Department of Neurology, Capital Institute of Pediatrics, Beijing 100020, China.
National Key Laboratory of Cognitive Neuroscience and Learning, Institute of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100020, China.
Chin Med J (Engl). 2020 Jul 20;133(14):1649-1654. doi: 10.1097/CM9.0000000000000925.
Benign epilepsy with centrotemporal spikes (BECTS) is the most common type of childhood idiopathic focal epilepsy. BECTS is associated with pervasive cognitive deficits and behavior problems. While seizures can be easily controlled, it is crucial to select anti-epileptic drugs that do not impair cognition, do not cause psychosocial effects, and improve the quality of life. Previous studies showed effects of oxcarbazepine (OXC) monotherapy on the cognitive and psychosocial profiles of patients with BECTS. Here, we studied the effects of OXC monotherapy on the neuropsychologic profiles and quality of life in patients with BECTS in China.
Thirty-one patients aged 6 to 12 years newly diagnosed with BECTS were recruited. A psychometric assessment was performed before and during the follow-up of OXC monotherapy with Cognitive Computerized Task Battery, Depression Self-Rating Scale for children, Screen for Child Anxiety Related Emotional Disorders, and Quality of Life in Epilepsy-31 (QOLIE-31). The results of the assessments were compared to explore the effect of OXC monotherapy in patients with BECTS.
Thirty children with BECTS completed the study. Five of ten cognitive test scores improved after treatment via OXC monotherapy, including visual tracing (F = 14.480, P < 0.001), paired associated learning (language) (F = 6.292, P < 0.001), paired associated learning (number) (F = 9.721, P < 0.05), word semantic (F = 6.003, P < 0.05), and simple subtraction (F = 6.229, P < 0.05). Of the neuropsychology data concerning the quality of life, statistically significant improvements were observed in emotion (F = 4.946, P < 0.05), QOLIE-social (F = 5.912, P < 0.05), and QOLIE-total (F = 14.161, P < 0.001).
OXC is safe and does not impair neuropsychologic functions, with no obvious mood burden on children with BECTS. Most importantly, OXC has positive impacts on children's perception of quality of life, especially in terms of happiness and life satisfaction.
良性癫痫伴中央颞区棘波（BECTS）是儿童特发性局灶性癫痫中最常见的类型。BECTS 与广泛的认知缺陷和行为问题有关。虽然癫痫发作很容易控制，但选择不损害认知、不引起心理社会影响、提高生活质量的抗癫痫药物至关重要。先前的研究表明奥卡西平（OXC）单药治疗对 BECTS 患者的认知和心理社会特征有影响。在这里，我们研究了 OXC 单药治疗在中国 BECTS 患者的神经心理特征和生活质量的影响。
招募了 31 名新诊断为 BECTS 的 6 至 12 岁儿童。在 OXC 单药治疗期间和随访期间，使用认知计算机化任务电池、儿童抑郁自评量表、儿童焦虑相关情绪障碍筛查和癫痫患者生活质量 31 项（QOLIE-31）进行心理计量评估。比较评估结果，探讨 OXC 单药治疗对 BECTS 患者的影响。
30 名 BECTS 患儿完成了研究。10 项认知测试中有 5 项在接受 OXC 单药治疗后有所改善，包括视觉追踪（F=14.480，P<0.001）、配对联想学习（语言）（F=6.292，P<0.001）、配对联想学习（数字）（F=9.721，P<0.05）、词语语义（F=6.003，P<0.05）和简单减法（F=6.229，P<0.05）。在与生活质量相关的神经心理学数据中，情绪（F=4.946，P<0.05）、QOLIE-社会（F=5.912，P<0.05）和 QOLIE-总（F=14.161，P<0.001）均有统计学显著改善。
OXC 是安全的，不会损害神经心理功能，对 BECTS 患儿没有明显的情绪负担。最重要的是，OXC 对儿童对生活质量的感知有积极的影响，特别是在幸福感和生活满意度方面。
