Wickens Steven, Bowden Stephen C, D'Souza Wendyl
Melbourne School of Psychological Sciences, University of Melbourne, Parkville, Victoria, Australia.
Department of Clinical Neurosciences, St. Vincent's Hospital Melbourne, Fitzroy, Victoria, Australia.
Epilepsia. 2017 Oct;58(10):1673-1685. doi: 10.1111/epi.13865. Epub 2017 Aug 12.
It is now well appreciated that benign epilepsy with centrotemporal spikes (BECTS, or more recently, ECTS) is associated with a range of cognitive and behavioral disturbances. Despite our improved understanding of cognitive functioning in ECTS, there have been to date no efforts to quantitatively synthesize the available literature within a comprehensive cognitive framework.
The present systematic review and meta-analysis was conducted according to PRISMA guidelines. Forty-two case-control samples met eligibility criteria comprising a total of 1,237 children with ECTS and 1,137 healthy control children. Univariate, random-effects meta-analyses were conducted on eight cognitive factors in accordance with the Cattell-Horn-Carroll model of intelligence.
Overall, children with ECTS demonstrated significantly lower scores on neuropsychological tests across all cognitive factors compared to healthy controls. Observed effects ranged from 0.42 to 0.81 pooled standard deviation units, with the largest effect for long-term storage and retrieval and the smallest effect for visual processing.
The results of the present meta-analysis provide the first clear evidence that children with ECTS display a profile of pervasive cognitive difficulties and thus challenge current conceptions of ECTS as a benign disease or of limited specific or localized cognitive effect.
目前人们已充分认识到，伴中央颞区棘波的良性癫痫（BECTS，或最近称为ECTS）与一系列认知和行为障碍有关。尽管我们对ECTS患者的认知功能有了更深入的了解，但迄今为止，尚未有人尝试在一个全面的认知框架内对现有文献进行定量综合分析。
本系统评价和荟萃分析按照PRISMA指南进行。42个病例对照样本符合纳入标准，共包括1237例ECTS患儿和1137例健康对照儿童。根据卡特尔-霍恩-卡罗尔智力模型，对八个认知因素进行单变量随机效应荟萃分析。
总体而言，与健康对照相比，ECTS患儿在所有认知因素的神经心理学测试中得分均显著较低。观察到的效应范围为0.42至0.81个合并标准差单位，对长期存储和提取的影响最大，对视觉加工的影响最小。
本荟萃分析结果首次明确表明，ECTS患儿存在普遍的认知困难，从而挑战了目前将ECTS视为良性疾病或具有有限特定或局部认知影响的观念。
