Abstracts

Childhood Absence Epilepsy (CAE) is associated with a variety of adverse behavioral and cognitive outcomes, including changes in attention. However, the precise nature of these difficulties is unclear. As part of a large, multi-center trial of CAE we are obtaining behavioral and cognitive measures including baseline examination of intelligence and in particular attention., To date, 153 subjects with newly diagnosed, untreated CAE have been enrolled; 36 subjects were less than 6 years of age, and 117 subjects were 6 years of age or older. All subjects received an age appropriate comprehensive neuropsychological evaluation at baseline, including measurement of I.Q. Testing was administered at each site by a trained psychometrician, and test data was double scored centrally by a psychometrician under supervision of a central Neuropsychologist (DM). Since attention was a critical outcome variable in this study, The Continuous Performance Test (CPT-II) was administered to children age 6 and up (n= 106) and the Kiddie CPT was administered to children age 4 to less than 6 (n=16). We employed the Confidence Index (CI) as the primary outcome measure of attention., The mean full scale IQ scores were 93.1 (sd=13.0) for subjects less than 6 yrs old, and 92.9 (sd= 15.3) for subjects 6 years or older. For the CPT, 28 of 117 subjects 6years of age and older had a CI greater than 60%, with 12 of the subjects having a CI of greater than 90%. For less than 6yrs old, 1 of 16 subjects had a CI of greater than 60%., The results indicate that for children with newly diagnosed and untreated CAE, despite generally average intellectual ability, almost 30% of our baseline sample demonstrate at least concerns regarding attention, and almost 10% demonstrate a strong indication of impairment of attention, as indicated by a CI of greater than 90%. There appears to be a trend towards greater attention difficulties in our older age sample relative to our younger subjects. These data suggest that problems with attention are a potentially serious manifestation of CAE, and may exist independent of more global neurocognitive deficit. It remains to be seen whether these attentional issues are due to the absence seizures themselves and will improve with treatment, or whether they are an integral part of the underlying disorder and will persist despite effective treatment., (Supported by Grants NS 045911 and NS 045803 from NINDS.)