Abstracts

Damage to the frontal lobes can produce deficits in executive functioning. Epileptic seizure foci, if localized to the frontal lobes, may result in executive functions deficits in individuals with epilepsy. The objective of this study was to examine executive functions as they manifest themselves in the everyday lives of children with epilepsy, comparing frontal versus extra-frontal seizure foci, using the Behavior Rating Inventory of Executive Functions (BRIEF)-Parent Version (Gioia et al., 2000).
29 individuals with seizure foci involving the frontal lobe (11 males/18 females) and 31 individuals with seizure foci not including the frontal lobe (14 males/17 females), aged between 6.9 and 18.8 years old (Mean =13.69, sd=3.3), participated in this study. The frontal and the non-frontal seizure groups were comparable with respect to gender, age, age of seizure onset and proportion of life with epilepsy. Children with either a Verbal or Performance IQ less than 70 were excluded. Site and laterality of seizure origin were determined from the children[apos]s medical records. The BRIEF is a questionnaire completed by parents that contains 86 statements pertaining to 8 areas of executive functioning (Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan and Organize, Organization of Materials and Monitor) in their children[apos]s everyday lives. The children were also administered the phonetic verbal fluency and the Wisconsin Card Sorting tests.
Full Scale IQ was significantly lower for the frontal group than for the non-frontal group (mean of 82 vs 91, respectively, p=.025); therefore IQ was used as a covariate in ANOVAs comparing the groups on the BRIEF scales. Children whose seizures originated from the frontal lobe showed significantly more problematic behaviours on 2 subscales: Initiate (F(1,56)=3.96, p=.05) and Organization of Materials (F(1,56)=4.24, p=.04). Within each group, performance on the fluency and card sorting tests was not significantly correlated with any of the BRIEF scales.
Children with frontal lobe seizures show greater evidence of executive function deficits than children with non-frontal seizure foci, in the areas of initiation (e.g. difficulty generating ideas or responses on their own, needing extensive cueing to get started on tasks) and organization of materials (e.g., orderliness, organizing and keeping track of their possessions). These results are significant because the structured assessment situation often does not allow direct observations of problem-behaviours related to executive functioning in the lives of these children. The BRIEF indexes behaviours not tapped by structured fluency and problem-solving tasks. Parental report using a standardized questionnaire such as the BRIEF is a valuable tool to document the type and severity of executive functions deficits as they manifest in the children[apos]s everyday lives.
[Supported by: Ontario Mental Health Foundation]