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Cognitive functioning in children with both epilepsy and ADHD: A systematic review and meta-analysis

Steven Wickens1, Persephone Gummersall1, Trevor Brown1

  • 1Neurocare Group, Melbourne, VIC, Australia.

Brain & Development
|April 12, 2026
PubMed

Insights

Children with both epilepsy and attention deficit hyperactivity disorder (ADHD) show poorer cognitive function compared to those with either condition alone or healthy peers. Comprehensive assessment and targeted interventions are crucial for this vulnerable group.

Area of Science:

  • Neuroscience
  • Developmental Psychology
  • Child Psychiatry

Background:

  • Epilepsy and attention deficit hyperactivity disorder (ADHD) exhibit a known bidirectional association in children.
  • Comorbid neurodevelopmental conditions can significantly impact cognitive functioning.

Purpose of the Study:

  • To systematically review and meta-analyze the neuropsychological functioning of children with comorbid epilepsy and ADHD.
  • To compare cognitive outcomes in children with epilepsy and ADHD against those with epilepsy alone, ADHD alone, and healthy controls.

Main Methods:

  • Systematic literature search across two databases.
  • Inclusion of 22 observational studies comparing neuropsychological outcomes.
  • Neuropsychological data organized according to the Cattell-Horn-Carroll (CHC) taxonomy.
  • Random effects meta-analyses to determine effect sizes.

Main Results:

  • Children with epilepsy and ADHD showed poorer cognitive outcomes compared to children with epilepsy alone or ADHD alone (SMD -0.30 to -0.72).
  • Compared to healthy controls, children with comorbid epilepsy and ADHD exhibited moderate to large effect sizes for cognitive deficits (SMD -0.61 to -1.12).
  • Wide and overlapping confidence intervals indicated a heterogeneous neuropsychological profile in this group.

Conclusions:

  • Children with comorbid epilepsy and ADHD present with significant cognitive dysfunction.
  • The findings highlight the vulnerability of cognitive function in children with co-occurring neurobehavioral conditions.
  • Emphasizes the necessity for comprehensive neuropsychological assessment and tailored interventions for affected children.

Keywords:
Attention deficit hyperactivity disorderCattell-horn-CarrollChildhood epilepsyCognitionNeuropsychology

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