Division of Neuropsychology, Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, United States; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, United States; UT Health Austin Pediatric Neurosciences, Dell Children's Medical Center, Austin, TX, United States.
Division of Neuropsychology, Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, United States; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, United States; UT Health Austin Pediatric Neurosciences, Dell Children's Medical Center, Austin, TX, United States.
Epilepsy Behav. 2021 Feb;115:107681. doi: 10.1016/j.yebeh.2020.107681. Epub 2020 Dec 23.
Youth with temporal lobe epilepsy (TLE) are at increased risk of depressive features and diminished health-related quality of life (HRQOL). To assist in the development of future behavioral interventions for youth with TLE, the current study explored potential pathways by which executive functioning (EF) and depressive features impinge upon HRQOL in the context of psychosocial and seizure-specific factors.
Data included parental ratings on the Behavior Assessment System for Children (BASC-2), Behavior Rating Inventory of Executive Function (BRIEF), and the Quality of Life in Childhood Epilepsy (QOLCE) questionnaires for 82 children (Age = 11.99, SD = 3.80) with TLE. Observed path analysis was used to simultaneously investigate the determinants of HRQOL in pediatric TLE. Indirect effects were evaluated with bootstrap analyses.
Both executive dysfunction and depressive features were negatively linked to child HRQOL, and, furthermore, EF and HRQOL were indirectly connected by depressive features. In addition, depressive features were linked to lower EF, current antiepileptic drug (AED) regimen, and the presence of hippocampal sclerosis. Diminished EF was linked to parental psychiatric history and family stress; EF mediated the relationship of parental psychiatric history and family stress on both depressive features and diminished HRQOL. Finally, a more complicated AED regimen and higher HRQOL were indirectly connected by depressive features.
This study underscores the importance of child depressive features and EF along with environmental and epilepsy-specific factors on HRQOL in pediatric TLE.
患有颞叶癫痫（TLE）的年轻人患抑郁特征和健康相关生活质量（HRQOL）下降的风险增加。为了协助为 TLE 青少年制定未来的行为干预措施，本研究探讨了执行功能（EF）和抑郁特征在心理社会和癫痫特异性因素背景下对 HRQOL 产生影响的潜在途径。
本研究纳入了 82 名 TLE 儿童（年龄=11.99，SD=3.80）的父母在行为评估系统儿童版（BASC-2）、行为评定量表的执行功能（BRIEF）和儿童癫痫生活质量问卷（QOLCE）上的评分数据。采用观察路径分析同时研究儿科 TLE 中 HRQOL 的决定因素。使用自举分析评估间接效应。
执行功能障碍和抑郁特征均与儿童 HRQOL 呈负相关，并且 EF 和 HRQOL 之间通过抑郁特征间接相关。此外，抑郁特征与较低的 EF、当前抗癫痫药物（AED）方案以及海马硬化有关。EF 与父母的精神病史和家庭压力有关；EF 介导了父母的精神病史和家庭压力对抑郁特征和 HRQOL 下降的关系。最后，更复杂的 AED 方案和更高的 HRQOL 之间通过抑郁特征间接相关。
本研究强调了儿童抑郁特征和 EF 以及环境和癫痫特异性因素对儿科 TLE 中 HRQOL 的重要性。
