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Published on: January 11, 2016
A neuropsychological assessment, using computerized battery tests (CANTAB), in children with benign rolandic epilepsy
M A Vinţan1, S Palade, A Cristea
1Department of Neurosciences, Iuliu Haţieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania.
Insights
Benign rolandic epilepsy (BRE) is linked to subtle visual memory deficits, even before treatment. These cognitive impairments suggest a broader brain involvement in the epilepsy process.
Area of Science:
- Neuroscience
- Pediatric Neurology
- Cognitive Psychology
Background:
- Benign rolandic epilepsy (BRE), a classification of idiopathic epilepsy, is increasingly recognized as potentially associated with cognitive deficits.
- The debate continues on whether these deficits stem from epilepsy itself, treatment, or other factors.
Purpose of the Study:
- To investigate cognitive deficits in children with BRE at seizure onset, before any anti-epileptic drug (AED) therapy.
- To determine if BRE is associated with pre-treatment cognitive impairments.
Main Methods:
- Neuropsychological assessment of 18 BRE children and an age-matched control group using the Cambridge Neuropsychological Test Automated Battery (CANTAB).
- Evaluation focused on visual memory, induction, and executive functions in subjects during their initial neurological assessment, prior to AED initiation.
- Analysis included correlations between cognitive test results and characteristics of centrotemporal spikes (CTS).
Main Results:
- BRE children showed comparable performance to controls in induction and executive functions.
- Significant differences were observed in visual memory subtests, specifically the Pattern Recognition Memory (PRM) and Spatial Recognition Memory (SRM) percent correct.
- Earlier age of seizure onset negatively impacted visual memory performance, and correlations were found between CANTAB subtest results and CTS characteristics.
Conclusions:
- Subtle neuropsychological deficits, particularly in visual memory, are present at seizure onset in BRE patients.
- These findings support the notion that BRE may involve more diffuse brain dysfunction.
- The results align with previous studies indicating that BRE is not always 'benign' in terms of cognitive impact.
Rationale:
Benign rolandic epilepsy (BRE) is a form of partial idiopathic epilepsy according to the International League Against Epilepsy (ILAE) syndromes classification (1989). Recent studies have identified cases of BRE that do not meet the initial definition of 'benign'; these included reports of cases with specific cognitive deficits. It is still a matter of debate, whether these deficits are due to epilepsy per se, to treatment or other associated factors.
Objectives:
The aim of this study was to evaluate if BRE children have cognitive deficits at the onset of their seizures, prior to their participation in any anti-epileptic drug therapy (AED).
Methods And Results:
We performed a neuropsychological assessment of 18 BRE children compared with a corresponding age-matched control group. We used the Cambridge Neuropsychological Test Automated Battery (CANTAB). Subjects were at their first neurological evaluation, before any AED therapy. We assessed: visual memory, induction and executive functions. In our group, the BRE children performed comparably with the control children for the induction and executive functions. Substantial differences were identified for the visual memory subtests: PRM percent correct (t = -2.58, p = 0.01) and SRM percent correct (t = -2.73, p = 0.01). Age of seizure onset had a negative impact on the visual memory subtest performances (PRM mean correct latency). We found significant correlations between the different CANTAB subtests results and characteristics of the centrotemporal spikes (CTS).
Discussion:
Our results are consistent with the findings of other similar studies. This form of epilepsy is associated with subtle neuropsychological deficits, present at seizure onset. Neuropsychological deficits identified, suggest a more diffuse brain involvement in the epileptiform process.
