a Division of Pediatric Neuropsychology , Children's National Medical Center , Washington , DC , USA.
b Department of Psychology , Georgia State University , Atlanta , GA , USA.
Child Neuropsychol. 2019 Jan;25(1):22-43. doi: 10.1080/09297049.2018.1424326. Epub 2018 Jan 29.
Executive function (EF) difficulties are a core neuropsychological feature of pediatric epilepsy, and parent-report measures of EF concerns are an important complement to task-based EF measures. The Behavior Rating Inventory of Executive Function (BRIEF) has shown sensitivity to parent-reported EF concerns in epilepsy and other pediatric populations. We compared profiles of parent-reported EF concerns using the BRIEF and its revision, the BRIEF2, in 117 pediatric patients with focal onset epilepsy to examine the clinical utility of the revised scale. We then compared BRIEF2 profiles between patients and age- and gender-matched healthy controls. Among patients, profiles on the BRIEF did not globally differ from the BRIEF2, and agreement was very good across scales. Patients and controls differed significantly on the BRIEF2, with patients showing higher EF difficulties reported by parents across most scales. High rates of clinical elevation among patients emerged on the Task Monitor, Plan/Organize, Working Memory, and Shift scales. Younger age of epilepsy onset, chronic epilepsy, and right hemisphere seizure focus were associated with higher parent-reported EF concerns. Findings suggest that the BRIEF2 demonstrates similar performance to the BRIEF among pediatric patients with focal onset epilepsy who are most at risk in the areas of task monitoring, working memory, planning and organization, and flexibility. These findings are informative when comparing literature across versions and provide additional insight into the nature of parent-reported EF difficulties among children with focal onset epilepsy.
执行功能（EF）障碍是儿科癫痫的核心神经心理学特征，家长报告的 EF 问题是基于任务的 EF 测量的重要补充。行为评定量表的执行功能（BRIEF）已显示出对癫痫和其他儿科人群中家长报告的 EF 问题的敏感性。我们比较了 117 例局灶性癫痫发作患儿使用 BRIEF 和其修订版 BRIEF2 报告的 EF 问题的特征，以检验修订版量表的临床实用性。然后，我们比较了患者和年龄、性别匹配的健康对照组之间的 BRIEF2 特征。在患者中，BRIEF 的特征与 BRIEF2 没有全局差异，并且两个量表之间的一致性非常好。BRIEF2 显示患者和对照组之间存在显著差异，父母报告的大多数量表上患者的 EF 困难程度更高。患者在任务监测、计划/组织、工作记忆和转换量表上出现高比例的临床升高。癫痫发作的年龄较小、慢性癫痫和右侧癫痫灶与家长报告的 EF 问题更严重相关。研究结果表明，BRIEF2 在最易受任务监测、工作记忆、计划和组织以及灵活性方面影响的局灶性癫痫发作的儿科患者中，与 BRIEF 表现出相似的性能。在比较不同版本的文献时，这些发现是有意义的，并为局灶性癫痫发作儿童的家长报告的 EF 困难的性质提供了更多的见解。
