Abstracts

While the elevated risk for psychopathology in pediatric epilepsy has long been recognized, the relationship between brain function and the risk for psychiatric comorbidity has not been well studied. These initial results are from an ongoing prospective study of different seizure subtypes of well-characterized medically treated pediatric epilepsy patients and matched controls. These children performed a battery of neurocognitive tests, diagnostic psychiatric interviewing, and tasks of cognitive control of behavior using oculomotor tasks., We report results from 12 pairs of pediatric epilepsy patients and age, gender, and IQ matched control subjects. From the 12 pairs studied up to the present, the average age of the children was 11.92 years (SD 3.2), and gender was split evenly between males and females. Mean IQ of the patient group was 96.5 (SD 11.9) and duration of disease was 3.5 years. Epilepsy type in the patient group was classified as complex partial (n=8), primary generalized (n=2), and benign focal epilepsy (n=2) based on EEG data and clinical semiology. All patients except one were being treated with anticonvulsants. Control subjects were free of psychiatric diagnoses, and had no history of neurological or psychiatric disorders.
Participants completed cognitive control oculomotor tasks including a test of sensorimotor control (visually guided saccade task) and a test of response inhibition (antisaccade). Oculomotor tasks are objective, non-verbal measures of executive function which are easily performed by children, and have been successfully used to study cognitive and brain systems in children with typical development and neurodevelopmental disorders. Comprehensive psychiatric assessment including a diagnostic psychiatric interview (KSADs -PL) and the Behavior Rating Inventory of Executive Function (BRIEF)., The rate of psychiatric diagnoses in the epilepsy patient group was elevated at 50% including attention deficit disorder (n=5) and depression (n=1). There were no psychiatric diagnoses in the control population.
Preliminary results of the oculomotor tasks demonstrate that all 24 children performed well on the control task, indicating intact basic sensorimotor function. Children with epilepsy commited more response inhibition errors on the antisaccade task compared to controls (p=0.06), indicating a deficit in response inhibition. Results from the BRIEF, a parent and teacher report of executive functioning indicate a significant correlation between poorer functioning and having psychiatric comorbidity (p[lt]0.001)., As part of an ongoing study to evaluate cognitive processes at risk due to epilepsy mediated effects, these results indicate a neurobiologically linked relationship between executive functioning and psychiatric comorbidity., (Supported by NINDS K23 NS052234.)