Varesio Costanza, Zanaboni Martina Paola, Salmin Elisa Carlotta, Totaro Chiara, Totaro Martina, Ballante Elena, Pasca Ludovica, Veggiotti Pierangelo, De Giorgis Valentina
Department of Child Neurology and Psychiatry, IRCCS Mondino Foundation, 27100 Pavia, Italy.
Department of Brain and Behavioral Sciences, University of Pavia, 27100 Pavia, Italy.
Diagnostics (Basel). 2020 Nov 10;10(11):931. doi: 10.3390/diagnostics10110931.
Although specific neuropsychological deficits have been recognized during the active phase of epilepsy with centrotemporal spikes (ECTS), the natural cognitive and neuropsychological history after remission has not been elucidated so far. We evaluated the natural cognitive and neuropsychological outcomes five years after disease remission and investigated possible predictors of long-term outcome among socio-demographic and electro-clinical variables. We performed an observational cross-sectional study. Electro-clinical characteristics during the active phase of epilepsy, as well as antiepileptic treatment and premorbid neurodevelopmental concerns were reviewed for 70 patients. At least five years after epilepsy remission, all patients were contacted, and 46 completed a structured questionnaire about patients' current education and academic skills, general health, and parents' socio-economic status. Among them, 23 patients underwent an ad hoc cognitive and neuropsychological protocol and emotional-behavioral assessment. Chi-square tests and -tests were carried out to define the role of putative predictors of neuropsychological outcomes. Mean cognitive and neuropsychological performances appeared to be overall adequate, except for the dictation. Positive family history for epilepsy ( = 0.01769) and familial socioeconomic status (mother's schooling ( = 0.04169), father's schooling ( = 0.01939), mother's income ( = 0.0262), father's income ( = 0.01331)) were identified as predictors of outcomes. Our data suggest that ECTS with typical electro-clinical features depicts an overall preserved cognitive and neuropsychological long-term outcome. We suggest particular attention should be paid to patients with socio-economic disadvantage and familial history of epilepsy, as they may experience worse neurocognitive post-morbid performances.
尽管在伴有中央颞区棘波的癫痫（ECTS）活动期已认识到特定的神经心理学缺陷，但迄今为止，缓解后的自然认知和神经心理学病史尚未阐明。我们评估了疾病缓解五年后的自然认知和神经心理学结局，并在社会人口统计学和电临床变量中调查了长期结局的可能预测因素。我们进行了一项观察性横断面研究。回顾了70例患者癫痫活动期的电临床特征、抗癫痫治疗以及病前神经发育问题。癫痫缓解至少五年后，联系了所有患者，46例完成了一份关于患者当前教育和学术技能、总体健康状况以及父母社会经济地位的结构化问卷。其中，23例患者接受了专门的认知和神经心理学方案以及情绪行为评估。进行卡方检验和t检验以确定神经心理学结局潜在预测因素的作用。除听写外，平均认知和神经心理学表现总体上似乎是足够的。癫痫的阳性家族史（P = 0.01769）和家族社会经济地位（母亲的受教育程度（P = 0.04169）、父亲的受教育程度（P = 0.01939）、母亲的收入（P = 0.0262）、父亲的收入（P = 0.01331））被确定为结局的预测因素。我们的数据表明，具有典型电临床特征的ECTS描绘了总体上保留的认知和神经心理学长期结局。我们建议应特别关注社会经济处于不利地位且有癫痫家族史的患者，因为他们可能在病后经历更差的神经认知表现。
