Law Nicole, Widjaja Elysa, Smith Mary Lou
Department of Psychology, University of Toronto, Toronto, Ontario, Canada; Department of Psychology, Hospital for Sick Children, Toronto, Ontario, Canada; Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada.
Program in Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Ontario, Canada; Diagnostic Imaging, Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, Hospital for Sick Children, Toronto, Ontario, Canada.
Epilepsy Behav. 2018 Mar;80:157-162. doi: 10.1016/j.yebeh.2017.12.035. Epub 2018 Feb 3.
Previous findings have been mixed in terms of identifying a distinct pattern of neuropsychological deficits in children with frontal lobe epilepsy (FLE) and in those with temporal lobe epilepsy (TLE). The current study investigated the neuropsychological similarities and differences across these two pediatric medically intractable localization-related epilepsies.
Thirty-eight children with FLE, 20 children with TLE, and 40 healthy children (HC) participated in this study. A comprehensive battery of standardized tests assessed five neuropsychological domains including intelligence, language, memory, executive function, and motor function. A principal component analysis (PCA) was used to distill our neuropsychological measures into latent components to compare between groups.
Principal component analysis extracted 5 latent components: executive function (F1), verbal semantics (F2), motor (F3), nonverbal cognition/impulsivity (F4), and verbal cognition/attention (F5). The group with FLE differed from the HC group on F1, F2, F4, and F5, and had worse performance than the group with TLE on F1; the group with TLE had lower performance relative to the HC group on F2.
Our findings suggest that, in comparison with neurotypically developing children, children with medically intractable FLE have more widespread neuropsychological impairments than do children with TLE. The differences between the two patient groups were greatest for the factor score most clearly related to executive function. The results provide mixed support for the concept of specificity in neuropsychological dysfunction among different subtypes of localization-related medically intractable childhood epilepsies.
以往研究在确定额叶癫痫（FLE）患儿和颞叶癫痫（TLE）患儿独特的神经心理学缺陷模式方面结果不一。本研究调查了这两种儿童药物难治性局灶性癫痫之间的神经心理学异同。
38名FLE患儿、20名TLE患儿和40名健康儿童（HC）参与了本研究。通过一套全面的标准化测试评估了五个神经心理学领域，包括智力、语言、记忆、执行功能和运动功能。采用主成分分析（PCA）将我们的神经心理学测量指标提炼为潜在成分，以比较不同组之间的差异。
主成分分析提取了5个潜在成分：执行功能（F1）、言语语义（F2）、运动（F3）、非言语认知/冲动性（F4）和言语认知/注意力（F5）。FLE组在F1、F2、F4和F5上与HC组存在差异，且在F1上的表现比TLE组差；TLE组在F2上相对于HC组表现更低。
我们的研究结果表明，与发育正常的儿童相比，药物难治性FLE患儿的神经心理学损伤比TLE患儿更广泛。两组患儿之间的差异在与执行功能最密切相关的因子得分上最为明显。这些结果为儿童药物难治性局灶性癫痫不同亚型神经心理功能障碍特异性的概念提供了混合支持。
