Association Between Magnetoencephalographic Interictal Epileptiform Discharge and Cognitive Function in Young Children With Typical Development and With Autism Spectrum Disorders

Abstract

Electroencephalograms of individuals with autism spectrum disorders (ASD) show higher rates of interictal epileptiform discharges (IEDs), which are known to have an inverse association with cognitive function in typically developed (TD) children. Nevertheless, that phenomenon has not been investigated adequately in children with ASD. From university and affiliated hospitals, 163 TD children (84 male, 79 female, aged 32–89 months) and 107 children (85 male, 22 female, aged 36–98 months) with ASD without clinical seizure were recruited. We assessed their cognitive function using the Kaufman Assessment Battery for Children (K-ABC) and recorded 10 min of MEG. Original waveforms were visually inspected. Then a linear regression model was applied to evaluate the association between the IED frequency and level of their cognitive function. Significantly higher rates of IEDs were found in the ASD group than in the TD group. In the TD group, we found significant negative correlation between mental processing scale scores (MPS) and the IED frequency. However, for the ASD group, we found significant positive correlation between MPS scores and the IED frequency. In terms of the achievement scale, correlation was not significant in either group. Although we found a correlative rather than a causal effect, typically developed children with higher IED frequency might better be followed up carefully. Furthermore, for children with ASD without clinical seizure, clinicians might consider IEDs as less harmful than those observed in TD children.

Association between Interictal Epileptiform Discharges and Autistic Spectrum Disorder

“…Few studies have analyzed the association between IEDs and ASD. The studies of Tetsu [30] and Milovanovic [75], which do not support an association between ASD and IED, are recent studies that present statistical significance. Few studies have reported clinical relevance [30,75].…”

“…In this way, treatment providers seek to minimize and prevent negative outcomes and to increasingly stimulate these children earlier and to a greater extent because, despite revealing a permanent problem, which is neither linear nor insurmountable, these children are receptive to treatment. Thus, the purpose of ASD treatment is to achieve a good level of social and mental functioning using various approaches, including educational or behavioral, psychotherapeutic, or psychopharmacological therapies [30,31,32,33].…”

“…Tetsu et al [30] did not find a pathogenic relationship between IED and grade 1 ASD in children, suggesting an epiphenomenon or compensatory changes. This finding is very important since it does not associate IED with autism.…”

“…On the one hand, it is necessary to determine the type of discharges that are associated with a cognitive-behavioral deficit, which is associated with ASD. At the same time, clinicians must bear in mind that, at present, there are data that do support the existence of an association between IEDs and ASD or ADI-R domains [75], and these studies label it as an epiphenomenon [30].…”

Exploring the Psychological Risk Factors in Children with Epilepsy

“…A study by Reddy and colleagues (Reddy, Younus, Sridhar & Reddy, 2019) found that epilepsy as one of the most complex brain disorders was associated with spontaneous damage as a result of abnormal electrical discharge in the brain and that about 40% of children diagnosed with epilepsy appear to have lesions that cannot be treated with antiepileptic drugs. In cases when generalized and partialtype epilepsy are associated with symptoms of synaptic failure (Joy & Fields, 2019), neurological damage, or manifestation characterized by a hyperexcitability of indefinite duration (Hirosawa, Kikuchi, Fukai, Hino & Kitamura et al, 2018), it may lead to a clinical manifestation of the chronic stage (Kynast, Lampe, Luck, Frisch & Arelin et al, 2018). According to Reddy the variety of antiepileptic drugs, however, does not help a part of epileptic patients (Izadi, Ondek, Schedlbauer, Keselman, Shahlaie & Gurkoff, 2018) who present a form of epilepsy which fails to be fully traced in its clinical symptomatology based on the type of damage it causes (Reilly, Atkinson, Memon, Jones & Dabydeen et al, 2018) and the area in which it lies in the brain (Jones, Asato, Brown, Doss & Felton et al, 2020;Burke, Naseh, Rodriguez, Burgess & Loewenstein, 2019;Noebels, 2015).…”