Screening of attention and executive functions in pediatric patients at a tertiary epilepsy center

Area of Science:

• Neurology
• Pediatric Epilepsy
• Neuropsychology

Background:

• Executive dysfunction is common in children with epilepsy, negatively impacting psychosocial outcomes.
• Effective screening tools are needed to identify executive dysfunction across varying impairment levels.
• EpiTrack Junior® (EpiTrackJr) is a potential tool for assessing attention and executive functions (EFs) in pediatric epilepsy.

Purpose of the Study:

• To evaluate the applicability of EpiTrackJr as a screening tool in a tertiary epilepsy center.
• To explore the combined utility of EpiTrackJr and a subjective measure (BRIEF) for assessing everyday attention and EFs.
• To determine the clinical significance of EpiTrackJr in conjunction with behavioral ratings.

Main Methods:

• A retrospective study of 235 pediatric epilepsy patients at the Norwegian National Centre for Epilepsy.
• Assessment using EpiTrackJr for objective performance and the Behavioral Rating Inventory of Executive Functioning (BRIEF) for subjective ratings.
• Analysis of correlations between EpiTrackJr scores, BRIEF indices, anti-seizure medication load, comorbidity, and IQ.

Main Results:

• Nearly half (47.7%) of patients showed significant impairment on EpiTrackJr; 23% had mild impairment.
• Impaired EpiTrackJr performance correlated with higher anti-seizure medication (ASM) load, comorbidity, and lower IQ.
• A significant, weak correlation was found between EpiTrackJr and the BRIEF Metacognitive Index (r=-0.236, p=.014), but not the Behavioral Regulation Index.

Conclusions:

• EpiTrackJr is applicable for screening attention and EFs in pediatric epilepsy patients at specialized centers.
• Objective performance measures (EpiTrackJr) and subjective behavior ratings (BRIEF) capture distinct aspects of executive functions.
• Combining both assessment types provides crucial, non-redundant information on a child's EFs in various contexts.