Abstract:Objective To investigate the effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children and the risk factors for cognitive impairment. Methods A retrospective analysis was performed for the clinical data of 38 children with temporal lobe epilepsy and 40 children with idiopathic epilepsy. The controls were 42 healthy children. All subjects received the following neuropsychological tests: Montreal Cognitive Assessment (MoCA) scale, verbal fluency test, digit span test, block design test, Social Anxiety Scale for Children (SASC), and Depression Self-rating Scale for Children (DSRSC). Results Compared with the control group, the temporal lobe epilepsy and idiopathic epilepsy groups showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). Compared with the idiopathic epilepsy group, the temporal lobe epilepsy group showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). In the temporal lobe epilepsy group, MoCA score was negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.571, -0.529, and -0.545 respectively; P<0.01). In the idiopathic epilepsy group, MoCA score was also negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.542, -0.487, and -0.555 respectively; P<0.01). Conclusions Children with temporal lobe epilepsy and idiopathic epilepsy show impaired whole cognition, verbal fluency, memory, and executive function and have anxiety and depression, which are more significant in children with temporal lobe epilepsy. High levels of anxiety, depression, and seizure frequency are risk factors for impaired cognitive function.
YANG Xiao-Yan,LONG Li-Li,XIAO Bo. Effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children[J]. CJCP, 2016, 18(7): 577-581.
Samarasekera SR, Helmstaedter C, Reuber M. Cognitive impairment in adults with epilepsy: The relationship between subjective and objective assessments of cognition[J]. Epilepsy Behav, 2015, 52(Pt A): 9-13.
[2]
Kanner AM, Soto A, Gross-Kanner H. Prevalence and clinical characteristics of postictal psychiatric symptoms in partial epilepsy[J]. Neurology, 2004, 62(5): 708-713.
[3]
Giovagnoli AR, Parente A, Tarallo A, et al. Self-rated and assessed cognitive functions in epilepsy: impact on quality of life[J]. Epilepsy Res, 2014, 108(8): 1461-1468.
[4]
Cascino GD. When drugs and surgery don't work[J]. Epilepsia, 2008, 49(Suppl 9): 79-84.
[5]
Baxendale S, Heaney D, Thompson PJ, et al. Cognitive consequences of childhood-onset temporal lobe epilepsy across the adult lifespan[J]. Neurology, 2010, 75(8): 705-711.
[6]
Elger CE, Helmstaedter C, Kurthen M. Chronic epilepsy and cognition[J]. Lancet Neurol, 2004, 3(11): 663-672.
[7]
Marques CM, Caboclo LO, da Silva TI, et al. Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis[J]. Epilepsy Behav, 2007, 10(3): 477-485.
[8]
Chowdhury FA, Elwes RD, Koutroumanidis M, et al. Impaired cognitive function in idiopathic generalized epilepsy and unaffected family members: an epilepsy endophenotype[J].Epilepsia, 2014, 55(6): 835-840.
[9]
Irwin LG, Fortune DG. Risk factors for psychosis secondary to temporal lobe epilepsy: a systematic review[J]. J Neuropsychiatry Clin Neurosci, 2014, 26(1): 5-23.
[10]
Giovagnoli AR, Franceschetti S, Reati F, et al. Theory of mind in frontal and temporal lobe epilepsy: cognitive and neural aspects[J]. Epilepsia, 2011, 52(11): 1995-2002.
Drane DL, Ojemann JG, Kim MS, et al. Interictal epileptiform discharge effects on neuropsychological assessment and epilepsy surgical planning[J]. Epilepsy Behav, 2016, 56: 131-138.
[13]
Mula M, Trimble MR. Antiepileptic drug-induced cognitive adverse effects: potential mechanisms and contributing factors[J]. CNS Drugs, 2009, 23(2): 121-137.
[14]
dos Santos EB, Tudesco Ide S, Caboclo LO, et al. Low educational level effects on the performance of healthy adults on a Neuropsychological Protocol suggested by the Commission on Neuropsychology of the Liga Brasileira de Epilepsia[J]. Arq Neuropsiquiatr, 2011, 69(5): 778-784.
[15]
Anonymous. Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy[J]. Epilepsia, 1989, 30(4): 389-399.
[16]
Orjuela-Rojas JM, Martínez-Juárez IE, Ruiz-Chow A, et al. Treatment of depression in patients with temporal lobe epilepsy: A pilot study of cognitive behavioral therapy vs. selective serotonin reuptake inhibitors[J]. Epilepsy Behav, 2015, 51: 176- 181.
[17]
Harden CL. New evidence supports cognitive decline in temporal lobe epilepsy[J]. Epilepsy Curr, 2007, 7(1): 12-14.
[18]
Henkin Y, Sadeh M, Kivity S, et al. Cognitive function in idiopathic generalized epilepsy of childhood[J]. Dev Med Child Neurol, 2005, 47(2): 126-132.
[19]
Realmuto S, Zummo L, Cerami C, et al. Social cognition dysfunctions in patients with epilepsy: Evidence from patients with temporal lobe and idiopathic generalized epilepsies[J]. Epilepsy Behav, 2015, 47: 98-103.
[20]
Hitiris N, Mohanraj R, Norrie J, et al. Predictors of pharmacoresistant epilepsy[J]. Epilepsy Res, 2007, 75(2-3): 192-196.
[21]
Rocha L, Alonso-Vanegas M, Martinez-Juarez IE, et al. GABAergic alterations in neocortex of patients with pharmacoresistant temporal lobe epilepsy can explain the comorbidity of anxiety and depression: the potential impact of clinical factors[J]. Front Cell Neurosci, 2014, 8: 442.
[22]
Leroy C, Poisbeau P, Keller AF, et al. Pharmacological plasticity of GABA(A) receptors at dentate gyrus synapses in a rat model of temporal lobe epilepsy[J]. J Physiol, 2004, 557(Pt 2): 473- 487.
[23]
Ragozzino D, Palma E, Di Angelantonio S, et al. Rundown of GABA type A receptors is a dysfunction associated with human drug-resistant mesial temporal lobe epilepsy[J]. Proc Natl Acad Sci U S A, 2005, 102(42): 15219-15223.
[24]
Goldberg H, Weinstock A, Bergsland N, et al. MRI segmentation analysis in temporal lobe and idiopathic generalized epilepsy[J]. BMC Neurol, 2014, 14(1): 1-20.
[25]
Ertekin BA, Kulaksizoglu IB, Ertekin E, et al. A comparative study of obsessive-compulsive disorder and other psychiatric comorbidities in patients with temporal lobe epilepsy and idiopathic generalized epilepsy[J]. Epilepsy Behav, 2009, 14(4): 634-639.
[26]
Crail-Melendez D, Herrera-Melo A, Martinez-Juarez IE, et al. Cognitive-behavioral therapy for depression in patients with temporal lobe epilepsy: a pilot study[J]. Epilepsy Behav, 2012, 23(1): 52-56.