Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy
Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy
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DOI：
10.1111/epi.13479
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发表时间：
2016-09-01
期刊：
影响因子：
5.6
通讯作者：
Baldeweg, Torsten
中科院分区：
文献类型：
--
作者：
Glennon, Jennifer M.;Weiss-Croft, Louise;Baldeweg, Torsten
目的：在病变局灶性癫痫儿童中，与潜在的脑病理学相比，发作间期癫痫样放电 (IED) 对认知功能障碍的相对影响尚不清楚。 方法：本研究调查了 103 名耐药局灶性癫痫儿童中 IED 与智力功能的关系。在控制病变病理学、癫痫持续时间和药物治疗的影响后，使用分层多元回归分析来确定 IED 特征对智力功能的独立贡献。对一部分参与者的语言和记忆得分以及学术技能进行了探索性分析。 结果：结果显示，简易爆炸装置与智商呈负相关，频繁和双边分布的简易爆炸装置以及睡眠中的放电增强记录了独立的累加效应。左脑简易爆炸装置对语言智力的影响显着，超过了左脑病理学的影响。这些影响延伸到其他认知功能，最显着的是促进睡眠的简易爆炸装置与语言表达和接受能力、阅读、拼写和数字技能的缺陷有关。意义：总体而言，简易爆炸装置对认知的影响与病变影响或药物影响（托吡酯的使用）类似。这项研究证明了简易爆炸装置与认知功能障碍之间的关联，与潜在的局灶性脑病理学无关。
Objectives: The relative contribution of interictal epileptiform discharges (IEDs) to cognitive dysfunction in comparison with the underlying brain pathology is not yet understood in children with lesional focal epilepsy.Methods: The current study investigated the association of IEDs with intellectual functioning in 103 children with medication-resistant focal epilepsy. Hierarchical multiple regression analyses were used to determine the independent contribution of IED features on intellectual functioning, after controlling for effects of lesional pathology, epilepsy duration, and medication. Exploratory analyses were conducted for language and memory scores as well as academic skills available in a subset of participants.Results: The results reveal that IEDs have a negative association with IQ with independent, additive effects documented for frequent and bilaterally distributed IEDs as well as discharge enhancement in sleep. Left-lateralized IEDs had a prominent effect on verbal intelligence, in excess of the influence of left-sided brain pathology. These effects extended to other cognitive functions, most prominently for sleep-enhanced IEDs to be associated with deficits in expressive and receptive language, reading, spelling and numerical skills.Significance: Overall, IED effects on cognition were of a magnitude similar to lesional influences or drug effects (topiramate use). This study demonstrates an association between IEDs and cognitive dysfunction, independent of the underlying focal brain pathology.