School of Psychology, The University of Sydney, 94 - 100 Mallett Street, Camperdown, Sydney, Australia; ARC Centre of Excellence in Cognition and its Disorders, Sydney, Australia.
Murdoch Children's Research Institute, Royal Children's Hospital, 50 Flemington Road, Parkville Melbourne, Australia.
Seizure. 2018 Aug;60:96-104. doi: 10.1016/j.seizure.2018.06.015. Epub 2018 Jun 18.
This study aimed to examine Theory of Mind (ToM) and social competence in children and adolescents with genetic generalised epilepsy (GGE), and explore how they relate to neurocognitive and epilepsy variables.
Twenty-two children and adolescents with GGE (8-16 years old) and 22 typically developing controls completed two behavioural tasks (faux-pas, strange stories) assessing cognitive and affective ToM, and a battery of standardised neuropsychological tests. Parents completed questionnaires assessing ToM and social competence. Neurologists completed the Global Assessment Severity of Epilepsy (GASE) scale to measure of epilepsy severity.
Children and adolescents with GGE were impaired in both cognitive and affective ToM, and had reduced social competence compared to controls, which was not attributable to low intellectual functioning or impaired executive skills (working memory, inhibition). Lower ToM correlated with reduced social competence in children and adolescents with GGE. Clinical variables identified included: (i) higher daily dosage of valproate, which was correlated with reduced affective ToM, (ii) higher daily dosages of ethosuximide and lamotrigine, which were correlated with reduced social competence, and (iii) overall epilepsy severity on the GASE, which was correlated with reduced social competence.
Our study revealed cognitive and affective ToM impairments in children and adolescents with GGE, which correlated with everyday social problems. Moreover, higher dosages of commonly prescribed anti-epileptic drugs and overall epilepsy severity were related to ToM impairments and social competence problems. Although preliminary, these findings provide critical information for detection and screening procedures for social difficulties in children and adolescents with GGE, which are currently lacking.
本研究旨在探讨伴有遗传性全面性癫痫（GGE）的儿童和青少年的心理理论（ToM）和社交能力，并探讨它们与神经认知和癫痫变量的关系。
22 名患有 GGE（8-16 岁）的儿童和青少年和 22 名发育正常的对照组完成了两项行为任务（错误归因、奇怪故事），评估认知和情感 ToM，以及一系列标准化神经心理学测试。父母完成了评估 ToM 和社交能力的问卷。神经科医生完成了全球癫痫严重程度评估（GASE）量表，以衡量癫痫的严重程度。
与对照组相比，患有 GGE 的儿童和青少年在认知和情感 ToM 方面均存在障碍，且社交能力下降，这与智力低下或执行功能障碍（工作记忆、抑制）无关。较低的 ToM 与患有 GGE 的儿童和青少年社交能力下降相关。临床变量包括：（i）丙戊酸的日剂量较高，与情感 ToM 下降相关，（ii）乙琥胺和拉莫三嗪的日剂量较高，与社交能力下降相关，以及（iii）GASE 上的整体癫痫严重程度，与社交能力下降相关。
我们的研究揭示了患有 GGE 的儿童和青少年存在认知和情感 ToM 障碍，这与日常社交问题相关。此外，常用抗癫痫药物的较高剂量和整体癫痫严重程度与 ToM 障碍和社交能力问题相关。尽管这是初步的，但这些发现为缺乏社交困难的 GGE 儿童和青少年的检测和筛查程序提供了重要信息。
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