Mapping the landscape of cognitive development in children with epilepsy

Abstract

Objective Normal childhood development is defined by age-dependent improvement across cognitive abilities, including language, memory, psychomotor speed and executive function. Epilepsy is often associated with a global disruption in cognitive development, however, it is still largely unknown how epilepsy affects the overall organization of overlapping cognitive domains. The aim of the study was to evaluate how childhood epilepsy affects the developmental interrelationships between cognitive domains. Methods We performed a comprehensive assessment of neuropsychological function in 127 children with new onset epilepsy and 80 typically developing children matched for age, gender, and socio-demographic status. A cross-correlation matrix between the performances across multiple cognitive tests was used to assess the interrelationship between cognitive modalities for each group (patients and controls). A weighted network composed by the cognitive domains as nodes, and pair-wise domain correlation as links, was assessed using graph theory analyses, with focus on global network structure, network hubs and community structure. Results Normally developing children exhibited a cognitive network with well-defined modules, with verbal intelligence, reading and spelling skills occupying a central position in the developing network. Conversely, children with epilepsy demonstrated a less well-organized network with less clear separation between modules, and relative isolation of measures of attention and executive function. Conclusion Our findings demonstrate that childhood-onset epilepsy, even within its early course, is associated with an extensive disruption of cognitive neurodevelopmental organization. The approach used in this study may be useful to assess the effectiveness of future interventions aimed at mitigating the cognitive consequences of epilepsy.

Graph theory and cognition: A complementary avenue for examining neuropsychological status in epilepsy

“…Therefore, this method has the capacity to investigate the brain at its different levels as a whole. Recently, this methodology has been extended to investigate the interrelationship of different cognitive tests between healthy and epilepsy pediatric participants [11], which proved the versatility of this methodology solely based on cognitive measures themselves.…”

“…This methodology has been applied to investigations of electrophysiological and imaging networks, as well as examination of brain structures, that have revealed global disruption in brain architecture and function in patients with epilepsy [2-7]. Large scale structural morphometrical brain changes have been correlated with specific cognitive deficits in epilepsy [8-9]; however, to date, there have been few examinations of neuropsychological measures considered as a cognitive network themselves using graph theory [10-11]. …”

Social attention in children with epilepsy

“…[20][21][22] Children with epilepsy without global developmental delay are at risk of disrupted developmental integration of attention and inhibitory control with other domains. 23 It is important to determine if there is a vulnerability to the developmental integration of social perceptual processes and cognitive control that underlies socio-emotional and behavioural regulation. The aims of the study are to compare social attentional orienting under low and high cognitive control to gaze cues and meaningful social signals, using a modified gaze emotion antisaccade eye-tracking paradigm.…”

The impact of bilingualism on working memory in pediatric epilepsy

“…We speculate that based on the differences in findings for this study from the broader bilingual research in typically developing children, epilepsy processes might mitigate the bilingual effect, potentially limiting it to only impact working memory. The present findings suggest that the impact of bilingualism on executive function skills in typically developing children may not be entirely generalizable to children with epilepsy, which could reflect differences in the organization of and relationships between cognitive skills in children with epilepsy [39]. Future studies that look more specifically at discrete executive skills and seizure foci may help further elucidate the role of bilingualism in childhood onset epilepsy.…”