Abstracts

Rationale: While the cognitive consequences of epilepsy are increasingly appreciated, the degree to which there are both shared and unique cognitive deficits across epilepsy syndromes remains to be fully understood. In particular, syndrome-specific abnormalities in cognition have rarely been examined in children with new-onset epilepsy an important first step in understanding the cognitive trajectories of childhood epilepsies. To that end, the purpose of the current study was to identify both shared and specific cognitive deficits across diverse childhood epilepsy syndromes. Methods: Research participants included children (ages 8-18) with localization-related (LRE, n=53) and idiopathic generalized (IGE, n=41) epilepsies who were seen and assessed within 12 months of diagnosis. Epilepsy participants had normal neurological examinations, no identifiable lesions as shown by MRI, and no other signs or symptoms indicative of neurological abnormality. Healthy controls (n=72) consisted of age- and gender-matched first-degree cousin controls. All participants completed a neuropsychological test battery assessing intelligence, memory, language, executive function, academic ability, and motor function. Epilepsy participant test scores were age- and gender-corrected and standardized relative to control participants. Cognitive profiles could therefore be derived for both broad syndromic groupings (e.g., LRE, IGE) as well as specific epilepsy syndromes (BECTS, JME). Results: Relative to controls, children with both IGE and LRE exhibited significantly impaired executive and motor function. IGE participants also showed broad deficits in academic ability (arithmetic, reading, spelling). LRE participants showed more widespread deficits across language and memory domains, in addition to lower performance and verbal IQ scores. Figure 1 depicts the performance of IGE participants with juvenile myoclonic epilepsy (JME; n = 26). Specific deficits of this group relative to controls included poorer speeded fine motor dexterity and psychomotor processing (Grooved Pegboard, WAIS-III Digit Symbol-Coding), poorer executive function (Delis-Kaplan Card-Sort Task and Color-Word Interference), and poorer arithmetic processes (WRAT-3 Arithmetic). Figure 2 depicts the performance of LRE participants with benign epilepsy with centrotemporal spikes (BECTS). In addition to showing similar deficits in fine motor dexterity, speeded psychomotor processing and arithmetic, BECTS (n = 22) participants showed specific immediate and delayed recall impairments during a list-learning task (see Figure 2).Conclusions: Children with new and recent onset LRE and IGE exhibit both shared (impaired motor and executive function) and specific (LRE: language and memory impairments; IGE: academic ability impairments) neuropsychological deficits relative to controls. By further parsing the sample into specific syndromes, patterns of shared and specific deficits associated with unique epilepsy syndrome (JME and BECTS) were observed close to the time of diagnosis of epilepsy. How these deficits evolve and change over time remains to be determined.