Abstracts

Rationale: Benign Epilepsy of Childhood with Centrotemporal Spikes (BECTS) is the most common focal epilepsy of childhood. Children and adolescents with BECTS have impairments in different areas of executive function (EF). Executive deficits are also described in Attention Deficit Hyperactivity Disorder (ADHD)described. ADHD is the most common psychiatric comorbidity in BECTS, mainly the inattentive type. However, the presence of ADHD and its cognitive impairments is not usually considered in studies that addressed the EF of children and adolescents with BECTS. Therefore, it is not possible to describe whether the deficits commonly described in patients with BECTS are related to epilepsy itself, the psychiatric comorbidity or both. In this context, the objective of this study was to evaluate the EF in patients with BECTS with and without ADHD. Methods: We prospectively evaluated 23 patients with BECTS and 20 healthy controls. We categorized patients with BECTS into groups: Group I - BECTS with ADHD (12 patients) and Group II - BECTS without ADHD (11 patients). There was no difference in the gender, age, schooling, school type and estimated IQ (Table 1).Exclusion criteria for patients and controls were as follows: an estimated IQ All participants with BECTS underwent a clinical and electroencephalographic evaluation by an epileptologist. The same child psychiatrist applied Kiddie-SADS-PL. All participants underwent a neuropsychological assessment with a comprehensive battery for executive functions.Statistical Analysis: We used t-test and chi-square test for differences in demographic aspects (age, gender, and education) and estimated IQ. To compare the performance in the neuropsychological test, we used t-test (parametric variables) and the Mann-Whitney test (nonparametric variables ). As for comparisons of three groups: we used the Kruskal-Wallis test used (nonparametric variables) and ANOVA (parametric variables). Results: Patients with BECTS and ADHD had worse scores than controls in persevering errors in WCST [p = 0.003], non-persevering errors in WCST [p = 0.018] and total phonemic verbal fluency (FAS) [p = 0.031]. Patients with BECTS without ADHD had worse performance than controls in non-perseverative errors in WCST [p = 0.003]. Patients with BECTS and ADHD had worse performance than those without ADHD in total FAS [p = 0.031] (Graph 1). Conclusions: We conclude that the presence of ADHD was a relevant factor for the profile and severity of executive and attentional impairments in BECTS. There was a distinct pattern of executive functioning for patients with BECTS and ADHD, with worse performance than controls and patients without ADHD. In this scenario, the authors postulate that we should consider this psychiatric comorbidity in the clinical and neuropsychological assessment of these patients. Funding: This work was supported by FAPESP - Foundation for the Support of Research in the State of Sao Paulo (grant number 2015/02796-2). Dr. Valente is also supported by CNPq - National Council for Scientific and Technological Development (grant number 308968/2015-8).