Abstracts

Rationale: It is well known that children with epilepsy experience neuropsychological deficits. However, the severity of cognitive impairments may vary even in a particular epilepsy syndrome. One possible way to describe the extension of cognitive impairment is by creating a composite score based on several cognitive tests designed to measure different cognitive domains. We aimed to create a composite score and test whether it can differentiate a group of children with epilepsy from healthy controls. Methods: Forty children with focal TLE (47.5% boys; mean age: 12.00 [SD:2.25]; mean schooling duration: 5.33 [SD:1.98], and mean estimated IQ: 97.44 [SD:13.34]) and 28 healthy children controls (32.1% boys; mean age: 11.96 [SD:2.30]; mean schooling duration: 5.96 [SD: 2.37], and mean estimated IQ: 109.42 [SD:14.34]) were submitted to a comprehensive neuropsychological battery with tests of Attention, Executive Functions, Memory and Learning, and Language. Raw scores of cognitive tests were Z scored and then were converted to a Global Deficit Scale (GDS), which simulates clinicians’ ratings by quantifying the number and degree of impaired performances throughout the test battery while attaching relatively less significance to superior performances and those within normal limits. Receiver-operating characteristic (ROC) curves were then generated to determine whether the GDS could adequately differentiate patients from controls. Results: Patients had a worse performance than controls in Trail Making B errors (p=0.026); Wisconsin Card Sorting Test (p=0.044); Verbal Fluency foods (p=0.079); Vocabulary (p=0.095); Sentence Memory (p=0.003); Number Letter (p=0.077) and delayed recall of Visual Learning (p=0.075). The mean GDS of patients was 0.17 [SD:0.19] and of controls was 0.09 [SD:0.17]. Statistical analysis revealed that GDS score could adequately discriminate children with TLE from controls (AUC=0.65, p=0.039). Conclusions: The Global Deficit Scale was efficient to discriminate children with TLE from healthy controls even though the score revealed a mild overall cognitive deficit in children with TLE. Composites scores can be used to describe a general cognitive profile of a specific group of patients with epilepsy. Moreover, this measure can also be used as an endpoint to investigate the effects of a particular intervention into the cognitive functioning of these children. Further studies are needed to test whether this composite score can be used in children with other types of epilepsy besides the TLE. Funding: No funding