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良性儿童期癫痫伴中央颞区棘波的自闭症谱系障碍和注意缺陷/多动障碍相关症状:一项前瞻性病例对照研究。

Autism spectrum disorder and attention-deficit/hyperactivity disorder-related symptoms in benign childhood epilepsy with centrotemporal spikes: A prospective case-control study.

机构信息

Division of Pediatric Neurology, Department of Pediatrics, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.

Department of Child and Adolescent Psychiatry, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Istanbul, Turkey.

出版信息

Epilepsy Behav. 2019 Jun;95:61-64. doi: 10.1016/j.yebeh.2019.03.044. Epub 2019 Apr 23.

Abstract

BACKGROUND

Benign childhood epilepsy with centrotemporal spikes (BECTS), one of the most common idiopathic epilepsy syndromes in children, has been associated with neuropsychological problems.

PURPOSE

The objective of this study was to investigate the frequency of symptoms related to comorbid neurodevelopmental disorders, the autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD) in children with typical BECTS, and to identify corresponding risk factors.

METHODS

Children and adolescents with typical BECTS aged 6-16 years were included in the study period from January 1, 2017, to December 31, 2017. Children with atypical presentations of BECTS, other neurological disorders, and preexisting neuropsychiatric disorders were excluded. The ASD and ADHD were assessed by the Social Communication Questionnaire (SCQ) and the Turgay Diagnostic and Statistical Manual of Mental Disorders - 4th Edition - Disruptive Behavior Disorders Rating Scale (T-DSM-IV-S), respectively. Patients' scores were compared with those of healthy subjects. Correlation analyses were performed to evaluate the association between the age at seizure onset, the total number of seizures and the SCQ and T-DSM-IV-S scores.

RESULTS

Fifty-eight children with BECTS and 60 healthy children participated in the study. The total SCQ score, the SCQ reciprocal social interaction score, and the SCQ communication score significantly differed between children with BECTS and the control group (p = 0.001, p < 0.001, p = 0.001, respectively). The total ADHD score was significantly different between patients and controls (p < 0.001). A significant difference was observed between patients and controls in terms of the T-DSM-IV-S hyperactivity-impulsivity score and the T-DSM-IV-S inattention score (p = 0.012, p < 0.001, respectively). The age at seizure onset was significantly correlated with the total SCQ score (p = 0.03). The Spearman's correlation coefficient was 0.352 for the total SCQ score, indicating a positive association between the age at seizure onset and the total SCQ score.

CONCLUSION

Children with typical BECTS may have an increased risk of suffering from symptoms of ASD and ADHD. Children with late onset of seizures may be more likely to develop neuropsychological disturbances regarding ASD and ADHD.

摘要

背景

良性儿童期癫痫伴中央颞区棘波(BECTS)是儿童中最常见的特发性癫痫综合征之一,与神经心理学问题有关。

目的

本研究旨在调查伴有神经发育障碍、自闭症谱系障碍(ASD)和注意缺陷/多动障碍(ADHD)的典型 BECTS 患儿的症状频率,并确定相应的危险因素。

方法

纳入 2017 年 1 月 1 日至 2017 年 12 月 31 日期间年龄在 6-16 岁的典型 BECTS 患儿。排除具有非典型 BECTS 表现、其他神经障碍和先前存在神经精神障碍的患儿。ASD 和 ADHD 通过社会沟通问卷(SCQ)和 Turgay 诊断和统计手册-第四版-破坏性行为障碍评定量表(T-DSM-IV-S)进行评估。将患者的评分与健康受试者的评分进行比较。进行相关分析以评估发病年龄、总发作次数与 SCQ 和 T-DSM-IV-S 评分之间的相关性。

结果

58 例 BECTS 患儿和 60 例健康儿童参加了研究。BECTS 患儿与对照组相比,SCQ 总分、SCQ 互惠社会互动评分和 SCQ 沟通评分差异有统计学意义(p=0.001,p<0.001,p=0.001)。患者与对照组的 ADHD 总分差异有统计学意义(p<0.001)。患者与对照组在 T-DSM-IV-S 多动-冲动评分和 T-DSM-IV-S 注意力不集中评分方面差异有统计学意义(p=0.012,p<0.001)。发病年龄与 SCQ 总分呈显著正相关(p=0.03)。Spearman 相关系数为 0.352,表明发病年龄与 SCQ 总分呈正相关。

结论

典型 BECTS 患儿可能有患 ASD 和 ADHD 症状的风险增加。发病年龄晚的患儿可能更容易出现 ASD 和 ADHD 相关的神经心理障碍。

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