Objective:Patients with epilepsy are at risk for several lifetime problems, in which neuropsychological impairments may represent an impacting factor. We evaluated the neuropsychological functions in children suffering from three main epilepsy categories. Further, we analyzed the longitudinal evolution of the neuropsychological profile over time.Methods:Patients undergoing neuropsychological evaluation at our Department from 2012 to 2018 were identified retrospectively. We selected patients aged 6–16 years and with at least two evaluations. Three epilepsy categories were considered: focal/structural, focal self-limited, and idiopathic generalized. Each evaluation included the same structured assessment of main neuropsychological domains. The effect of the epilepsy category, illness duration, seizure status, and medication was computed in multilevel models.Results:We identified 103 patients (focal self-limited = 27; focal/structural = 51; and idiopathic generalized = 25), for 233 evaluations. The majority of deficits were reported in attention and executive functions (>30% of patients); the results were dichotomized to obtain global indexes. Multilevel models showed a trend toward statistical significance of category of epilepsy on the global executive index and of illness duration on global attention index. Illness duration predicted the scores of executive and attention tasks, while category and medication predicted executive task performance. Focal/structural epilepsies mostly affected the executive domain, with deficits persisting over time. By contrast, an ameliorative effect of illness duration for attention was documented in all epilepsies.Conclusions:This study offers lacking information about the evolution of deficits in time, the role of epilepsy category, and possible psychological implications for high-order cognitive skills, central in several social and academic problems.

中文翻译：

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儿童癫痫的执行功能和注意力：功能障碍的神经心理学标志？

目的：癫痫患者面临多种终生问题的风险，其中神经心理障碍可能是一个影响因素。我们评估了患有三种主要癫痫类别的儿童的神经心理功能。此外，我们分析了神经心理学特征随时间的纵向演变。方法：回顾性确定2012年至2018年在我科接受神经心理学评估的患者。我们选择了 6-16 岁且至少接受过两次评估的患者。考虑了三种癫痫类别：局灶性/结构性、局灶性自限性和特发性全身性癫痫。每项评估都包括对主要神经心理学领域的相同结构化评估。癫痫类别、病程、癫痫发作状态的影响，并在多级模型中计算药物。结果：我们确定了 103 名患者（局灶自限性 = 27；局灶性/结构性 = 51；特发性全身性 = 25），进行 233 次评估。据报道，大多数缺陷是注意力和执行功能（>30% 的患者）；将结果二分以获得全局索引。多层次模型显示癫痫类别对全球执行指数的统计显着性和疾病持续时间对全球注意力指数的统计显着性趋势。疾病持续时间预测执行和注意力任务的得分，而类别和药物预测执行任务的表现。局灶性/结构性癫痫主要影响执行领域，随着时间的推移持续存在缺陷。相比之下，在所有癫痫中都记录了疾病持续时间对注意力的改善作用。