Executive functioning phenotypes in youth with epilepsy
Executive functioning phenotypes in youth with epilepsy
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DOI：
10.1016/j.yebeh.2018.11.026
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发表时间：
2019-01-01
影响因子：
2.6
通讯作者：
Mara, Constance A.
中科院分区：
文献类型：
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作者：
Modi, Avani C.;Gutierrez-Colina, Ana M.;Mara, Constance A.
目的：本研究的目的是确定青年癫痫患者的执行功能（El）表型，并检查表型是否在心理社会和医疗结果上存在差异（即，在过去的三个月内癫痫发作的存在/不存在），健康相关的生活质量（HRQOL），和情绪和行为functioning.Methods：青年5-18岁的诊断癫痫和照顾者完成了一系列的问卷调查的一部分，一个更大的国家验证的儿科生活质量（PedsQL）癫痫模块。兴趣的主要措施是执行功能的行为评定量表-父母表。还收集了病历审查和人口统计学数据。用潜在类别分析来鉴定EF表型。卡方和协方差分析（ANCOVA）进行检查EF表型组癫痫发作的结果，HRQOL，行为和情绪functioning.Results的差异：二百三十七名儿童癫痫（M-年龄= 11.2岁，56%的女性，60%白色：非西班牙裔，55%的经历癫痫发作在过去的三个月）和他们的照顾者参加。确定了四种EF表型：第1组-无EF缺陷（45%的样品），第2组-整体EF缺陷（29%的样品），第3组-行为调节+工作记忆缺陷（8%的样品），和第4组-元认知缺陷（17%的样品）。癫痫发作特征无显著EF表型组间差异。ANCOVA表明EF表型组在HRQOL方面存在显著差异（父母报告的影响、认知、睡眠、EF和情绪/行为子量表以及儿童报告的认知、睡眠、EF和情绪/行为子量表; ps < .001）和情绪和行为功能（外化、内化和行为症状指数; ps < .001），其中整体EF缺陷组（第2组）和行为调节+工作记忆缺陷组（第3组）表现出最大程度的损害。EF的表型变异与患者报告的结果显著相关。针对EF缺陷的干预措施需要针对儿童的特定EF表型进行个体化，以实现最佳结果。(C)2018爱思唯尔公司All rights reserved.
Objective: The objectives of this study were to identify executive functioning (El) phenotypes in youth with epilepsy and to examine whether phenotypes differ on psychosocial and medical outcomes (i.e., absence/presence of seizures in the past three months), health-related quality of life (HRQOL), and emotional and behavioral functioning.Methods: Youth 5-18 years with diagnosed epilepsy and caregivers completed a battery of questionnaires as part of a larger national validation of the Pediatric Quality of Life (PedsQL) Epilepsy Module. The primary measure of interest was the Behavior Rating Inventory of Executive Function-Parent Form. Medical chart reviews and demographic data were also collected. Latent class analysis was used to identify EF phenotypes. Chi-square and analyses of covariance (ANCOVA) were conducted to examine EF phenotype group differences on seizure outcomes, HRQOL, and behavioral and emotional functioning.Results: Two-hundred and thirty-seven children with epilepsy (M-age = 11.2 years; 56% female; 60% White: Non-Hispanic; 55% experienced seizures in the past three months) and their caregivers participated. Four EF phenotypes were identified: Group 1 - No EF deficits (45% of sample), Group 2 - Global EF deficits (29% of sample), Group 3 - Behavioral Regulation + Working Memory deficits (8% of sample), and Group 4 - Metacognitive deficits (17% of sample). No significant EF phenotype group differences were found for seizure characteristics. The ANCOVAs indicated significant EF phenotype group differences on HRQOL (parent-reported Impact, Cognitive, Sleep, EF, and Mood/Behavior and child-reported Cognitive, Sleep, EF, and Mood/Behavior subscales; ps < .001) and emotional and behavioral functioning (Externalizing, Internalizing, and Behavioral Symptom Index; ps < .001), with the Global EF deficits (Group 2) and Behavioral Regulation + Working Memory deficits groups (Group 3) demonstrating the greatest level of impairment.Conclusion: Phenotypic variability in EF is significantly related to patient-reported outcomes.Interventions addressing EF deficits need to be individualized to a child's particular EF phenotype to achieve optimal outcomes. (C) 2018 Elsevier Inc. All rights reserved.