Children with new-onset epilepsy: neuropsychological status and brain structure
Children with new-onset epilepsy: neuropsychological status and brain structure
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DOI：
10.1093/brain/awl196
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发表时间：
2006-10-01
期刊：
影响因子：
14.5
通讯作者：
Seidenberg, Michael
中科院分区：
文献类型：
--
作者：
Hermann, Bruce;Jones, Jana;Seidenberg, Michael
据报道，慢性癫痫儿童的认知、学习成绩和脑容量下降。这些问题在癫痫发作时可能存在的性质和程度，或者随着时间的推移可能变得更加明显，仍有待确定。本研究的特点是神经心理状态，脑结构和它们之间的相互关系，在儿童与健康对照组相比，最近发作的癫痫。儿童（年龄：8-18岁）和健康对照组（n = 50）进行了全面的神经心理学评估和全大脑和脑叶区域的分段（灰色和白色物质）体积的定量体积测量。与对照组相比，近期发作癫痫的儿童表现出轻度弥漫性认知障碍的模式，无论癫痫综合征，以及学业成绩不佳，在一个子集的儿童早于第一次公认的癫痫发作。在全脑或脑叶组织体积的MR形态测量分析中没有总体差异。对照组显示认知发育与脑组织体积（尤其是白色物质体积）增加之间存在强相关性，而癫痫儿童中不存在这种相关性。有学习成绩问题史的儿童表现出最异常的认知功能，左枕叶和顶叶灰质体积显著减少。特发性癫痫患者在疾病发作时表现出认知功能障碍和学业成绩不良，与癫痫综合征无关，并且在儿童亚组中存在先前神经认知障碍的指征。体积异常在癫痫组整体上还不明显，但有迹象表明癫痫的结构-功能关系改变，并且有学习问题病史的儿童的子集具有左后半球灰质的异常体积。这些早期异常需要整合到癫痫神经心理学的寿命模型中。
Abnormalities in cognition, academic performance and brain volumetrics have been reported in children with chronic epilepsy. The nature and degree to which these problems may be present at epilepsy onset or may instead become more evident over time remains to be determined. This study characterizes neuropsychological status, brain structure and their interrelationship in children with recent-onset epilepsy compared with healthy controls. Children (age: 8-18 years) with recent-onset idiopathic epilepsy (n = 53) and healthy controls (n = 50) underwent comprehensive neuropsychological assessment and quantitative volumetric measurement of segmented (grey and white matter) volumes of total cerebrum and lobar regions. Compared with controls, children with recent-onset epilepsy exhibit a pattern of mild diffuse cognitive impairment, regardless of epilepsy syndrome, as well as academic underachievement that in a subset of children antedates the first recognized seizure. There are no overall differences in MR morphometric analyses of total cerebral or lobar tissue volumes. Controls show a strong association between cognitive development and increasing cerebral tissue volume (especially white matter volume), an association that is absent in children with epilepsy. Children with a history of academic achievement problems exhibit the most abnormal cognitive function and have significant volumetric reductions in left occipital and parietal lobe grey matter. Patients with idiopathic epilepsy exhibit cognitive dysfunction and academic underachievement at the onset of the disorder, irrespective of epilepsy syndrome, and indications of antecedent neurocognitive impairment are present in a subset of children. Volumetric abnormalities are not yet apparent in the epilepsy group as a whole, but there are indications of an altered structure-function relationship in epilepsy, and the subset of children with prior history of academic problems have abnormal volume of posterior left hemisphere grey matter. These early abnormalities need to be integrated into lifespan models of the neuropsychology of epilepsy.