Association Between Lateralization of Interictal Spikes and Neurocognitive Performance and EEG Functional Connectivity in Children with Self-limited Epilepsy with Centro-temporal Spikes (SeLECT)
Abstract number :
1.109
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2024
Submission ID :
809
Source :
www.aesnet.org
Presentation date :
12/7/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Min-Lan Tsai, MD, MS – Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
Syu-Jyun Peng, PhD – Taipei Medical University
Chuang-Jin Wang, BS – School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
Angei Ka-Pek Lao, MS – Department of Psychiatry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
Yu-Jui Huang, MD – Department of Psychiatry, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
Feng-Chin Lee, MD – Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
Hsi Chang, MD, PhD – Division of Pediatric Neurology, Department of Pediatrics, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan
Rationale: Our aim is to study the relationship between either side or bilateral localization of interictal focal stereotyped spikes and neurocognitive and attention performance in self-limited epilepsy with centro-temporal spikes (SeLECT). EEG functional connectivity based on graph theory in either or bilateral side of inerictal spikes are also analyzed.
Methods: A cohort of 74 children with SeLECT divided into 3 groups (right, left and bilateral) and healthy controls was recruited to evaluate the association between cognitive function and the lateralization of interictal epileptiform discharges (EDs). Other clinical parameters were also analyzed. The fifth edition of the Wechsler Intelligence Scale (WISC-V) and CPT-3 or SANP-IV were used for analysis in children with SeLECT after 1-2 years of diagnosis, and only right-handed patients were enrolled. The EEG functional connectivity analysis based on graph theory and network-based statistics in different frequency bands was assessed as global efficiency, clustering coefficient, betweenness centrality, and nodal strength among different lateralization.
Results: Our study showed that full scale intelligence quotient (FSIQ) scores and 5 composite scores were significantly lower in SeLECT children than normal controls, particularly PSI scores. While divided into 3 groups including right, left and bilateral EDs, the bilateral and left-side groups have significantly lower Verbal Comprehension index (VCI), Visual Spatial Index (VSI), Fluid Reasoning Index (FRI) and Working Memory Index (WMI) compared to children with right-sided focus (p < 0.001). There was no significant difference in the Processing Speed Index (PSI) among 3 groups. However, there was no difference in seizure frequency, attention deficit hyperactivity disorder (ADHD) or other comorbidities among 3 groups. The EEG connectivity strength was significantly higher in children with SeLECT compared to age-matched controls. Children with bilateral or left-sided spikes showed significantly increased global efficiency (bilateral and left side) and mean nodal strength (bilateral) in the beta frequency at nearly all proportional thresholds, in comparison with those with right-sided focus (p < 0.05 after false discovery rate correction).
Conclusions: Children with SeLECTs with interictal bilateral and left interictal EDs demonstrated lower performance on FSIQ, VCI, VSI, FRI and WMI compared to the right-sided EDs. However, the PSI did not show difference among 3 groups. Bilateral or left-sided spikes had significantly increased global efficiency in the beta frequency compared to the right-sided focus. The cognitive and behavioral effect in relation to the lateralization of interictal EDs in SeLECT patients was suggested. We recommend early psychosocial diagnostics to offer targeted support to these children and their families if developmental problems are present.
Funding: Taipei Medical University Hospital, grant number 112TMU-TMUH-13 and 113TMU-TMUH-15
Behavior