1
|
Wan W, Chen Z, Xun Y, Yi K, Zhu Y, Pu Y, Su G, Zhou C, Wang Y, Yang P. Comprehensive evaluation of functional vision, quality of life, and cognitive ability in pediatric uveitis. BMC Ophthalmol 2023; 23:381. [PMID: 37723468 PMCID: PMC10507833 DOI: 10.1186/s12886-023-03117-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND Pediatric uveitis may cause severe impairment of vision in children and affect their quality of life as well as cognitive ability. This study aims to evaluate the functional vision, visual-related and health-related quality of life, and cognitive ability in pediatric uveitis. METHODS Children with uveitis aged 5-16 years old completed six validated instruments to assess functional visual ability with Cardiff Visual Ability Questionnaire for Children (CVAQC), vision-related quality of life with Impact of Vision Impairment for Children (IVI-C), health-related quality of life with Pediatric Quality of Life Inventory (PedsQL), cognitive ability with Chinese Wechsler Intelligence Scale for Children (C-WISC), and depression and anxiety evaluation with Hospital Anxiety and Depression Scale (HAD). RESULTS The CVAQC, IVI-C, and PedsQL scores of pediatric uveitis were significantly lower than that of normal levels. Full-scale intelligence quotient (IQ) and performance IQ were significantly lower in pediatric uveitis patients with impaired vision in their best eye (visual acuity < 0.3) compared to those with a vision equal to or better than 0.3. Verbal IQ was significantly lower in male pediatric uveitis patients with impaired vision compared to those with a vision equal to or better than 0.3. Additionally, parents of pediatric uveitis patients with impaired vision generally had lower educational levels than parents of those with a vision equal to or better than 0.3. CONCLUSIONS Impaired vision caused by pediatric uveitis has a significant impact on children's functional visual ability and quality of life. The development of cognitive function in pediatric uveitis is also significantly hindered.
Collapse
Grants
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- CSTC, 2008CA5003 Chongqing Key Laboratory of Ophthalmology
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- cstc2014pt-sy10002 Chongqing Science & Technology Platform and Base Construction Program
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- CSTC2021jscx-gksb-N0010 Key Project of Chongqing Science and Technology Bureau
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- 81970832 National Natural Science Foundation of China
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- cstc2021jcyj-msxmX0967 Natural Science Foundation of Chongqing Science and Technology Bureau
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2019 Chongqing Outstanding Scientists Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
- 2018 the Chongqing Chief Medical Scientist Project
Collapse
Affiliation(s)
- Wenjuan Wan
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Zhijun Chen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yan Xun
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Kun Yi
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Ying Zhu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yanlin Pu
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Guannan Su
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Chunjiang Zhou
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Yao Wang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China
| | - Peizeng Yang
- The First Affiliated Hospital of Chongqing Medical University, Chongqing Key Lab of Ophthalmology, Chongqing Branch of National Clinical Research Center for Ocular Diseases, Chongqing Eye Institute, Chongqing, P. R. China.
- The First Affiliated Hospital of Chongqing Medical University, Youyi Road 1, 400016, Chongqing, P.R. China.
| |
Collapse
|
2
|
Yang Y, Wang F, Andrade-Machado R, De Vito A, Wang J, Zhang T, Liu H. Disrupted functional connectivity patterns of the left inferior frontal gyrus subregions in benign childhood epilepsy with centrotemporal spikes. Transl Pediatr 2022; 11:1552-1561. [PMID: 36247884 PMCID: PMC9561512 DOI: 10.21037/tp-22-270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 08/26/2022] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Benign epilepsy with centrotemporal spikes (BECTS) is one of the most common pediatric epileptic syndromes. Recent studies have shown that BECTS can lead to significant language dysfunction. Although research supports the role of the left inferior frontal gyrus (LIFG) in BECTS, it is unclear whether the subregions of the LIFG show different change patterns in patients with this syndrome. METHODS Using resting-state functional magnetic resonance imaging (fMRI) data in a group of 49 BECTS patients and 49 healthy controls, we investigated whether the BECTS patients show abnormal connectivity patterns of the LIFG subregions. RESULTS Compared with healthy controls, the BECTS patients exhibited higher connectivity between the following: the inferior frontal sulcus (IFS) and the right anterior cingulate cortex (ACC), and the ventral area 44 (A44v) region and the left hippocampus/parahippocampus. Also, a decreased connectivity was found between the IFS and the left inferior temporal gyrus (ITG). No other significant differences in functional connectivity were found in the other 4 functional subregions of the LIFG in the BECTS. CONCLUSIONS These findings provide evidence for BECTS-related functional connectivity patterns of the LIFG subregions and suggest that different subregions may be involved in different neural circuits associated with language function in the BECTS.
Collapse
Affiliation(s)
- Yang Yang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China.,Department of Radiology, Suining Central Hospital, Suining, China
| | - Fuqin Wang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
| | - René Andrade-Machado
- Epilepsy Fellow at Children Hospital of Michigan, Detroit Medical Center, Detroit, MI, USA
| | - Andrea De Vito
- Department of Neuroradiology, H. S. Gerardo Monza, Monza, Italy
| | - Jiaojian Wang
- School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu, China.,Center for Language and Brain, Shenzhen Institute of Neuroscience, Shenzhen, China
| | - Tijiang Zhang
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
| | - Heng Liu
- Department of Radiology, Affiliated Hospital of Zunyi Medical University, Medical Imaging Center of Guizhou Province, Zunyi, China
| |
Collapse
|
3
|
Wang P, Li Y, Sun Y, Sun J, Niu K, Zhang K, Xiang J, Chen Q, Hu Z, Wang X. Altered functional connectivity in newly diagnosed benign epilepsy with unilateral or bilateral centrotemporal spikes: A multi-frequency MEG study. Epilepsy Behav 2021; 124:108276. [PMID: 34547687 DOI: 10.1016/j.yebeh.2021.108276] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 08/15/2021] [Accepted: 08/15/2021] [Indexed: 11/22/2022]
Abstract
OBJECTIVE Rolandic epilepsy (RE) is one of the most common forms of epilepsy syndromes in children. The condition is usually accompanied with either unilateral or bilateral centrotemporal epileptic discharge. Despite the term "benign", many studies have reported that children with benign epilepsy with centrotemporal spikes (BECTS) display a range of pervasive cognitive difficulties. In addition, existing research suggests that unilateral and bilateral centrotemporal spikes may affect cognition through different mechanisms. Consequently, the present study aimed to investigate cognitive impairment and the resting-state network topology of children with benign epilepsy with unilateral centrotemporal spikes (U-BECTS) and with bilateral centrotemporal spikes (B-BECTS). METHODS This study recruited 14 children with U-BECTS and 14 with B-BECTS. Thereafter, cognition was assessed in 28 children with BECTS and 14 healthy controls, using the fourth edition of the Wechsler Intelligence Scale (WISC-IV). Additionally, the functional network of the brain was constructed through magnetoencephalography (MEG) to record the resting-state brain magnetic signals of the brain and by computing virtual sensor waveforms at the source level. Moreover, graph theory (GT) analysis was used to assess the properties of the brain network. RESULTS Children in the B-BECTS group had an earlier onset of epilepsy compared to those in the U-BECTS category. In addition, both the B-BECTS and U-BECTS groups had lower Full Scale Intelligence Quotient (FSIQ), Verbal Comprehension Index (VCI), and Working Memory Index (WMI) scores, compared to the healthy controls although only children in the B-BECTS category had lower Perceptual Reasoning Index (PRI) scores. The results also showed that both BECTS groups had increased frontal cortex connectivity in specific frequency bands. Notably, children with B-BECTS showed a more disorderly and randomized network in the 1-4-Hz and 80-250-Hz frequency bands. Moreover, GT analysis showed that children with B-BECTS had lower clustering coefficient and characteristic path length in the 80-250-Hz frequency bands and higher connection strength in the 4-8-Hz frequency bands. On the other hand, the U-BECTS group had a higher clustering coefficient in the 8-12-Hz frequency bands, compared to the healthy controls. Correlation analysis revealed that there were negative correlations between network parameters, clinical characteristics, and neuropsychological data in the U-BECTS category. CONCLUSION The findings revealed that children with BECTS display a diffuse early cognitive deficit. In addition, resting-state suboptimal network topology may be the mechanism of cognitive impairment in children with BECTS. The study also showed that and children with B-BECTS may be at a higher risk of cognitive impairment.
Collapse
Affiliation(s)
- Pengfei Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yihan Li
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Yulei Sun
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jingtao Sun
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Kai Niu
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Ke Zhang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China
| | - Jing Xiang
- MEG Center, Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45220, United States
| | - Qiqi Chen
- MEG Center, Nanjing Brain Hospital, Nanjing, Jiangsu 210029, China
| | - Zheng Hu
- Department of Neurology, Nanjing Children's Hospital, Nanjing, Jiangsu 210029, China
| | - Xiaoshan Wang
- Department of Neurology, Nanjing Brain Hospital, Nanjing Medical University, Nanjing, Jiangsu 210029, China.
| |
Collapse
|
4
|
Bakke KA, Howlin P, Helverschou SB. Hyperactive behaviour in Angelman syndrome: the association with sleep problems and age of epilepsy onset. JOURNAL OF INTELLECTUAL DISABILITY RESEARCH : JIDR 2021; 65:666-674. [PMID: 33951249 DOI: 10.1111/jir.12842] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/12/2021] [Accepted: 03/31/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Sleep problems are common in many neurodevelopmental disorders, but little is known about how sleep is related to behavioural symptoms in Angelman syndrome (AS) or other genetic disorders. Hyperactive behaviour, sleep problems and epilepsy seem to be more common in AS than in other genetic conditions associated with severe intellectual disability. We hypothesised that both more sleep problems and earlier onset of epileptic seizures would predict more symptoms of hyperactivity. Hence, the aim of the project was to explore the association between hyperactive behaviour, sleep problems and age of epilepsy onset in individuals with AS. METHOD All known parents/guardians (n = 115) of individuals with AS in Norway were invited to participate in this descriptive correlational study. Fifty-six individuals (49%) responded, and 42 people (25 male and 17 female; mean age 18.5 years, range 2-57 years) with genetically verified AS were included. Scores for 'hyperactivity' and 'sleep problems' were derived from questionnaire data. Information on epilepsy was obtained from medical records. RESULTS 'Hyperactivity' was positively correlated with 'total sleep problems' (r = 0.46, P = 0.002) and negatively correlated with 'age of epilepsy onset' (r = -0.47, P = 0.01). 'Age of epilepsy onset' was not correlated with 'total sleep problems'. An overall multiple regression model with 'hyperactivity' as the dependent variable and 'age of epilepsy onset' and 'total sleep problems' as covariates was significant (R2 = 0.39, F = 8.16, P = 0.002). Hence, hyperactivity in AS could be predicted from both age of epilepsy onset and current sleep problems. CONCLUSIONS Sleep problems may increase hyperactivity symptoms in individuals with AS. The association between hyperactivity and sleep problems in AS indicates that both should be investigated together as part of routine clinical assessment and intervention for either area of difficulty. Younger age of epilepsy onset was associated with more hyperactivity in AS, which may be related to encephalopathic effects of seizures and epilepsy.
Collapse
Affiliation(s)
- K A Bakke
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - P Howlin
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - S B Helverschou
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| |
Collapse
|
5
|
van den Berg L, de Weerd A, Reuvekamp M, van der Meere J. Cognitive control deficits in pediatric frontal lobe epilepsy. Epilepsy Behav 2020; 102:106645. [PMID: 31760200 DOI: 10.1016/j.yebeh.2019.106645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/19/2019] [Revised: 09/25/2019] [Accepted: 10/09/2019] [Indexed: 11/16/2022]
Abstract
Executive dysfunction and behavioral problems are common in children with epilepsy. Inhibition and shifting, both aspects of cognitive control, seem related to behavior problems and are thought to be driven mainly by the frontal lobes. We investigated if inhibition and shifting deficits are present in children with frontal lobe epilepsy (FLE). Secondly, we studied the relationship between these deficits and behavior problems. Thirty-one children were administered the Stroop Color Word Test and a digital version of the Wisconsin Card Sorting Test (WCST). Parents completed the Behavioral Rating Inventory for Executive Function (BRIEF) and the Achenbach scale (Child Behavior Checklist (CBCL)). About 20% of the children displayed significant low results on the Stroop Effect. About 60% showed shifting problems on the WCST. Parents reported cognitive control and behavioral deficits in about a third of the children. Also, behavioral problems and deficits in inhibition and shifting in daily life (BRIEF) seem to be related. There were no correlations between questionnaires and the Stroop and the WCST. Only in the group of children with many perseverative errors there were especially high correlations between Inhibit of the BRIEF.
Collapse
Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands; RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands.
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - Marieke Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - Jaap van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands
| |
Collapse
|
6
|
van den Berg L, de Weerd AW, Reuvekamp HF, van der Meere JJ. The burden of parenting children with frontal lobe epilepsy. Epilepsy Behav 2019; 97:269-274. [PMID: 31254848 DOI: 10.1016/j.yebeh.2019.05.034] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 05/14/2019] [Accepted: 05/23/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE Caring for a child with a chronic illness adds stress to the typical parenting stress in healthy developing children. This stress can place a heavy burden on parents and may increase when a child displays problem behavior. In general, parenting and child's behavior problems are associated. Furthermore, externalizing (more outgoing) behavior is reported frequently in children with frontal lobe epilepsy (FLE). Therefore, in this study, we first investigated the burden of parents of children with FLE, and second, we investigated the relation between the experienced burden and reported behavioral problems. The validity of parents' reports on proxy measures as well as duration of epilepsy is taken into account. METHODS Thirty-one parents of children with FLE completed validated questionnaires about behavioral problems and burden of parenting. To examine if parents tend to be inconsistent or unusually negative, we used the two validity scales of the Behavioral Rating Inventory of Executive Function (BRIEF) (Negativity and Inconsistency). RESULTS Only parents of children with FLE who have had epilepsy for 5 years or longer report more problems on the Nijmeegse Vragenlijst voor de Opvoedingssituatie (NVOS) subscales 'Able to manage', 'Child is a burden', and 'Good Interaction' compared with the healthy controls. The subscale 'Child is a burden' significantly predicts scores in about 20% to 49% on the main scales of the Child Behavior Checklist (CBCL), the Global Executive Composite (GEC), and Behavioral Regulation Index (BRI) of the BRIEF. Only 6% of parents scored in the clinical range of the negativity scale of the BRIEF. For the inconsistency scale, this was 45%. CONCLUSION Parents of children with FLE do not report excessive parental burden. Longer duration of epilepsy might be a risk factor in experiencing burden. The findings suggest a link between parental burden and behavioral problems in children with FLE. Externalizing behavioral problems are the most marked behavioral problems, which relate to the parental burden. Parents tend to be inconsistent in their ratings.
Collapse
Affiliation(s)
- L van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands; RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands.
| | - A W de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - H F Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000 AN Zwolle, Netherlands
| | - J J van der Meere
- RijksUniversiteitGroningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712 TS Groningen, Netherlands
| |
Collapse
|
7
|
Vannest J, Maloney TC, Tenney JR, Szaflarski JP, Morita D, Byars AW, Altaye M, Holland SK, Glauser TA. Changes in functional organization and functional connectivity during story listening in children with benign childhood epilepsy with centro-temporal spikes. BRAIN AND LANGUAGE 2019; 193:10-17. [PMID: 28209266 PMCID: PMC5554735 DOI: 10.1016/j.bandl.2017.01.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2015] [Revised: 12/28/2016] [Accepted: 01/26/2017] [Indexed: 05/31/2023]
Abstract
Children with Benign Epilepsy with Centrotemporal Spikes (BECTS), despite high likelihood for seizure remission, are reported to have subtle difficulties in language and other cognitive skills. We used functional MRI and a story listening task to examine the effect of BECTS on patterns of activation and connectivity. Language and cognitive skills were assessed using standardized measures. Twenty-four children with recently diagnosed BECTS and 40 typically-developing children participated. In a functionally-defined region of interest in right inferior frontal gyrus, BECTS patients showed a lower level of activation. Across both groups combined, increased activation in superior/middle temporal regions of interest was associated with better language scores. Connectivity in the story processing network was similar between groups, but connectivity within left inferior frontal gyrus was decreased in children with BECTS. These results suggest that language networks are largely maintained in new-onset BECTS, but some subtle changes in activation and connectivity can be observed.
Collapse
Affiliation(s)
| | | | | | | | - Diego Morita
- Cincinnati Children's Hospital Medical Center, United States
| | - Anna W Byars
- Cincinnati Children's Hospital Medical Center, United States
| | - Mekibib Altaye
- Cincinnati Children's Hospital Medical Center, United States
| | - Scott K Holland
- Cincinnati Children's Hospital Medical Center, United States
| | - Tracy A Glauser
- Cincinnati Children's Hospital Medical Center, United States
| |
Collapse
|
8
|
Ho NT, Kroner B, Grinspan Z, Fureman B, Farrell K, Zhang J, Buelow J, Hesdorffer DC. Comorbidities of Rare Epilepsies: Results from the Rare Epilepsy Network. J Pediatr 2018; 203:249-258.e5. [PMID: 30195559 DOI: 10.1016/j.jpeds.2018.07.055] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2018] [Revised: 06/18/2018] [Accepted: 07/12/2018] [Indexed: 01/10/2023]
Abstract
OBJECTIVE To describe the prevalence and characteristics of comorbidities in persons with rare epilepsies. STUDY DESIGN Persons with rare epilepsies and caregivers of those affected were recruited through the Epilepsy Foundation and more than 30 rare epilepsy advocacy organizations affiliated with the Rare Epilepsy Network (REN). A web-based survey was conducted using a questionnaire consisting of core sections to collect data from affected persons on various aspects, including comorbidities. Comorbidity information was grouped into 15 classes, 12 of which had a stem question followed by detailed branch questions and 3 that were created from a combination of related questions. RESULTS Of 795 persons with more than 30 different rare epilepsy diagnosis groups, one-half had ≥5 comorbidity classes and 97% were classified as complex chronic disease (C-CD). The highest number of comorbidity classes reported per person were persons with Aicardi syndrome, Phelan-McDermid syndrome (median, 7.0; IQR, 5.0-9.0), and tuberous sclerosis complex (median, 6.0; IQR, 4.0-8.0). The most common comorbidity classes were learning/developmental disability (71%), mental health issues (71%), sleep disorders (60%), brain abnormalities (52%), oral issues (49%), bone-joint issues (42%), hyper/hypotonia (42%), and eye-vision disorders (38%). The prevalence of brain abnormalities, hyper/hypotonia, eye, and cardiac disorders was significantly higher in persons first diagnosed with epilepsy at a younger age (<9 months) than in those first diagnosed at an older age (P < .05 for trend). CONCLUSIONS Nearly all persons with rare epilepsies are medically complex, with a high prevalence of multiple comorbidities, especially those who were diagnosed with epilepsy in the first year of life. Comorbidities should be carefully considered in the diagnosis and management of persons with rare epilepsies.
Collapse
Affiliation(s)
- Nhan Thi Ho
- Gertrude H. Sergievsky Center, Department of Epidemiology, Columbia University, New York, NY
| | - Barbara Kroner
- Department of Epidemiology, Research Triangle Institute, Research Triangle Park, NC
| | | | - Brandy Fureman
- Research and New Therapies, Epilepsy Foundation, Landover, MD
| | | | - Jingzhou Zhang
- Gertrude H. Sergievsky Center, Department of Epidemiology, Columbia University, New York, NY
| | - Janice Buelow
- Indiana University School of Nursing, Indianapolis, IN
| | - Dale C Hesdorffer
- Gertrude H. Sergievsky Center, Department of Epidemiology, Columbia University, New York, NY.
| |
Collapse
|
9
|
Kagitani-Shimono K, Kato Y, Hanaie R, Matsuzaki J, Tanigawa J, Iwatani Y, Azuma J, Taniike M. Abnormal cortical activation during an auditory word comprehension task in benign childhood epilepsy with centrotemporal spikes: A magnetoencephalographic study. Epilepsy Behav 2018; 87:159-166. [PMID: 30120072 DOI: 10.1016/j.yebeh.2018.05.035] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 05/06/2018] [Accepted: 05/20/2018] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Benign childhood epilepsy with centrotemporal spikes (BECTS), also known as rolandic epilepsy, has recently been reported to be associated with variable degrees of cognitive dysfunction. Many studies reported poor language ability in children with BECTS compared with healthy control children. To elucidate the harmful effects of BECTS on language cognition, we studied the magnetoencephalographic activity elicited by an auditory language comprehension task. METHODS The participants (N = 20) included 10 children diagnosed with BECTS (aged 10.8 ± 2.8 years) and 10 age-matched healthy children (control) (aged 10.6 ± 1.6 years). Cognitive function was assessed using general intellectual function and language ability. In patients with BECTS, we reviewed the clinical course and electroencephalogram (EEG) findings. We recorded the cortical responses elicited by an auditory language comprehension task using magnetoencephalography (MEG). We compared those results between groups and analyzed the correlation with cognitive scores and frequency of spikes. RESULTS The full-scale intelligence quotient (FSIQ) by the Wechsler Intelligence Scale for Children-4th edition was significantly reduced in the group with BECTS (96.4 ± 12.3) compared with the control group (110.0 ± 7.4). In half of the group with BECTS, the auditory comprehension score fell below the age-standard level. In the group with BECTS, the cortical activation during the task showed reduced intensity in language-associated areas such as the bilateral primary auditory cortex, left superior and mid-temporal areas, and inferior frontal area compared with those in the control group. In addition, the cortical activation in the left superior temporal area was negatively correlated with spike frequency and positively correlated with FSIQ in the group with BECTS. Conversely, the right inferior frontal and mid-temporal areas had increased the activations in the group with BECTS. From the time frequency analysis, low gamma band event-related desynchronization was reduced in the group with BECTS. CONCLUSION Epileptic spikes negatively influenced responsiveness to the auditory language comprehension task in the language-associated cortices. These findings suggest that epileptic spikes could have a negative impact on the functional activity in rolandic areas and become a reason to change the functional development of the language network.
Collapse
Affiliation(s)
- Kuriko Kagitani-Shimono
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Epilepsy center, Osaka University Hospital, Suita, Osaka, Japan.
| | - Yoko Kato
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Ryuzo Hanaie
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Junko Matsuzaki
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan
| | - Junpei Tanigawa
- Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| | - Yoshiko Iwatani
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan; Epilepsy center, Osaka University Hospital, Suita, Osaka, Japan
| | | | - Masako Taniike
- Division of Developmental Neuroscience, United Graduate School of Child Development, Osaka University, Suita, Osaka, Japan; Department of Pediatrics, Osaka University Graduate School of Medicine, Suita, Osaka, Japan
| |
Collapse
|
10
|
van den Berg L, de Weerd A, Reuvekamp M, Hagebeuk E, van der Meere J. Executive and behavioral functioning in pediatric frontal lobe epilepsy. Epilepsy Behav 2018; 87:117-122. [PMID: 30115605 DOI: 10.1016/j.yebeh.2018.07.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/23/2018] [Accepted: 07/24/2018] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Epilepsy, as a chronic and neurological disease, is generally associated with an increased risk for social and emotional behavior problems in children. These findings are mostly derived from studies on children with different epilepsy types. However, there is limited information about the associations between frontal lobe epilepsy (FLE) and cognitive and behavioral problems. The aim of this study was to examine relationships between FLE and executive and behavioral functioning reported by parents and teachers. MATERIAL AND METHODS Teachers and parents of 32 children (18 boys, 14 girls, mean age 9; 2 years ±1;6) with a confirmed diagnosis of FLE completed the Behavioral Rating Inventory of Executive Function (BRIEF), the Child Behavior Checklist (CBCL), and Teacher Report Form (TRF). RESULTS About 25 to 35% of the parents and teachers rated children in the abnormal range of the main scales of the BRIEF, CBCL, and TRF. Teachers tend to report more metacognition problems, whereas parents tend to report more behavior regulation problems. Children with left-sided FLE showed more problems than children with bilateral or right-sided FLE. The whole range of executive dysfunctioning is linked to behavioral dysfunctioning in FLE, but ratings vary across settings and informants. The epilepsy variables age of onset, lateralization, drug load, and duration of epilepsy had only a small and scattered contribution. CONCLUSION Ratings on the BRIEF, CBCL, and TRF are moderately to highly correlated, suggesting a (strong) link between executive and behavioral functioning. Subtle differences between parents and teachers ratings suggest different executive function demands in various settings.
Collapse
Affiliation(s)
- Lydia van den Berg
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands; Rijksuniversiteit Groningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712, TS, Groningen, Netherlands.
| | - Al de Weerd
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Marieke Reuvekamp
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Eveline Hagebeuk
- Stichting Epilepsie Instellingen Nederland, Postbus 563, 8000, AN, Zwolle, Netherlands
| | - Jaap van der Meere
- Rijksuniversiteit Groningen, Faculteit Gedrags- & Maatschappijwetenschappen, Klinische & Ontwikkelingsneuropsychologie, Grote Kruisstraat 2/1, 9712, TS, Groningen, Netherlands
| |
Collapse
|
11
|
Bakke KA, Howlin P, Retterstøl L, Kanavin ØJ, Heiberg A, Nærland T. Effect of epilepsy on autism symptoms in Angelman syndrome. Mol Autism 2018; 9:2. [PMID: 29340132 PMCID: PMC5759870 DOI: 10.1186/s13229-017-0185-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2017] [Accepted: 12/25/2017] [Indexed: 12/02/2022] Open
Abstract
Background Autism spectrum disorder and epilepsy often co-occur; however, the extent to which the association between autism symptoms and epilepsy is due to shared aetiology or to the direct effects of seizures is a topic of ongoing debate. Angelman syndrome (AS) is presented as a suitable disease model to explore this association. Methods Data from medical records and questionnaires were used to examine the association between age of epilepsy onset, autism symptoms, genetic aberration and communication level. Forty-eight participants had genetically verified AS (median age 14.5 years; range 1–57 years). A measure of autism symptoms (the Social Communication Questionnaire; SCQ) was completed for 38 individuals aged ≥ 4 years. Genetic cause was subgrouped into deletion and other genetic aberrations of the 15q11-q13 area. The number of signs used to communicate (< 20 sign and ≥ 20 signs) was used as a measure of nonverbal communication. Results Mean age of epilepsy onset was 3.0 years (range 3 months–7.8 years). Mean SCQ score for individuals without epilepsy was 13.6 (SD = 6.7) and with epilepsy 17.0 (SD = 5.6; p = 0.17); 58% used fewer than 20 signs to communicate. There were no age differences between groups according to presence of epilepsy, level of nonverbal communication or type of genetic aberration. SCQ scores were higher in individuals with the deletion than in those with other genetic aberrations (18.7 vs 10.8 p = 0.008) and higher in the group who used < 20 signs to communicate (19.4 vs 14.1 p = 0.007). Age of epilepsy onset was correlated with SCQ (r = − 0.61, p < 0.001). Multiple regression showed that age of seizure onset was significantly related to SCQ score (β = − 0.90; p = 0.006), even when the type of genetic abnormality was controlled (R2 = 0.53; F = 10.7; p = 0.001). Conclusions The study provides support for the notion that seizures themselves contribute more to autism symptoms than expected from the underlying genetic pathology alone. The study demonstrates how a rare genetic syndrome such as Angelman syndrome may be used to study the relation between epilepsy and autism symptomatology.
Collapse
Affiliation(s)
- Kristin A Bakke
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway
| | - Patricia Howlin
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Faculty of Health Sciences, University of Sydney, Sydney, NSW Australia
| | - Lars Retterstøl
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Øivind J Kanavin
- Frambu National Resource Center for Rare Disorders, Siggerud, Norway
| | - Arvid Heiberg
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Terje Nærland
- NevSom, Department of Rare Disorders, Oslo University Hospital, Oslo, Norway.,NORMENT, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| |
Collapse
|
12
|
Wickens S, Bowden SC, D'Souza W. Cognitive functioning in children with self-limited epilepsy with centrotemporal spikes: A systematic review and meta-analysis. Epilepsia 2017; 58:1673-1685. [DOI: 10.1111/epi.13865] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/14/2017] [Indexed: 01/08/2023]
Affiliation(s)
- Steven Wickens
- Melbourne School of Psychological Sciences; University of Melbourne; Parkville Victoria Australia
| | - Stephen C. Bowden
- Department of Clinical Neurosciences; St. Vincent's Hospital Melbourne; Fitzroy Victoria Australia
| | - Wendyl D'Souza
- Department of Medicine; St. Vincent's Hospital; University of Melbourne; Fitzroy Victoria Australia
| |
Collapse
|
13
|
Tong X, Chen J, Park SP, Wang X, Wang C, Su M, Zhou D. Social support for people with epilepsy in China. Epilepsy Behav 2016; 64:224-232. [PMID: 27764733 DOI: 10.1016/j.yebeh.2016.08.010] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2016] [Revised: 08/08/2016] [Accepted: 08/09/2016] [Indexed: 02/05/2023]
Abstract
The aim of this study was to better understand social support in adult people with epilepsy (PWE) in China and to explore the factors related to weaker or stronger social support in PWE when compared with a group of matching healthy controls. Consecutively, we recruited PWE from the epilepsy outpatient clinic of the West China Hospital and healthy controls from nearby urban and rural areas. People with epilepsy and healthy controls were gender- and age-matched. Each participant was interviewed and completed the following instruments: the Social Support Rating Scale (SSRS) and the Hospital Anxiety and Depression Scale (HADS). In addition, we measured quality of life (QoL) in PWE using the Quality of Life in Epilepsy Inventory (QOLIE-31). We compared the SSRS scores between PWE and healthy controls and searched for relevant factors using correlation and regression analyses. The results showed that PWE scored lower on the SSRS than healthy controls. For PWE, early onset and depression were related to weaker social support. In healthy controls, being married and being psychiatrically healthy (i.e., scored lower on the HADS) were related to stronger support. Family members, especially parents and spouses, were the most powerful supporters for PWE and healthy people, but PWE relied on their families to a greater extent. Early intervention and psychiatric treatment are important to address and improve social support for PWE.
Collapse
Affiliation(s)
- Xin Tong
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Jiani Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China
| | - Sung-Pa Park
- Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Xi Wang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Chiyi Wang
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Minglian Su
- West China School of Medicine, Sichuan University, Chengdu, Sichuan, PR China
| | - Dong Zhou
- Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, PR China.
| |
Collapse
|