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Neuropsychological Phenotypes in Pediatric Temporal Lobe Epilepsy
Journal of the International Neuropsychological Society ( IF 2.6 ) Pub Date : 2021-08-27 , DOI: 10.1017/s1355617721001090
William A Schraegle 1, 2, 3 , Nancy L Nussbaum 1, 2, 3 , Rosario C DeLeon 1, 2, 3 , Jeffrey B Titus 1, 2, 3
Affiliation  

Objective:

Adults with temporal lobe epilepsy (TLE) have been found to have a fairly characteristic pattern of neuropsychological performance, but there is considerably less research and more variability in findings with children. Because the cognitive domains included in most studies with children have been limited, the current study attempted to better characterize the cognitive phenotype of children with TLE using a broader neuropsychological battery.

Methods:

The study included 59 children with TLE (59% male) age 7 to 16 (M = 12.67; SD = 3.12) who underwent comprehensive neuropsychological evaluation. Patient results were grouped into cognitive domains (reasoning, language, visuoperceptual, verbal memory, executive function, and motor function) based upon their test performance. These factor scores were subjected to Ward’s hierarchical clustering method with squared Euclidean distance.

Results:

Cluster analysis revealed three distinct cognitive profiles: (1) normal functioning (20% of sample); (2) delayed verbal memory and motor weaknesses (61% of the sample); and (3) global impairment (19% of the sample). Cluster 3 had longer epilepsy duration and a higher incidence of hippocampal sclerosis (HS) compared to Cluster 1 (p < .05). There were no significant differences among the three cluster groups on demographic characteristics or remaining clinical characteristics.

Conclusions:

Children with TLE present with distinct cognitive phenotypes ranging from average performance to global impairment. Results partially support previous hypotheses highlighting the cumulative neurobiological burden on the developing brain in the context of chronic epilepsy and provide a preliminary framework for the cognitive domains most vulnerable to the TLE disease process.



中文翻译:

小儿颞叶癫痫的神经心理学表型

客观的:

已发现患有颞叶癫痫 (TLE) 的成人具有相当典型的神经心理学表现模式,但对儿童的研究相当少,而且研究结果的差异性更大。由于大多数儿童研究中包含的认知领域有限,目前的研究试图使用更广泛的神经心理学电池来更好地描述 TLE 儿童的认知表型。

方法:

该研究包括 59 名 7 至 16 岁(M = 12.67;SD = 3.12)的 TLE 儿童(59% 为男性),他们接受了全面的神经心理学评估。患者的结果根据他们的测试表现分为认知领域(推理、语言、视觉感知、语言记忆、执行功能和运动功能)。这些因子得分采用 Ward 的欧几里得平方距离层次聚类方法。

结果:

聚类分析揭示了三种不同的认知特征:(1) 正常功能(20% 的样本);(2) 延迟语言记忆和运动弱点(样本的 61%);(3) 全球减值(样本的 19%)。与群集 1 相比,群集 3 的癫痫持续时间更长,海马硬化 (HS) 的发生率更高 ( p < .05)。三个集群组之间在人口统计学特征或剩余临床特征上没有显着差异。

结论:

患有 TLE 的儿童表现出不同的认知表型,从一般表现到整体损伤不等。结果部分支持先前的假设,强调在慢性癫痫的背景下发育中大脑的累积神经生物学负担,并为最易受 TLE 疾病过程影响的认知领域提供初步框架。

更新日期:2021-08-27
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