Self-limited focal epilepsy of childhood (SFEC) is often related to mild impairments in several neuropsychological domains, including cognitive flexibility, which is generally considered a process requiring volition and attention. However, recent evidence showed that it can be implicitly adjusted exploiting simple 'stimulus-response' associations as for example, the probability of the stimulus occurrence. Here, we evaluated the capability to implicitly extract environmental patterns of regularities and use them to flexibly adjust proactive control motor control. We tested 21 children with epilepsy (total IQ > 80; 13 with Childhood epilepsy with centro-temporal spikes, 8 with Panayiotopoulos syndrome (PS); 5-13 years old) compared to a healthy age-matched control group (32 participants). We used the Dynamic Temporal Prediction (DTP) task to investigate how behavioral performance is implicitly shaped by the manipulation of the stimulus occurrence probability over time. We recorded EEG to identify neural markers to differentiate the two groups. SFEC group showed a reduction in accuracy (p = .0013) and response speed (p < .001) as well as an absence of response adjustment (p = .65) in relation to the implicit changes in stimulus probability occurrence, in comparison to the control group. The epilepsy group performance in the DTP showed a significant correlation with the phonemic fluency (r = -0.50) and the Perseverations index of the CPT test (r = 0.53). Finally, children with SFEC did not show the modulation of the contingent negative variation (CNV) evoked potential. Overall, children with SFEC showed poor implicit flexibility compared to a control group. This pattern is individually related to high-level executive function, suggesting to extend neuropsychological assessment to the implicit domain.

中文翻译：

---

儿童自限性局灶性癫痫的内隐认知灵活性：一项 HD-EEG 研究

儿童自限性局灶性癫痫 (SFEC) 通常与几个神经心理学领域的轻度损伤有关，包括认知灵活性，这通常被认为是一个需要意志和注意力的过程。然而，最近的证据表明，它可以利用简单的“刺激-反应”关联进行隐式调整，例如刺激发生的概率。在这里，我们评估了隐式提取规律性环境模式并使用它们来灵活调整主动控制电机控制的能力。我们测试了 21 名患有癫痫症的儿童（总 IQ > 80；13 名患有中央颞区尖峰的儿童癫痫症，8 名患有 Panayiotopoulos 综合征（PS）；5-13 岁）与健康的年龄匹配对照组（32 名参与者）相比。我们使用动态时间预测 (DTP) 任务来研究行为表现是如何通过随时间的刺激发生概率的操纵而隐含地形成的。我们记录 EEG 以识别神经标记以区分两组。与刺激概率发生的隐性变化相比，SFEC 组表现出准确性 (p = .0013) 和响应速度 (p < .001) 以及缺乏响应调整 (p = .65) 的降低对照组。DTP中癫痫组的表现与音素流畅度（r = -0.50）和CPT测试的Perseverations指数（r = 0.53）显着相关。最后，患有 SFEC 的儿童没有表现出对偶然负向变异 (CNV) 诱发电位的调节。全面的，与对照组相比，SFEC 儿童表现出较差的内隐灵活性。这种模式单独与高级执行功能相关，建议将神经心理学评估扩展到内隐领域。