Department of Developmental Psychology and Socialization, University of Padova, 35100Padova, Italy.
Paediatric Neurology and Neurophysiology Unit, Department of Women's and Children's Health, University Hospital of Padova, 35100Padova, Italy.
J Int Neuropsychol Soc. 2021 Aug;27(7):673-685. doi: 10.1017/S1355617720001125. Epub 2020 Nov 13.
Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time.
Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6-16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models.
We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies.
This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.
癫痫患者存在多种终生问题的风险，神经认知障碍可能是一个重要影响因素。我们评估了三类主要癫痫患者的神经认知功能。此外，我们还分析了神经认知特征随时间的纵向演变。
我们回顾性地确定了 2012 年至 2018 年在我科接受神经心理评估的患者。我们选择了年龄在 6-16 岁之间且至少接受过两次评估的患者。考虑了三种癫痫类型：局灶性/结构性、局灶性自限性和特发性全面性。每次评估均包括对主要神经认知领域的相同结构化评估。在多层次模型中计算了癫痫类型、疾病持续时间、发作状态和药物的影响。
我们确定了 103 名患者（局灶性自限性=27；局灶性/结构性=51；特发性全面性=25），共 233 次评估。注意力和执行功能障碍报告的比例最高（>30%的患者）；将结果二值化以获得整体指数。多层次模型显示，癫痫类型对整体执行指数和疾病持续时间对整体注意力指数有统计学意义的趋势。疾病持续时间预测了执行和注意力任务的分数，而癫痫类型和药物预测了执行任务的表现。局灶性/结构性癫痫主要影响执行域，且缺陷随时间推移而持续存在。相比之下，在所有癫痫中都记录到了疾病持续时间对注意力的改善作用。
本研究提供了有关时间内缺陷演变、癫痫类型的作用以及对高阶认知技能的可能心理影响的信息，这些技能在多种社交和学术问题中至关重要。
