Disadvantage, Cognition and Cognitive Development in Children with Epilepsy
Abstract number :
2.298
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2021
Submission ID :
1825490
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:44 AM
Authors :
Bruce Hermann, PhD - University of Wisconsin School of Medicine and Public Health; Carson Gundlach, BS - University of Wisconsin-Madison; David Hsu, MD - University of Wisconsin SChool of Medicine and Public Health; Carl Stafstrom, MD, PhD - The Johns Hopkins University School of Medicine; Michael Seidenberg, PhD - Rosalind Franklin University of Medicine and SCience; Jana Jones, PhD - University of Wisconsin SChool of Medicine and Public Health
Rationale: The relationship between socioeconomic disadvantage and the cognitive status of children with epilepsy has not been fully explored. Here we used the Area Deprivation Index [ADI]1 to identify associations between neighborhood socioeconomic disadvantage and baseline cognition and academic problems as well as prospective (2-year) cognitive development in children with new and recent onset idiopathic epilepsies compared to neurotypical youth.
Methods: 182 children with idiopathic new and recent onset epilepsy (mean age=12.2, SD=3.2, 51% female) and 106 neurotypical youth (mean age=12.5, SD=3.0, 53% female) underwent neuropsychological assessment at baseline and two years later. Assessed were intelligence (verbal, nonverbal), language (naming, comprehension), memory (verbal learning and delayed recall), executive function (problem solving, response inhibition, sustained attention) and motor/psychomotor speed. Cognitive performance at baseline and cognitive development over the ensuing two years was examined in relation to the ADI which is an index constructed from 17 area-level US Census indicators of poverty, education, employment, and physical environment. Children whose residence fell in the two most impaired quintiles (high disadvantage) were compared those children who resided in the two least disadvantaged quintiles (low disadvantage).
Results: There was no overall difference in the distribution of disadvantage between the control and epilepsy groups (p=.63). In youth with epilepsy, baseline cognitive performance was significantly poorer in those residing in high disadvantage neighborhoods reflected in significantly lower Performance IQ (p=.021), expressive naming (EVT p=.031, BNT p=.008), phonemic fluency (p=.001), with greater inattention (CPT omission errors p= < .001), slower dominant speeded fine motor dexterity (p=.005), with trends for delayed word list recall (p=.069), verbal category switching (p=.067) and nondominant hand speed (p=.07). In controls the disadvantage-cognition relationship was limited to word list learning (p=.007). Rates of subsequent two-year cognitive development were equivalent in the high and low disadvantaged groups for both youth with epilepsy and controls. Additionally, based on parent report, children from disadvantaged neighborhoods reported more academic difficulties compared to children residing in low disadvantage areas (p=.007).
Conclusions: While there was no overall difference in exposure to disadvantaged neighborhoods between epilepsy and controls groups, disadvantage in youth with new onset epilepsy was associated with greater adverse baseline cognitive (fluid intelligence, language, executive, psychomotor speed) and academic problems. Neighborhood disadvantage did not further impact the rate of cognitive development over the ensuing two-year period. Overall, greater integration of socioeconomic impact on models of the neuropsychology of childhood epilepsy appears warranted.
1. Kind AJ, Buckingham WR. Making Neighborhood-Disadvantage Metrics Accessible - The Neighborhood Atlas. N Engl J Med, 2018, 28;378(26):2456-2458.
Funding: Please list any funding that was received in support of this abstract.: NINDS 2RO1-44351.
Behavior