Pediatric epilepsy and comorbid reading disorders, math disorders, or autism spectrum disorders: Impact of epilepsy
Loretta van Iterson1, Peter F de Jong2, Bonne J H Zijlstra2
1Epilepsy Institute in the Netherlands Foundation (SEIN), Department of Psychology, The Netherlands; School De Waterlelie, Expertise Centre for Education and Epilepsy, The Netherlands.
Insights
Children with epilepsy and neurodevelopmental disorders show altered cognitive patterns. Epilepsy impacts verbal and performance abilities, suggesting shared underlying mechanisms in these pediatric comorbidities.
Area of Science:
- Pediatric Neurology
- Neurodevelopmental Disorders
- Cognitive Psychology
Background:
- Comorbidities are frequent in pediatric epilepsy.
- This study investigates cognitive patterns in children with isolated epilepsy, isolated neurodevelopmental disorders (NDDs), and comorbid epilepsy and NDDs.
Purpose of the Study:
- To compare cognitive patterns (verbal vs. nonverbal abilities) in children with isolated epilepsy, isolated NDDs (reading disorders, math disorders, autism spectrum disorders [ASDs]), and comorbid conditions.
- To explore the independent contribution of epilepsy and NDD type to cognitive patterns.
Main Methods:
- Utilized WISC (Wechsler Intelligence Scale for Children) data from two samples: isolated disorders (n=117) and comorbid epilepsy and NDDs (n=171).
- Employed repeated measures ANOVA and exploratory 2*3*2 factorial analysis to compare verbal (VIQ) and performance (PIQ) intelligence quotient patterns.
Main Results:
- Isolated epilepsy showed a VIQ>PIQ pattern, not observed in isolated NDDs.
- Comorbid epilepsy altered patterns, blending features of isolated epilepsy and NDDs.
- Epilepsy exacerbated VIQ>PIQ in math disorders, mitigated it in reading disorders, and showed no clear pattern in ASDs.
- Epilepsy consistently shifted patterns toward lower performance or relatively spared verbal abilities, suggesting shared mechanisms.
Conclusions:
- Epilepsy significantly influences cognitive patterns in children with neurodevelopmental disorders.
- The impact of epilepsy on cognitive profiles appears to involve shared underlying mechanisms across different comorbidities.
- Understanding these patterns is crucial for targeted interventions in pediatric epilepsy and NDDs.
Introduction:
In pediatric epilepsy, comorbidities are reported to be frequent. The present study focusedon the cognitive patterns of children with isolated epilepsy, children with isolated neurodevelopmental disorders (reading disorders, math disorders, autism spectrum disorders), and children with epilepsy and these neurodevelopmental disorders as comorbidities.
Methods:
Based on two samples of referred children, one with epilepsy, reading disorders, math disorders, or ASDs occurring in "isolation" (n=117) and one with reading disorders, math disorders, and ASDs occurring comorbid with epilepsy (n=171), cognitive patterns were compared. The patterns displayed by verbal and nonverbal abilities from the WISC series were studied with repeated measures ANOVA. Thereafter, an exploratory 2∗3∗2 factorial analysis was done to study the independent contribution of the type of comorbidity and of the presence or absence of epilepsy to the VIQ-PIQ pattern.
Results:
In isolated epilepsy, a VIQ>PIQ pattern was found, which was not seen in the other disorders. When epilepsy and another disorder co-occurred, patterns were altered. They resembled partly the pattern seen in isolated epilepsy and partly the pattern seen in the isolated neurodevelopmental disorder. In comorbid reading disorders, the VIQ>PIQ pattern was mitigated; in comorbid math disorders, it was exacerbated. In comorbid ASDs, no clear pattern emerged. In the presence of epilepsy, patterns characteristic of isolated disorders appeared systematically shifted toward relatively lowered performance abilities or relatively spared verbal abilities. The similar "impact" exerted by epilepsy on the patterns of the various conditions suggested shared mechanisms.
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