Extremely/Very Premature Birth Associated With Focal Epileptic Activity in Comorbid Autism and Epilepsy

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Clinical Neurology

Background:

• Autism spectrum disorder and epilepsy frequently co-occur (ASD+EPI), indicating shared underlying pathologies.
• Epilepsy phenotypes in individuals with ASD+EPI are highly variable.
• Preterm birth is a known risk factor for both autism and epilepsy, potentially leading to distinct phenotypes.

Purpose of the Study:

• To investigate the impact of gestational age at birth on epilepsy phenotypes in patients with ASD+EPI.
• To determine if extremely preterm birth is associated with a predisposition to focal versus generalized epileptic activity.

Main Methods:

• Analysis of clinical EEG reports from over 200 patients diagnosed with ASD+EPI.
• Extraction of seizure lateralization and location data from EEG recordings.
• Comparison of epilepsy phenotypes across three gestational age groups: <32 weeks, 32-36⁺⁶ weeks, and 37-40⁺⁶ weeks.

Main Results:

• Patients born before 32 weeks' gestational age exhibited a significantly increased incidence of focal interictal activity.
• No significant differences in seizure or interictal categorization were observed between moderate/late preterm and term-born groups.
• This suggests a specific predisposition towards focal epileptic activity in extremely/very preterm infants with ASD+EPI.

Conclusions:

• Very preterm birth (<32 weeks) is associated with a higher likelihood of focal epileptic activity in individuals with ASD+EPI.
• This predisposition may stem from alterations in white matter development following extremely preterm birth.
• Gestational age at birth is a critical factor influencing epilepsy phenotype in the context of ASD+EPI.