Baseline Neurobehavioral Comorbidities Impact 10-year Outcomes in Childhood Onset Epilepsy
Abstract number :
3.316
Submission category :
11. Behavior/Neuropsychology/Language / 10B. Pediatrics
Year :
2016
Submission ID :
195474
Source :
www.aesnet.org
Presentation date :
12/5/2016 12:00:00 AM
Published date :
Nov 21, 2016, 18:00 PM
Authors :
Jana Jones, University of Wisconsin - Madison, Madison, Wisconsin; Dace Almane, University of Wisconsin - Madison, Madison, Wisconsin; Melissa Hanson, University of Wisconsin - Madison, Madison, Wisconsin; Blaise Morrison, University of Wisconsin - Madiso
Rationale: This study examined the relation of baseline neurobehavioral comorbidities to 10-year health and disability outcomes of childhood onset epilepsy. The purpose of the study was to determine if baseline comorbidities would impact outcomes in early adulthood. Methods: At study entry participants were children ages 8-18 years with new/recent onset idiopathic epilepsies (n=53) and healthy controls (n=42). All participants completed baseline assessment and 10-year follow-up evaluation. Children with epilepsy were recruited from pediatric neurology clinics at three Midwestern medical centers and met the following inclusion criteria: diagnosis of epilepsy within the past 12 months and normal clinical MRI. First-degree cousins were used as controls. At baseline, each participant underwent comprehensive assessment that included structured psychiatric and clinical interviews. The baseline predictors of interest were: a) presence/absence of ADHD and/or b) presence/absence of interventions to address academic problems, including: Individualized Education Plan (IEP), birth-to-age 3 services, early childhood programs, grade retention, remedial summer school, tutors, and learning centers. Children with epilepsy who were positive on either were considered Epi Comorbidity+, while those children negative on both were Epi Comorbidity-. At 10-year follow-up each participant completed the WHO Disability Assessment Schedule (WHODAS 2.0). MANOVA and follow-up ANOVA with post-hoc Tukey's Tests to adjust for multiple pair-wise comparisons were conducted using IBM SPSS Statistics Software 22.0 to assess between group (EpiComorb+ [n=28], EpiComorb-[n=25], controls [n=42]) differences on the WHODAS scales. Results: See Table 1 for sample demographics. There was a significant main effect of Group for WHODAS scales, F(2, 14) = 2.54, p=0.002. Post-hoc analyses revealed that the EpiComorb+ had significantly higher disability scores compared to EpiComorb- on the following WHODAS scales: Cognitive, Getting along with others, and Total score (p < 0.05). With the exception of the Self-care scale, EpiComorb+ had significantly higher disability scores on all other scales when compared to controls (p < 0.05). Only the Participation scale was significantly higher for EpiComorb- compared to controls (p=0.002). Conclusions: The presence of baseline neurobehavioral comorbidities is a significant predictor of health and disability status 10 years later. Children without neurobehavioral comorbidities at baseline are comparable to healthy controls at 10-year follow-up, and they appear to have similarly positive outcomes. In contrast, these results underscore the importance of identification of comorbidities as early as possible as they appear to have far reaching effects 10-years after the diagnosis of epilepsy negatively impacting those in early adulthood. Funding: NIH 3RO1-44351, 1UL1RR025011, 9U54TR000021.
Neurophysiology