Hermann Bruce P, Zhao Qianqian, Jackson Daren C, Jones Jana E, Dabbs Kevin, Almane Dace, Hsu David A, Stafstrom Carl E, Koehn Monica A, Seidenberg Michael, Rathouz Paul J
Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Department of Biostatistics and Medical Informatics, University of Wisconsin School of Medicine and Public Health, Madison, WI, United States.
Epilepsy Behav. 2016 Aug;61:269-274. doi: 10.1016/j.yebeh.2016.05.013. Epub 2016 Jul 18.
The objective of this study was to identify cognitive phenotypes in children with new-onset focal and generalized idiopathic epilepsies and determine their relationship with epilepsy syndrome, brain structure, neurodevelopmental history, and family characteristics.
One hundred thirty-eight children with new-onset epilepsy and 95 controls (age: 8-18) underwent neuropsychological, clinical, and quantitative MR evaluations. Control participants' neuropsychological data were subjected to confirmatory factor analysis and then resultant factor scores were applied to participants with epilepsy and subjected to latent class analysis. Identified cognitive phenotypes were examined in relation to epilepsy syndrome, quantitative neuroimaging, and familial and neurodevelopmental variables.
Confirmatory factor analysis identified five cognitive factors (verbal, perceptual, speed, attention, executive), and latent class analysis identified three clusters of participants with epilepsy: 1) average and similar to controls, 2) mild impairment across multiple cognitive domains, and 3) impairment across all domains with severe attentional impairment, representing 44%, 44%, and 12% of the epilepsy sample, respectively. Cognitive phenotype membership was not associated with epilepsy syndrome but was associated with increasing abnormalities in brain structure, parental IQ, and features of early developmental history.
Cognitive phenotypes are present in idiopathic childhood epilepsies that are unassociated with traditional epilepsy syndromes but are associated with measures of brain structure, family history, and neurodevelopmental features.
本研究的目的是识别新发局灶性和全身性特发性癫痫患儿的认知表型，并确定它们与癫痫综合征、脑结构、神经发育史和家庭特征之间的关系。
138例新发癫痫患儿和95名对照者（年龄8 - 18岁）接受了神经心理学、临床和定量磁共振评估。对对照者的神经心理学数据进行验证性因素分析，然后将所得因素得分应用于癫痫患儿，并进行潜在类别分析。研究已识别的认知表型与癫痫综合征、定量神经影像学以及家族和神经发育变量之间的关系。
验证性因素分析确定了五个认知因素（语言、感知、速度、注意力、执行功能），潜在类别分析确定了三组癫痫患儿：1）平均水平且与对照者相似；2）多个认知领域轻度受损；3）所有领域均受损且伴有严重注意力障碍，分别占癫痫样本的44%、44%和12%。认知表型类别与癫痫综合征无关，但与脑结构异常增加、父母智商以及早期发育史特征有关。
认知表型存在于特发性儿童癫痫中，这些表型与传统癫痫综合征无关，但与脑结构测量、家族史和神经发育特征有关。
