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Neuropsychological outcomes in children of mothers with epilepsy
Elisa Kantola-Sorsa1, Eija Gaily, Mirva Isoaho
1Hospital for Children and Adolescents, Department of Pediatric Neurology, Helsinki University Central Hospital, Helsinki, Finland. elisa.kantola-sorsa@hus.fi
Insights
Children of mothers with epilepsy showed lower cognitive performance, particularly in attention and memory. Maternal anti-epileptic drug exposure may exacerbate these deficits, suggesting both genetic and environmental factors contribute.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatrics
Background:
- Maternal epilepsy can impact offspring neurodevelopment.
- Understanding the specific cognitive effects and contributing factors is crucial for early intervention.
Purpose of the Study:
- To investigate the cognitive performance of children born to mothers with epilepsy.
- To explore the influence of maternal anti-epileptic drug (AED) exposure on offspring cognition.
Main Methods:
- A neuropsychological assessment using NEPSY subtests was administered to 154 children of mothers with epilepsy and 130 controls.
- Cognitive domains assessed included attention, memory, auditory-verbal, visuomotor, and fine motor abilities.
Main Results:
- Children of mothers with epilepsy performed significantly lower on attention, memory, and fine-motor tasks.
- Cognitive deficits were more pronounced in children exposed to maternal AEDs in utero.
- Valproate-exposed children showed specific weaknesses in working memory and auditory attention.
Conclusions:
- Both maternal AED exposure and potential genetic factors associated with epilepsy may contribute to cognitive deficits in offspring.
- Further research is needed to disentangle the effects of epilepsy type, polytherapy, and specific AEDs.
Abstract:
The study investigated the nature of the effects of maternal epilepsy on cognitive performance of the offspring. One hundred fifty-four children of mothers with epilepsy aged 5 to 11 years (study group), along with 130 control children, comparable with respect to IQ, socio-economic status, age, and gender underwent a neuropsychological assessment using subtests from the NEPSY: A Developmental Neuropsychological Assessment, tapping attentional, auditory-verbal, visuomotor, fine motor, and memory abilities. The study group scored significantly lower than the controls on measures of attention, memory, and fine-motor function. Deficits were more marked in but not limited to the subset of the study group exposed to maternal medication in utero. Group differences on auditory attention were found only in younger children. Valproate-exposed children obtained lower scores on sentence repetition, as well as on the more demanding part of a test of auditory attention, than other children in the study group, suggesting weaknesses in working memory in the former subgroup. Confounding by maternal epilepsy type and polytherapy complicate interpretation of this finding. Differences between subsets of children not exposed to anti-epileptic drugs in utero and controls suggest that both drug exposure and genetic factors may contribute to cognitive deficits associated with maternal epilepsy.
