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Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy

Glennon, JM; Weiss-Croft, L; Harrison, S; Cross, JH; Boyd, SG; Baldeweg, T; (2016) Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy. Epilepsia , 57 (9) pp. 1436-1442. 10.1111/epi.13479. Green open access

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Abstract

OBJECTIVES: The relative contribution of interictal epileptiform discharges (IEDs) to cognitive dysfunction in comparison with the underlying brain pathology is not yet understood in children with lesional focal epilepsy. METHODS: The current study investigated the association of IEDs with intellectual functioning in 103 children with medication-resistant focal epilepsy. Hierarchical multiple regression analyses were used to determine the independent contribution of IED features on intellectual functioning, after controlling for effects of lesional pathology, epilepsy duration, and medication. Exploratory analyses were conducted for language and memory scores as well as academic skills available in a subset of participants. RESULTS: The results reveal that IEDs have a negative association with IQ with independent, additive effects documented for frequent and bilaterally distributed IEDs as well as discharge enhancement in sleep. Left-lateralized IEDs had a prominent effect on verbal intelligence, in excess of the influence of left-sided brain pathology. These effects extended to other cognitive functions, most prominently for sleep-enhanced IEDs to be associated with deficits in expressive and receptive language, reading, spelling and numerical skills. SIGNIFICANCE: Overall, IED effects on cognition were of a magnitude similar to lesional influences or drug effects (topiramate use). This study demonstrates an association between IEDs and cognitive dysfunction, independent of the underlying focal brain pathology.

Type: Article
Title: Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy
Location: United States
Open access status: An open access version is available from UCL Discovery
DOI: 10.1111/epi.13479
Publisher version: http://doi.org/10.1111/epi.13479
Language: English
Additional information: Wiley Periodicals, Inc. © 2016 International League Against Epilepsy. This is the peer reviewed version of the following article: Glennon, JM; Weiss-Croft, L; Harrison, S; Cross, JH; Boyd, SG; Baldeweg, T; (2016) Interictal epileptiform discharges have an independent association with cognitive impairment in children with lesional epilepsy. Epilepsia , 57 (9) pp. 1436-1442. 10.1111/epi.13479, which has been published in final form at http://doi.org/10.1111/epi.13479. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving.
Keywords: Children, Cognition, Focal epilepsy, Intelligence, Interictal epileptiform discharges
UCL classification: UCL
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 Population Health Sciences > UCL GOS Institute of Child Health
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > UCL GOS Institute of Child Health > Developmental Neurosciences Dept
URI: https://discovery.ucl.ac.uk/id/eprint/1508097
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