Authors :
Presenting Author: Schraegle William, PhD – Dell Medical School at The University of Texas at Austin
Thomas Tran, BS – The University of Texas at Austin; Elice Shin, BS – The University of Texas at Austin; Sonya Swami, High School Diploma – The University of Texas at Austin; Bruce Hermann, PhD – University of Wisconsin School of Medicine and Public Health; Rosario DeLeon, PhD – Dell Medical School at The University of Texas at Austin; Nancy Nussbaum, PhD – Dell Medical School at The University of Texas at Austin
Rationale:
To characterize the presence and nature of discrete behavioral phenotypes and their correlates in a cohort of youth with frontal lobe epilepsy (FLE).Methods:
Data included parental ratings on the Behavior Assessment System for Children (BASC-2, n=29; & BASC-3, n=23) for 52 children (Age = 12.87, SD = 3.87) with FLE. The nine clinical subscales were subjected to hierarchical clustering analysis to identify behavioral subgroups. Further examination of subgroup differences among demographics (age, gender, handedness, and minority status), seizure characteristics (age of onset, seizure frequency, current ASMs, seizure laterality, MRI abnormality, and referral type), functional status (history of developmental delay and parent-rated sleep concerns), psychosocial factors (maternal and paternal education, neighborhood disadvantage, family stress, and parental psychiatric history), neuropsychological performance, and both parent-rated executive functions and health-related quality of life (HRQOL) was conducted.
Results:
Hierarchical clustering identified three behavioral phenotypes, which included no behavioral concerns (Cluster 1, 31% of sample), atypicality and attention problems (Cluster 2, 50% of sample), and generalized behavioral problems (Cluster 3, 19% of sample). Behavioral phenotypes were characterized by important differences across clinical seizure variables, psychosocial/familial factors, everyday executive functioning, and HRQOL. Cluster 3 was associated with younger age of epilepsy onset, greater seizure frequency, higher proportion of developmental delay, higher rate of prescribed attention medications, poorer sleep quality as rated by caregivers, greater family stress, family history of learning disabilities, greater parent-rated executive dysfunction, and worse HRQOL. Cluster 2 demonstrated lower age of seizure onset, greater seizure frequency, and worse executive and HRQOL outcome as compared to Cluster 1. Cluster groups did not differ across cognitive variables or seizure laterality (i.e., left, right, bilateral). Conclusions:
Youth with FLE present with three distinct behavioral phenotypes that correspond to important clinical and sociodemographic markers and point to the contributions of disease (i.e., age of seizure onset and seizure frequency), functional status (i.e., delayed milestones and sleep concerns), and psychosocial factors (i.e., family stress, family history of learning disability). The current findings demonstrate the variability of behavioral presentations in youth with FLE and provide a preliminary framework for providing tailored psychotherapeutic interventions to support youth with FLE and their families. Funding: None