BACKGROUND Attention-deficit/hyperactivity disorder (ADHD) and benign epilepsy with centrotemporal spikes (BECTS or rolandic epilepsy) present with a very high level of comorbidity. We aimed to review the existing literature focusing on two aspects: the possible role of epileptic activity in the damage of ADHD-related neural networks and the clinical approach to patients presenting with both conditions. MATERIAL AND METHODS A systematic review was performed using Sapienza Library System and PubMed. The following search terms have been considered: attention networks, ADHD, attention systems, rolandic epilepsy, benign epilepsy with centrotemporal spikes, centrotemporal spikes epilepsy, and focal epilepsy in children. The target population consisted of patients under 18 years of age diagnosed with either BECTS and ADHD or healthy controls. RESULTS Nine case-control and cohort studies have been selected. The reported prevalence of ADHD in patients with BECTS was around 60%. No clinical correlation was found between the medical records and the presence of ADHD in patients with BECTS, if not due to febrile convulsion (FC). One study showed higher levels of bilateral discharges in patients with severe ADHD. The negative influence of the age at onset of seizures was demonstrated on attention but not on intelligence quotient (IQ). Moreover, the frequency of seizures and the occurrence of discharges during nonrapid eye movement (NREM) sleep were correlated to attention impairment. From a neurobiological point of view, functional connectivity in patients with BECTS and ADHD appears to be disrupted. Two studies reported a specific impairment in selective visual attention, while one study underlined a decreased activation of the dorsal attention network (DAN). Two different studies found that patients with BECTS and comorbid ADHD presented with altered thickness in their magnetic resonance imaging (MRI) scans in the cortical and subcortical regions (including the frontal lobes, lingual-fusiform cortex, cuneus and precuneus, limbic area and pericalcarine cortex among others). This might explain the cognitive and behavioral symptoms such as poor selective visual attention, speech disturbance, and impulsivity. CONCLUSIONS Despite BECTS being considered to have a relative benign course, many studies have documented cognitive and/or behavioral problems in patients diagnosed with this type of epilepsy. In particular, children affected by rolandic epilepsy should receive a complete neuropsychological evaluation at seizure onset considering the high rate of comorbidity with ADHD. A further investigation of the common pathogenic substrate is desirable to better orientate the clinical and therapeutic interventions applied.

中文翻译：

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ADHD 和 ADHD 相关神经网络在良性癫痫伴中央颞区棘波中的作用：系统评价

背景注意力缺陷/多动障碍（ADHD）和良性癫痫伴中央颞区棘波（BECTS 或 rolandic 癫痫）具有非常高的共病水平。我们旨在回顾现有文献，重点关注两个方面：癫痫活动在 ADHD 相关神经网络损伤中的可能作用，以及对出现这两种情况的患者的临床方法。材料和方法 使用 Sapienza 图书馆系统和 PubMed 进行系统评价。已经考虑了以下搜索词：注意力网络、多动症、注意力系统、rolandic 癫痫、良性癫痫伴中心颞部棘突、中心颞部棘突癫痫和儿童局灶性癫痫。目标人群包括被诊断患有 BECTS 和 ADHD 或健康对照的 18 岁以下患者。结果 选择了九项病例对照和队列研究。据报道，BECTS 患者 ADHD 的患病率约为 60%。如果不是由于热性惊厥 (FC)，那么在 BECTS 患者的病历和 ADHD 之间没有发现临床相关性。一项研究表明，严重 ADHD 患者的双侧放电水平较高。癫痫发作年龄的负面影响表现在注意力上，但对智商 (IQ) 没有影响。此外，非快速眼动 (NREM) 睡眠期间癫痫发作的频率和放电的发生与注意力障碍相关。从神经生物学的角度来看，BECTS 和 ADHD 患者的功能连接似乎被破坏了。两项研究报告了选择性视觉注意的特定损害，而一项研究强调了背侧注意力网络 (DAN) 的激活减少。两项不同的研究发现，BECTS 和共病 ADHD 患者在皮质和皮质下区域（包括额叶、舌梭状皮层、楔叶和楔前叶、边缘区和皮层周皮层）的磁共振成像 (MRI) 扫描显示厚度改变其中）。这可能可以解释认知和行为症状，例如选择性视觉注意力差、言语障碍和冲动。结论 尽管 BECTS 被认为具有相对良性的过程，但许多研究已经记录了诊断为此类癫痫的患者的认知和/或行为问题。特别是，考虑到 ADHD 的高共病率，受 rolandic 癫痫影响的儿童应在癫痫发作时接受完整的神经心理学评估。需要对常见致病底物进行进一步研究，以更好地确定所应用的临床和治疗干预措施。