Prevalence of Comorbid Psychological Disorders in Pediatric Focal Epilepsy and Neuroanatomical Changes
Abstract number :
3.083
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2025
Submission ID :
527
Source :
www.aesnet.org
Presentation date :
12/8/2025 12:00:00 AM
Published date :
Authors :
Presenting Author: Dana Martino, BS – Boston Children's Hospital
Ryan Ho, BS – Boston Children's Hospital
Simon Warfield, PhD – Boston Children’s Hospital & Harvard Medical School
Alyssa Ailion, PhD – Boston Children's Hospital & Harvard Medical School
Rationale: Children with temporal lobe epilepsy (TLE) exhibit high rates of psychological comorbidities alongside cognitive impairments. Cognition in pediatric TLE has been extensively studied and attributed to neuroanatomical changes induced by epileptic activity. Moreover, the interplay of epilepsy-related brain changes during vulnerable developmental stages increases the risk of psychological disorders in pediatric patients with TLE. This study aims to 1) examine the prevalence of comorbid psychiatric disorders in pediatric TLE in relation to brain volume alterations, and 2) identify seizure-related factors that may exacerbate the risk of comorbid disorders and associated structural changes.
Methods: 41 pre-surgical patients with refractory TLE underwent Neuropsychological Assessment at Boston Children’s Hospital. Patients completed age-appropriate intelligence assessments in addition to measures of adaptive, memory, and executive functioning. The manifestation of psychological disorders was identified based on parent reports on the Behavior Assessment System for Children (BASC). Whole brain T1-weighted images were acquired for each patient and regional brain volumes were extracted using FreeSurfer. Correlations were computed between demographic factors, anxiety and depression scores, neuropsychological performance, and brain volumes.
Results: Patients who were at risk (n=4; 10%) or clinically significant (n=3; 7%) for depression were more likely to have a parent with a history of depression (r=.362, p=.020) and had higher anti-epileptic drug intake (r=.311, p=.048). Additionally, these patients displayed lower full scale (r=-.331, p=.037), verbal (r=-.310, p=.048), and perceptual/fluid reasoning (r=-.407, p=.015) IQ and performed worse on adaptive measures (r=-.535, p=.005). Patients who were at risk or clinically significant for anxiety based on BASC reports had lower total cortical gray matter (r=-.316, p=.044) and lower right superior frontal volumes. Hippocampal volume was a significant factor influencing intelligence and memory in which increased volume in the right hippocampus was associated with higher FSIQ (r=.316, p=.047), VIQ scores (r=.401, p=.009) and better performance on immediate (r=.374, p=.038) and delayed (r=.395, r=.028) story recall.
Conclusions: Reduced cortical gray matter was associated with anxiety in patients with TLE, while depression was influenced by both biological and familial factors. Both conditions were linked to lower cognitive and adaptive functioning. The underlying mechanism remains unclear, thus, the relationship between epilepsy and psychological comorbidities may be best characterized as bidirectional. These findings underscore the need for early screening and intervention to mitigate the effect of untreated psychological disorders which may exacerbate cognitive deficits and negatively impact quality of life in patients with TLE.
Funding: none
Behavior