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Dysembryoplastic neuroepithelial tumors: A model for examining the effects of pathology versus seizures on cognitive dysfunction in epilepsy

Baxendale, S; Thompson, P; Sander, JW; Donnachie, E; (2013) Dysembryoplastic neuroepithelial tumors: A model for examining the effects of pathology versus seizures on cognitive dysfunction in epilepsy. Epilepsia , 54 (12) 2214 - 2218. 10.1111/epi.12425. Green open access

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Abstract

Purpose Dysembryoplastic neuroepithelial tumors (DNTs) provide a unique model for studying the effects of seizures on cognitive development. Epilepsy and antiepileptic medications are prominent features in the lives and schooling of people who develop seizures in childhood. People with an adult onset share the same underlying brain pathology, but their childhood development is unaffected by seizures. Therefore, DNTs provide a model to examine the specific influence of seizures and their treatment on cognitive development, over and above the effects of the underlying pathology in epilepsy. Methods We examined the neuropsychological characteristics of 56 adults with DNT and medically intractable epilepsy (mean age 32.7 years). Twenty-two adults (39%) had an age of onset of epilepsy before the age of 12 years (childhood-onset group). Scores on tests of intelligence (Verbal IQ and Performance IQ), reading, working memory, verbal learning, verbal recall, visual learning, and expressive and receptive language ability were analyzed. Key Findings There were no significant localization effects (right vs. left vs. extratemporal) on any of the neuropsychological test scores. In the group as a whole, the neuropsychological test scores were significantly lower than healthy, age-matched controls on measures of Verbal IQ (p < 0.01), naming p < 0.01, verbal learning (p < 0.01), and working memory (p < 0.05). The childhood-onset group had significantly lower scores on the measures of Verbal IQ (p < 0.01), Performance IQ (p < 0.05), reading (p < 0.05), naming (p = 0.05), and verbal retention (p < 0.05) than those with an onset of seizures at the age of 12 or older. Significance The traditional pattern of lateralized memory deficits seen in people with hippocampal sclerosis may not be present in people with temporal lobe epilepsy associated with a DNT. The presence of seizures and their treatment in early childhood may adversely influence the development of these core cognitive abilities, resulting in patterns of cognitive deficits that remain apparent in adulthood.© 2013 International League Against Epilepsy.

Type: Article
Title: Dysembryoplastic neuroepithelial tumors: A model for examining the effects of pathology versus seizures on cognitive dysfunction in epilepsy
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/epi.12425
Publisher version: http://dx.doi.org/10.1111/epi.12425
Additional information: © 2013 The Authors. Epilepsia published by Wiley Periodicals, Inc. on behalf of International League Against Epilepsy. This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
Keywords: Dysembryoplastic neuroepithelial tumor; Memory; IQ ; Cognitive function; Seizures;
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy
URI: https://discovery.ucl.ac.uk/id/eprint/1417850
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