The Impact of Disadvantage on Cognition and Academic Performance in Children with New-Onset Epilepsy: Longitudinal and Familial Effects
Abstract number :
3.459
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2022
Submission ID :
2233036
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:29 AM
Authors :
Temitayo Oyegbile-Chidi, MD, PhD – University of California Davis; Danielle Harvey, PhD – University of California Davis; Jana Jones, PhD – University of Wisconsin School of Medicine and Public Health; Phil Fastenau, PhD – University Hospitals Cleveland Medical Center and Case Western Reserve University School of Medicine; Anna Byars, PhD – Cincinnati Children’s Hospital at the University of Cincinnati; David Dunn, MD – Indiana University; Joan Austin, PhD – Indiana University; Bruce Hermann, PhD – University of Wisconsin School of Medicine and Public Health
This is a Late Breaking abstract
Rationale: Accumulating evidence indicates that children with new-onset epilepsy often experience co-morbidities including cognitive dysfunction, which adversely affects academic performance. Research investigating these co-morbidities has focused primarily on clinical epilepsy characteristics, as well as potential neurobiological and genetic correlates of cognitive dysfunction. However, limited attention has been given to the role that social disadvantage may play in the presence of these co-morbidities. This study investigates the role of social disadvantage in cognitive and academic status in youth with new-onset epilepsy and their siblings over a 3-year period to determine its effect, extent, and duration. _x000D_
Methods: A total of 312 subjects (aged 6-16 years) were recruited within 6 weeks of their first recognized seizure along with 223 of their unaffected siblings. Each child underwent a comprehensive neuropsychological assessment evaluating intelligence, language, immediate and delayed verbal and visual memory, executive function, and speeded fine motor dexterity (Clinical Evaluation of Language Fundamentals; Comprehensive Test of Phonological Processing; Conners’ Continuous Performance Test; Kaufman Brief Intelligence Test; Coding and Symbol Search Subtests of Wechsler's Intelligence Scale for Children; Wide Range Assessment of Memory and Learning Design Copy and the Wisconsin Card Sorting Test) as well as targeted measures of academic achievement (Woodcock-Johnson Revised Tests of Achievement: Letter-Word Identification, Calculation and Dictation) at baseline, 18 months later and 36 months from baseline. Sociodemographic data (race, caregiver’s education, household income, and parental marital status), clinical epilepsy characteristics (age of onset, seizure syndrome, seizure frequency and anti-seizure medication), and presence/absence magnetic resonance imaging (MRI) and electroencephalography (EEG) abnormalities were collected. A Disadvantage Score was computed for each family (children and siblings) and data was categorized into 4 groups ranging from most disadvantaged (DS4) to least disadvantaged (DS1).
Results: In both children with new-onset epilepsy and siblings, the least disadvantaged group exhibited the highest Full-Scale IQ (mean IQ=107.0 at baseline), neuropsychological factor scores and academic performances; while the most disadvantaged group showed the polar opposite with the worst performances across all test metrics (mean IQ = 90.57 at baseline). Findings remained significant and stable through 36 months. Linear regression indicated that social disadvantage may be a more constant and stable predictor of cognitive and academic performance over time compared to clinical epilepsy characteristics and MRI/EEG abnormalities. _x000D_
Conclusions: This study indicates that the effect of disadvantage is associated with a strong and lasting impact on cognitive and academic performance in children with new-onset epilepsy and their siblings, at baseline and longitudinally. Future studies would be beneficial to determine if this social disadvantage factor is modifiable with early intervention. _x000D_
Funding: NINDS (NS22416, J. Austin, PI), NCATS (UL1 TR001860 and linked award KL2 TR001859, T. Oyegbile-Chidi, PI)
Behavior