Department of Psychology, University of Alabama at Birmingham, United States.
Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, United States; Department of Anesthesiology, University of North Carolina, Chapel Hill, United States.
Seizure. 2022 May;98:79-86. doi: 10.1016/j.seizure.2022.03.021. Epub 2022 Mar 30.
To date, laboratory-based experimental behavioral methods have not been used to identify factors associated with pediatric functional seizures (FS), leaving a critical gap for effective treatment development.
Children ages 13-18 with video-EEG-confirmed FS were matched to controls (MCs) based on income, sex, race, and age. A modified Stroop task which included a condition requiring participants to report the ink colors in which seizure symptom words were written (e.g., "shaking" in blue) measured selective attention and cognitive inhibition through response time. The magic and turbulence task assessed sense of control in three conditions (magic, lag, turbulence). Children with FS were asked to report premonitory symptoms predicting FS.
Participants included 26 children with FS and 26 MCs (Mean=15.2, 74% female, 59% white). On Stroop, children with FS had a slower reaction time (Mean=1193.83) than MCs (Mean=949.26, p = 0.022) for seizure symptom words. Children with FS had significantly poorer sense of control in the turbulence condition of the magic and turbulence task (Mean=-3.99, SD=8.83) than MCs (Mean=-11.51, SD=7.87; t(20)=-2.61, p =0.017). Children with FS (Mean=-1.80, SD=6.54) also had significantly poorer sense of control in the magic condition than MCs (Mean=-5.57, SD=6.01; p =0.028). Ninety-eight percent of patients endorsed premonitory symptoms.
Compared with MCs, children with FS have (1) poorer selective attention and cognitive inhibition when presented with seizure-related information and (2) lower sense of control (i.e. poorer awareness that their control was manipulated). Premonitory symptoms were common. Sense of control, selective attention, and inhibition may be novel treatment targets for FS intervention.
迄今为止，基于实验室的实验行为方法尚未用于确定与儿科功能性癫痫发作（FS）相关的因素，这为有效治疗方法的开发留下了一个关键的空白。
根据收入、性别、种族和年龄，将年龄在 13-18 岁之间、经视频脑电图确诊为 FS 的儿童与对照者（MCs）相匹配。一项改良的 Stroop 任务，包括一项要求参与者报告以书写癫痫症状词的颜色的条件（例如，“颤抖”为蓝色），通过反应时间来衡量选择性注意力和认知抑制。魔术和湍流任务评估了在三种条件下（魔术、滞后、湍流）的控制感。要求 FS 患儿报告预测 FS 的前驱症状。
参与者包括 26 名 FS 患儿和 26 名 MCs（Mean=15.2，74%女性，59%白人）。在 Stroop 任务中，FS 患儿对癫痫症状词的反应时间（Mean=1193.83）比 MCs 慢（Mean=949.26，p=0.022）。FS 患儿在魔术和湍流任务的湍流条件下的控制感明显较差（Mean=-3.99，SD=8.83），而 MCs 则较好（Mean=-11.51，SD=7.87；t（20）=-2.61，p=0.017）。FS 患儿（Mean=-1.80，SD=6.54）在魔术条件下的控制感也明显比 MCs 差（Mean=-5.57，SD=6.01；p=0.028）。98%的患者出现前驱症状。
与 MCs 相比，FS 患儿（1）在出现与癫痫发作相关的信息时，选择性注意力和认知抑制能力较差，（2）控制感较差（即对自己的控制被操纵的意识较差）。前驱症状很常见。控制感、选择性注意力和抑制能力可能是 FS 干预的新治疗靶点。
