Guerra Amanda, Fliss Rafika, Campiglia Mélodie, Remaud Julie, Cadeau Olivier, Seegmuller Caroline, Boulay Clotilde, Gauer Lucas, Van Bogaert Patrick, de Grissac-Moriez Nathalie, Paola Valenti Hirsch Maria, Kuchenbuch Mathieu, Roulin Jean-Luc, Fournet Nathalie, Le Gall Didier, Roy Arnaud
Univ Angers, Nantes Université, LPPL, SFR CONFLUENCES, Angers, France; Santos Dumont Institute (ISD), Macaíba, Brasil.
Les Capucins, Centre de Réadaptation spécialisée adultes et enfants, Soins de Longue Durée, F-49000 Angers, France.
Epilepsy Behav. 2024 Dec;161:110124. doi: 10.1016/j.yebeh.2024.110124. Epub 2024 Nov 15.
Children with focal epilepsy often present with executive functions (EFs) deficits. EFs deficits can contribute to adaptive challenges and have a negative impact on academic achievement. The purpose of this study was to investigate the EFs profiles of children diagnosed with frontal lobe epilepsy or temporal lobe epilepsy. Also, we aimed to examine the impact of medical and sociodemographic features on executive functioning and to compare the results of performance-based tests and ratings measures.
EFs were assessed using performance based-tests and rating scales. The Child Executive Functions Battery (CEF-B) and the Behavior Rating Inventory of Executive Function (BRIEF) for parents and teachers were used.
Fifty children aged 6-16 years participated in the study, 28 diagnosed with frontal lobe epilepsy and 22 diagnosed with temporal lobe epilepsy. Results showed that approximately 30 % of both groups of epilepsy patients had significant deficits in EFs compared to normative data. Deficits were observed across various domains of EFs (inhibition, working memory, flexibility and planning). Most patients exhibited deficits in one or two of the 4 domains. Worse executive performances were significantly associated with older age at assessment time, longer duration of epilepsy, higher seizure frequency, earlier age at onset and higher number of anti-seizure medication. Additionally, correlation and congruence analyses showed significant discrepancies between the performance-based and rating measures of executive functioning.
Our findings provide substantial evidence of significant executive deficits in children with FLE and TLE and support the clinical validity of the CEF-B battery in this population. The low level of agreement between performance tests and daily life questionnaires suggests that the two methods are complementary for understanding children's executive functioning. Comprehensive assessment and targeted interventions to address EFs difficulties are recommended for this particular population.
局灶性癫痫患儿常伴有执行功能（EFs）缺陷。执行功能缺陷会导致适应性挑战，并对学业成绩产生负面影响。本研究旨在调查被诊断为额叶癫痫或颞叶癫痫患儿的执行功能概况。此外，我们旨在研究医学和社会人口学特征对执行功能的影响，并比较基于表现的测试结果和评定量表。
使用基于表现的测试和评定量表评估执行功能。采用儿童执行功能成套测验（CEF-B）以及针对家长和教师的执行功能行为评定量表（BRIEF）。
50名6至16岁儿童参与了本研究，其中28名被诊断为额叶癫痫，22名被诊断为颞叶癫痫。结果显示，与常模数据相比，两组癫痫患儿中约30%在执行功能方面存在显著缺陷。在执行功能的各个领域（抑制、工作记忆、灵活性和计划）均观察到缺陷。大多数患者在4个领域中的一两个领域表现出缺陷。更差的执行表现与评估时年龄较大、癫痫持续时间较长、发作频率较高、发病年龄较早以及抗癫痫药物数量较多显著相关。此外，相关性和一致性分析表明，基于表现的执行功能测试与评定量表之间存在显著差异。
我们的研究结果提供了大量证据，证明额叶癫痫和颞叶癫痫患儿存在显著的执行功能缺陷，并支持CEF-B成套测验在该人群中的临床有效性。表现测试与日常生活问卷之间的一致性较低，这表明这两种方法在理解儿童执行功能方面具有互补性。建议对这一特定人群进行全面评估和针对性干预，以解决执行功能方面的困难。
