Epilepsy and Sociodemographic Predictors of Executive Functioning in Pediatric TLE and FLE
Abstract number :
2.033
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2024
Submission ID :
601
Source :
www.aesnet.org
Presentation date :
12/8/2024 12:00:00 AM
Published date :
Authors :
Presenting Author: Emma Burnham, BA – Northwestern University
Alexandra Rousseau, MS, PhD – Palo Alto University
Charlotte Beard, MD, MS, MS – Palo Alto University
Priscilla Duong, PhD – Ann & Robert H. Lurie Children's Hospital of Chicago
Rationale: Recurrent seizures in frontal and temporal lobe epilepsy (FLE and TLE, respectively) can severely affect a child’s cognitive trajectory. Certain patient-specific variables have been associated with poor neuropsychological outcomes, such as greater seizure frequency, number of anti-seizure medications (ASMs), and sociodemographic factors. Specifically of interest is their impact on executive functioning (EF), including working memory (WM). It’s well cited that individuals with FLE carry risk for EF dysfunction, but EF alterations are also seen in TLE. Few between-group comparison studies have been performed; most citing small differences in cognitive performance and behavioral ratings. Further, the impact of sociodemographic factors (e.g., childhood opportunity by neighborhood) on EF is not well established. This study adds to the literature by examining both seizure-related and psychosocial factors in pediatric FLE/TLE patients.
Methods: A retrospective analysis of data collected from 56 focal epilepsy patients aged 6 through 17 was conducted. Two models were created using general cognitive ability (GCA), Child Opportunity Index (COI), age of seizure onset, and localization to predict (1) behavioral ratings of executive functioning (i.e., Global Executive Composite, GEC) and (2) direct measurement of working memory.
Results: Patients’ mean age was 12 (SD = 3.24) with 43% frontal seizure localization. Patients’ mean GCA was 90.38 (SD = 16.45), and mean GEC was 59.57 (SD = 12.56). Mean age of epilepsy onset was 7.78 years, and median ASMs were 2. Confirming prior findings1, COI was positively correlated with IQ (r = .43, p< .001) while ASMs were negatively correlated with IQ (r = -.33, p = .01). A stepwise hierarchical regression showed that neither IQ, COI, seizure localization, nor age of onset were significant predictors of GEC ( BIQ = -0.07, Bonset = - .28, Blocalization = 2.24, BCOI= .54, ps =ns at step 1 and 2), explaining less than 3% of the variance. Contrarily, in a second model examining working memory, IQ and COI were significant predictors (BIQ = .15; BCOI= -.96, ps< .001). Further, age of onset and seizure localization indicated a significantly predictive trend of EF (Bonset = - .11, p= .08 and at Blocalization = -1.11, p = .07 at step 2). Moreover, IQ and age of onset explained 32% of the variance of WM scores at step 1, while seizure localization and COI added an additional 19% (ΔR2 = .19 ) at step 2. All variables accounted for an overall 52% of the variance in the model (R2 =.32). Post-hoc analyses did not identify IQ, COI, seizure localization, nor age of onset as significant predictors of behavioral ratings of WM.
Behavior