Neuropsychological profile in new-onset benign epilepsy with centrotemporal spikes (BECTS): Focusing on executive functions |
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| Affiliation: | 1. Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, via Altura 3, 40139 Bologna, Italy;2. Health Medical Centre, via della Chiusetta 14, 17021 Alassio, Italy;3. DISFOR Psychology, University of Genoa, Polo M.T. Bozzo, vico S. Antonio 5/7, 16121 Genova, Italy;1. Owensboro Medical Health System Neurology, USA;2. Department of Neurology, Vanderbilt University, Nashville, TN, USA;3. Hamad Medical Corporation, Doha, Qatar;1. Department of Psychology, Hospital for Sick Children, 555 University Ave., Toronto, ON M5G 1X8, Canada;2. Department of Psychology, York University, 4700 Keele St., Toronto, ON M3J 1P3, Canada;3. Department of Psychology, University of Toronto, 3359 Mississauga Rd., Mississauga, ON L5L 1C6, Canada;1. Epilepsy Unit, Pitié-Salpêtrière Hospital, APHP, Paris, France;2. Brain and Spine Institute, (Centre de Recherche de l''Institut du Cerveau et de la Moelle Epinière, ICM), Paris, France;3. Rothschild Foundation, Paris, France;4. Affiliated Teaching Hospital of Tsinghua University, Beijing, China;5. Psitec Laboratory (EA 4072), University of Lille, France;1. Cincinnati Children''s Hospital Medical Center, University of Cincinnati, USA;2. Children''s Health Care of Atlanta, Emory University School of Medicine, USA;3. Indiana University School of Medicine, USA;4. Case Western Reserve University, USA;5. Indiana University School of Nursing, USA;1. Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil;2. Department of Human Development and Rehabilitation, University of Campinas (UNICAMP), Campinas, Brazil;3. Department of Physiotherapy, Communication Science & Disorders, University of São Paulo (USP), São Paulo, Brazil |
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| Abstract: | PurposeIncreased evidence of subnormal neuropsychological functioning in new-onset childhood epilepsy has been obtained, although results are still rare and controversial. With a prospective study, we aimed to define the very early neuropsychological profile of children with benign epilepsy with centrotemporal spikes (BECTS), including executive functions (EF) because of their key role in learning. Additionally, we enrolled drug-naïve children, with a NREM sleep frequency of discharges < 85% and with a Performance Intelligence Quotient equal or superior to 85, in order to exclude additional effects on the neuropsychological functioning.MethodsFifteen school-aged children with BECTS (mean age: 8.8 years, standard deviation [SD]: 2.4 years) and fifteen healthy children (mean age: 9.2 years, [SD]: 2.5 years) were enrolled and assessed with a comprehensive neuropsychological battery. The assessment included domain-specific standardized tests of language, EF, academic skills, visuomotor and visuospatial skills, and short-term memory. A p-value < 0.05 was considered significant.ResultsSignificant differences between patients and controls emerged with respect to 3 domains. Language was affected in color naming (p = .026), spoonerism (p = .003), and phonemic synthesis (p = .009). Executive functions appeared inadequate in the five point test with respect to the number of correct figures (p = .003) and errors (p = .008). In the domain of academic skills, significant differences between groups emerged regarding the number of mistakes in nonword writing (p = .001), nonword reading speed (p = .027), nonword reading number of mistakes (p = .019), and word reading errors (p = .023).DiscussionResults showed that children with new-onset BECTS may demonstrate a range of neuropsychological dysfunctions, particularly affecting executive attention, despite a normal IQ, a low frequency of NREM sleep discharges, and the absence of drugs. These difficulties indicate a frontal dysfunction with cascading effects on language and academic skills. The inclusion of EF in the assessment battery and in the intervention since the very onset is warranted in order to avoid further and persistent academic difficulties. |
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