Rzezak Patricia, Guimarães Catarina A, Guerreiro Marilisa M, Valente Kette D
Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, SP, Brazil.
Neurology Department, University of Campinas, Campinas, SP, Brazil.
Eur J Paediatr Neurol. 2017 May;21(3):500-506. doi: 10.1016/j.ejpn.2016.12.010. Epub 2016 Dec 29.
Patients with TLE are prone to have lower IQ scores than healthy controls. Nevertheless, the impact of IQ differences is not usually considered in studies that compared the cognitive functioning of children with and without epilepsy. This study aimed to determine the effect of using IQ as a covariate on memory and attentional/executive functions of children with TLE.
Thirty-eight children and adolescents with TLE and 28 healthy controls paired as to age, gender, and sociodemographic factors were evaluated with a comprehensive neuropsychological battery for memory and executive functions. The authors conducted three analyses to verify the impact of IQ scores on the other cognitive domains. First, we compared performance on cognitive tests without controlling for IQ differences between groups. Second, we performed the same analyses, but we included IQ as a confounding factor. Finally, we evaluated the predictive value of IQ on cognitive functioning.
Although patients had IQ score in the normal range, they showed lower IQ scores than controls (p = 0.001). When we did not consider IQ in the analyses, patients had worse performance in verbal and visual memory (short and long-term), semantic memory, sustained, divided and selective attention, mental flexibility and mental tracking for semantic information. By using IQ as a covariate, patients showed worse performance only in verbal memory (long-term), semantic memory, sustained and divided attention and in mental flexibility. IQ was a predictor factor of verbal and visual memory (immediate and delayed), working memory, mental flexibility and mental tracking for semantic information.
Intelligence level had a significant impact on memory and executive functioning of children and adolescents with TLE without intellectual disability. This finding opens the discussion of whether IQ scores should be considered when interpreting the results of differences in cognitive performance of patients with epilepsy compared to healthy volunteers.
与健康对照相比，颞叶癫痫（TLE）患者的智商得分往往较低。然而，在比较有癫痫和无癫痫儿童认知功能的研究中，通常未考虑智商差异的影响。本研究旨在确定将智商作为协变量对TLE儿童记忆及注意力/执行功能的影响。
对38名患有TLE的儿童和青少年以及28名在年龄、性别和社会人口统计学因素上相匹配的健康对照进行了全面的神经心理测验，以评估记忆和执行功能。作者进行了三项分析，以验证智商得分对其他认知领域的影响。首先，我们在不控制组间智商差异的情况下比较了认知测试的表现。其次，我们进行了相同的分析，但将智商作为一个混杂因素纳入。最后，我们评估了智商对认知功能的预测价值。
尽管患者的智商得分在正常范围内，但他们的智商得分低于对照组（p = 0.001）。在分析中不考虑智商时，患者在言语和视觉记忆（短期和长期）、语义记忆、持续性、分散性和选择性注意力、心理灵活性以及语义信息的心理追踪方面表现较差。通过将智商作为协变量，患者仅在言语记忆（长期）、语义记忆、持续性和分散性注意力以及心理灵活性方面表现较差。智商是言语和视觉记忆（即时和延迟）、工作记忆、心理灵活性以及语义信息心理追踪的预测因素。
智力水平对无智力残疾的TLE儿童和青少年的记忆及执行功能有显著影响。这一发现引发了关于在解释癫痫患者与健康志愿者认知表现差异的结果时是否应考虑智商得分的讨论。
