ABSTRACT

Self-limited epilepsy with centrotemporal spikes (ECTS) is one of the most frequent focal epilepsies amongst children. Because remission usually occurs before 16 years old and patients present infrequent clinical manifestation, ECTS was considered benign for a long time. Despite the reports on cognitive deficits associated with ECTS in the last years, knowledge about the condition’s specific executive function domains (inhibitory control, working memory, cognitive flexibility, verbal fluency, and higher-order executive functions) is still lacking. The following systematic review was conducted according to PRISMA guidelines. The PubMed and Scopus databases and gray literature were searched according to the following eligibility criteria: (1) original articles published in peer-review journals; (2) studies that present assessment of children with ECTS; and (3) studies with an available assessment of the executive function of the participants. A total of 43 studies (1179 patients and 1086 healthy controls) met the inclusion criteria. Data from 19 studies were extracted, and meta-analysis methods were used to compare results in the three main executive function domains and verbal fluency. The study quality was measured through the Newcastle-Ottawa Scale (NOS) and the evidence quality with the GRADEpro tool. Results and conclusions: The present systematic review is the first to gather information about executive functioning in children with ECTS. According to the meta-analyses, children with ECTS show weaker performances when compared with a control group in inhibitory control, cognitive flexibility, and verbal fluency. However, because the quality of evidence was classified as very low, caution is needed when interpreting the strength of the results.

摘要

自限性中央颞叶癫痫（ECTS）是儿童最常见的局灶性癫痫之一。由于缓解通常发生在 16 岁之前，患者临床表现不常见，因此 ECTS 长期以来被认为是良性的。尽管过去几年有关于与 ECTS 相关的认知缺陷的报告，但仍然缺乏关于该病症特定执行功能领域（抑制控制、工作记忆、认知灵活性、语言流畅性和高级执行功能）的知识。以下系统评价是根据 PRISMA 指南进行的。PubMed和Scopus _根据以下资格标准检索数据库和灰色文献：（1）在同行评审期刊上发表的原创文章；(2) 对患有 ECTS 的儿童进行评估的研究；(3) 对参与者的执行功能进行评估的研究。共有 43 项研究（1179 名患者和 1086 名健康对照）符合纳入标准。提取了 19 项研究的数据，并使用荟萃分析方法比较了三个主要执行功能域和语言流利度的结果。研究质量通过纽卡斯尔-渥太华量表 (NOS) 和 GRADEpro 工具的证据质量来衡量。结果和结论：本系统评价首次收集有关 ECTS 儿童执行功能的信息。根据荟萃分析，与对照组相比，ECTS 儿童在抑制控制、认知灵活性和语言流畅性方面表现较弱。然而，由于证据质量被归类为非常低，在解释结果的强度时需要谨慎。