Sibilia V, Barba C, Metitieri T, Michelini G, Giordano F,
Genitori L, Guerrini R. Cognitive outcome after epilepsy surgery in children: A
controlled longitudinal study. Epilepsy Behav. 2017 Jun 9;73:23-30.
Abstract
OBJECTIVE:
To analyze the determinants of cognitive outcome two years
after surgery for drug-resistant epilepsy in a cohort of 31 children when
compared to a control group of 14 surgical candidates who had yet to undergo
surgery two years after the first neuropsychological assessment.
METHODS:
Controlled longitudinal study including three evaluations of
IQ (Intelligence Quotient) scores or GDQ (General Developmental Quotient) for
each group depending on the patient's age: prior to surgery (T0), one year (T1)
and two years (T2) after surgery for the surgical group; baseline (T0) and one
year (T1) and 2years (T2) after the first evaluation for the control-group. At
follow-up, 25 children (80%) of the surgical group were seizure free, while
seizure outcome was unsatisfactory in the remaining six (20%). To analyze
language, visuomotor skills, memory, reading, visual attention, and behavior,
we selected 11 school age children in the surgical group and nine controls. We
reported performance prior to (T0) and one year after surgery (T1).
RESULTS:
There was a significant correlation between earlier age at
seizure onset and lower IQ/GDQ at T0 (r=0.39; p=0.03) in the overall cohort.
IQ/GDQ scores did not significantly differ between the surgical and control
groups when analyzed at T0 and T2. However, they evolved differently with an
improved developmental trajectory becoming identifiable only in the surgical
group (F1,31=5.33 p=0.028; η2=0.15). There was also a significant increase of
forward digit span (Z=2.33; p=0.02) and Rey recall scores (Z=1.97; p=0.049) in
the surgical school age subgroup at T1 versus T0.
SIGNIFICANCE:
We identified significantly different developmental
trajectories in operated versus non- operated children with improved IQ/GDQ
scores in operated children only. We also observed a significant increase of
digit span scores and Rey recall scores a year after surgery. Further studies
including larger samples with longer follow-ups are needed to confirm these
preliminary findings.
Courtesy of Mendeley
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