Abstracts

Rationale: There is increasing evidence that individuals with temporal lobe epilepsy (TLE) exhibit executive function abnormalities, implicating the frontal lobe. It is unclear which specific cognitive functions within the frontal lobe are affected by these abnormalities. In addition, few pediatric TLE studies have investigated this phenomenon. The purpose of the present study was to characterize these frontal lobe abnormalities in a pediatric TLE population.Methods: Study participants were children and adolescents (ages 8-16) with TLE along with age-, gender-, and grade-matched healthy controls. All participants underwent neurocognitive tests that engage all major components of frontal lobe function - working memory, inhibition, set-shifting, and fluency. The tests included CMS word list and dot location (working memory), D-KEFs color-word interference (inhibition), D-KEFs card sort (set-shifting) and grooved pegboard (fluency). Currently, the sample size is 4 per group, but subject accrual is currently ongoing and should be significantly higher by the time of the AES meeting. Seizure history was obtained by structured interview, detailed questionnaires, and medical record review.Results: Analysis will be performed using MANCOVA adjusting for medications and handedness. However due to the small current sample size; T-tests only are being presented here. Compared to controls, children with TLE have more total frontal lobe cognitive dysfunction compared to controls (p=0.03). Specific regions of the frontal lobe cognitive function also differed between subjects with TLE and controls. Children with TLE have deficits in all the major components of frontal lobe cognitive function. Compared to controls, participants with TLE exhibited worse working memory (p=0.05), inhibition (p=0.04), set shifting (p=0.05) and fluency (p=0.05).Conclusions: Children with TLE exhibit significant frontal lobe cognitive abnormalities compared to controls and are all components of frontal lobe cognitive function are affected. These findings suggest that frontal lobe dysfunction must be taken into consideration when assessing and treating TLE in children. Further research using functional neuroimaging to evaluate the frontal lobe in children with TLE may further corroborate these findings. Funding: This research was supported by funding from the Epilepsy Foundation, ID: 336343