Gascoigne Michael B, Smith Mary Lou, Barton Belinda, Webster Richard, Gill Deepak, Lah Suncica
School of Psychological Sciences, Australian College of Applied Psychology, Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders Sydney, New South Wales, Australia; School of Psychology, The University of Sydney, Australia.
The University of Toronto, Toronto, Canada; ARC Centre of Excellence in Cognition and its Disorders Sydney, New South Wales, Australia; The Hospital for Sick Children, Toronto, Canada.
Epilepsy Behav. 2017 Feb;67:7-12. doi: 10.1016/j.yebeh.2016.11.013. Epub 2017 Jan 10.
Attention difficulties are a common clinical complaint among children with epilepsy. We aimed to compare a range of attentional abilities between groups of children with two common epilepsy syndromes, Temporal Lobe Epilepsy (TLE) and Idiopathic Generalized Epilepsy (IGE), and to healthy controls. We also investigated whether epilepsy factors (laterality of seizure focus, epilepsy onset, duration, and severity) were related to attentional abilities.
Multiple dimensions of attention (selective, sustained, and divided attention and attentional control) were assessed directly with standardized neuropsychological measures in 101 children aged 6-16years (23 children with TLE, 20 with IGE and 58 healthy controls). Attention was also assessed indirectly, via a parent-report measure.
Children with TLE performed worse than children with IGE (p=0.013) and healthy controls (p<0.001) on a test of attentional control, but no between-group differences were apparent on tests of other attentional abilities. Compared to healthy controls, greater attention problems were reported by parents of children with TLE (p=0.006) and IGE (p=0.012). Left-hemisphere seizure focus and greater epilepsy severity were associated with poorer attentional control and sustained-divided attention, respectively, but no other epilepsy factors were associated with attentional abilities.
These findings suggest that children with localization-related epilepsy, but not generalized epilepsy, may be at risk of deficits in attentional control. Interventions aimed at improving attentional control may be targeted at children with localization-related epilepsy, particularly those with a left-hemisphere seizure focus, who appear to be particularly susceptible to this type of attentional deficit.
注意力障碍是癫痫患儿常见的临床症状。我们旨在比较患有两种常见癫痫综合征（颞叶癫痫（TLE）和特发性全身性癫痫（IGE））的儿童组与健康对照组之间的一系列注意力能力。我们还研究了癫痫因素（发作灶的侧别、癫痫发作起始、病程和严重程度）是否与注意力能力相关。
采用标准化神经心理学测量方法，对101名6至16岁儿童（23名TLE患儿、20名IGE患儿和58名健康对照）直接评估注意力的多个维度（选择性、持续性、分散性注意力和注意力控制）。还通过家长报告测量法间接评估注意力。
在注意力控制测试中，TLE患儿的表现比IGE患儿（p = 0.013）和健康对照组（p < 0.001）差，但在其他注意力能力测试中，组间差异不明显。与健康对照组相比，TLE患儿（p = 0.006）和IGE患儿（p = 0.012）的家长报告的注意力问题更多。左侧半球发作灶和更高的癫痫严重程度分别与较差的注意力控制和持续性 - 分散性注意力相关，但没有其他癫痫因素与注意力能力相关。
这些发现表明，与局灶性相关癫痫患儿而非全身性癫痫患儿可能存在注意力控制缺陷的风险。旨在改善注意力控制的干预措施可能针对与局灶性相关癫痫患儿，特别是那些发作灶在左侧半球的患儿，他们似乎特别容易出现这种类型的注意力缺陷。
