受试者均参加了注意力网络测试（ANT），评估测试的反应时间（RT）和准确性。结果表明，与BECTS患儿相比，健康对照组在注意力系统定向方面（P<0.001）和注意力网络测试准确性方面（P<0.001）表现明显更好。患者组的总平均效应（分数越高越差）显著高于对照组（P<0.001）。多元线性回归分析显示发病年龄与注意力网络测试结果准确性呈正相关，与总平均效应结果呈负相关。非快速眼动睡眠期的棘波指数（SI）与注意力网络测试结果准确性呈负相关。我们发现总平均效应与性别、临床病程持续时间、发作持续时间、发作总数、发作严重程度（发作频率）、脑电图（EEG）半球侧化及清醒时SI等临床因素之间无关联。此外，未观察到临床因素与测试结果准确性之间的关联。研究结果表明，BECTS与注意力网络受损有关，且发病年龄越小，受损越严重。
