Interictal Discharges Delay Target-directed Eye Movements and Impair Attention in Children with Epilepsy
Abstract number :
2.32
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2022
Submission ID :
2204169
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Nebras Warsi, MD – Hospital for Sick Children; Simeon Wong, MHSc – Hospital for Sick Children; Hrishikesh Suresh, MD – Hospital for Sick Children; Olivia Arski, MSc – Hospital for Sick Children; Han Yan, MD – Hospital for Sick Children; Mark Ebden, DPhil – Hospital for Sick Children; Elizabeth Kerr, PhD – Hospital for Sick Children; Mary Lou Smith, PhD – University of Toronto; Ayako Ochi, MD – Hospital for Sick Children; Hiroshi Otsubo, MD – Hospital for Sick Children; Roy Sharma, RET, REPT – Hospital for Sick Children; Puneet Jain, MD – Hospital for Sick Children; Elizabeth Donner, MD – Hospital for Sick Children; Carter Snead, MD – Hospital for Sick Children; George Ibrahim, MD, PhD – Hospital for Sick Children
Rationale: Attentional disturbances are amongst the most common and debilitating comorbidities affecting children with epilepsy. The theory of transient cognitive impairment posits that lapses in attention result from ephemeral disruption of attentional circuitry by interictal events.1,2 Eye movements are intimately associated with human attention and can be monitored in real-time using eye-tracking technologies. Here, we sought to characterize the associations between interictal discharges (IEDs), gaze, and attentional behaviour in children with epilepsy._x000D_
Methods: Eleven consecutive children undergoing invasive monitoring with stereotactic electrodes for localization-related epilepsy performed an attentional set-shifting task while tandem intracranial electroencephalographic signals and eye-tracking data were recorded. Using an established algorithm, IEDs were detected across all intracranial electrodes on a trial-by-trial basis. Hierarchical mixed-effects modelling was performed to delineate associations between trial reaction time (RT), eye movements, and IEDs.
Results: Hierarchical mixed-effects modelling revealed that both the presence (p=0.008) and frequency (p=0.001) of IEDs were associated with impaired performance on the attentional set-shifting task (Figure 1A). IED occurrence at the time of stimulus presentation was associated with delays in gaze initiation toward the visual targets (Figure 1B,C; p=0.017).
Conclusions: The occurrence of epileptiform activity in close temporal association with stimulus presentation is associated with delays in target-directed gaze and prolonged RT, hallmarks of momentary lapses in attention. These first-in-human findings provide novel insights into the mechanisms of transient lapses of attention and support the use of visual tracking as a correlate of higher-order attentional behaviour in children with epilepsy.
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References:_x000D_
1. Aarts JHP, Binnie CD, Smit AM, Wilkins AJ. Selective cognitive impairment during focal and generalized epileptiform EEG activity. Brain. 1984;107(1):293-308._x000D_
2. Binnie CD. Cognitive impairment during epileptiform discharges: is it ever justifiable to treat the EEG? Lancet Neurol. 2003;2(12):725-730.
Funding: None
Behavior