Cognitive development in absence epilepsy during long-term follow-up

Abstract

Absence epilepsy (AE) has been associated with lower than average cognitive functioning, which are clinically relevant in some and may predispose to problems later in life. This study aimed to assess cognitive development during long-term follow-up in children with AE. Thirty-one children with AE, who had undergone two neuropsychological assessments between 2010 and 2017 were analyzed retrospectively. Cognitive measurements were 1.7 ± 0.95 years apart. The difference in neurocognitive test scores was assessed on a group level and on an individual level using reliable change methodology. Results show that sustained attention was lower at the first measurement compared to the normative mean. Sustained attention improved during follow-up and 7 out of 14 children showed improvement after correction for practice effects. Receptive vocabulary showed a decline over time, but did not differ from the normative mean. Significant lower mean group scores were present for performance IQ, perceptual organization, processing speed, simple reaction times, and visual motor integration, while being stable over time in the majority of children. Cognitive development was not associated with seizure freedom. Mild-to-severe academic underachievement was present in 65% and comorbidities that might affect learning in 38%. This study in children with AE showed improvement in sustained attention during long-term follow-up while other cognitive weaknesses persisted over time, regardless of seizure freedom.

The interictal activities load and cognitive performance of children with typical absence epilepsy

“…In this study, the high IISL was correlated with cognitive impairment. These results agree with Fonseca et al [29] who found that suppression of interictal epileptiform discharges (IEDs) is associated with improved cognitive functions in children with epilepsy. These results were also consistent with the outcomes of Ung et al [30] who reported that frequent IEDs in more than 10% of the record can impair cognitive performance in children.…”

Executive Functions and Attention in Childhood Epilepsies: A Neuropsychological Hallmark of Dysfunction?

“…Attention involves several different components and partially overlap with executive functions; previous studies showed that children with epilepsy exhibit a wide range of attention difficulties (D'Alessandro et al, 1990;Gascoigne et al, 2017;Semrud-Clikeman & Wical, 1999) and a high percentage of inattentivetype ADHD (Dunn & Kronenberger, 2005;Gascoigne et al, 2017). However, a cross-sectional design (e.g., Cnaan et al, 2017;D'Alessandro et al, 1990;Deonna et al, 2000;Fonseca Wald et al, 2019;Masur et al, 2013;Shinnar et al, 2017), short follow-up periods and a lack of proper age bias correction (Cnaan et al, 2017;Glauser et al, 2010;Masur et al, 2013;Shinnar et al, 2017) are significant limitations of these studies, making further confirmation necessary. In this regard, our paper based on well-defined eligibility criteria, comparable protocols, and an extended follow-up -confirmed this observation, showing a high percentage of attention deficits without significant differences in frequency between the three groups of examined patients in our cohort.…”

Absence epilepsy: Characteristics, pathophysiology, attention impairments, and the related risk of accidents. A narrative review

“…The anomalous interictal epileptiform activity may momentarily disrupt cortical processing as well [32,42]. A follow-up retrospective survey [43] assessed the main cognitive fields (i.e., intelligence, attention visualperceptual function, language, memory, and learning) in 31 children with CAE or JAE, based on Baron's distinction of neurocognitive domains in children [44]. In this study, educational achievements were also included, collected with reports and academic evaluations filled by school-specialists.…”