Disadvantage and neurocognitive comorbidities in childhood idiopathic epilepsies

Schraegle, William A.; Slomowitz, Rebecca F.; Gundlach, Carson; Hsu, David; Almane, Dace; Stafstrom, Carl E.; Seidenberg, Michael; Jones, Jana E.; Hermann, Bruce P.

doi:10.1111/epi.17581

Cited by 3 publications

(1 citation statement)

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“…Neighbourhood deprivation was also related to g in that higher g was associated with less disadvantage, consistent with recent investigations of adults and children with epilepsy where greater disadvantage was associated with poorer cognition. 79 , 80 In fact, in a model using g as the dependent variable with both national ADI percentile group as independent variables, both remain significant (ADI: P = 0.0018 and group: P = 0.00118) indicating independent effects.…”

Section: Discussionmentioning

confidence: 95%

The relevance of Spearman's g for epilepsy

Struck,

Garcia-Ramos,

Nair

et al. 2024

Brain Communications

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Whilst the concept of a general mental factor known as ‘g’ has been of longstanding interest, for unknown reasons, it has never been interrogated in epilepsy despite the 100+ year empirical history of the neuropsychology of epilepsy. This investigation seeks to identify g within a comprehensive neuropsychological data set and compare participants with temporal lobe epilepsy to controls, characterize the discriminatory power of g compared with domain-specific cognitive metrics, explore the association of g with clinical epilepsy and sociodemographic variables and identify the structural and network properties associated with g in epilepsy. Participants included 110 temporal lobe epilepsy patients and 79 healthy controls between the ages of 19 and 60. Participants underwent neuropsychological assessment, clinical interview and structural and functional imaging. Cognitive data were subjected to factor analysis to identify g and compare the group of patients with control participants. The relative power of g compared with domain-specific tests was interrogated, clinical and sociodemographic variables were examined for their relationship with g, and structural and functional images were assessed using traditional regional volumetrics, cortical surface features and network analytics. Findings indicate (i) significantly (P < 0.005) lower g in patients compared with controls; (ii) g is at least as powerful as individual cognitive domain-specific metrics and other analytic approaches to discriminating patients from control participants; (iii) lower g was associated with earlier age of onset and medication use, greater number of antiseizure medications and longer epilepsy duration (Ps < 0.04); and lower parental and personal education and greater neighbourhood deprivation (Ps < 0.012); and (iv) amongst patients, lower g was linked to decreased total intracranial volume (P = 0.019), age and intracranial volume adjusted total tissue volume (P = 0.019) and age and intracranial volume adjusted total corpus callosum volume (P = 0.012)—particularly posterior, mid-posterior and anterior (Ps < 0.022) regions. Cortical vertex analyses showed lower g to be associated specifically with decreased gyrification in bilateral medial orbitofrontal regions. Network analysis of resting-state data with focus on the participation coefficient showed g to be associated with the superior parietal network. Spearman's g is reduced in patients, has considerable discriminatory power compared with domain-specific metrics and is linked to a multiplex of factors related to brain (size, connectivity and frontoparietal networks), environment (familial and personal education and neighbourhood disadvantage) and disease (epilepsy onset, treatment and duration). Greater attention to contemporary models of human cognition is warranted in order to advance the neuropsychology of epilepsy.

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Section: Discussionmentioning

confidence: 95%

The relevance of Spearman's g for epilepsy

Struck,

Garcia-Ramos,

Nair

et al. 2024

Brain Communications

Self Cite

View full text Add to dashboard Cite

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Neighborhood disadvantage and intellectual development in youth with epilepsy

Schraegle,

Hsu,

Almane

et al. 2023

Epilepsy & Behavior

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Latent cognitive phenotypes in juvenile myoclonic epilepsy: Clinical, sociodemographic, and neuroimaging associations

Struck,

Garcia‐Ramos,

Prabhakaran

et al. 2024

Epilepsia

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ObjectiveApplication of cluster analytic procedures has advanced understanding of the cognitive heterogeneity inherent in diverse epilepsy syndromes and the associated clinical and neuroimaging features. Application of this unsupervised machine learning approach to the neuropsychological performance of persons with juvenile myoclonic epilepsy (JME) has yet to be attempted, which is the intent of this investigation.MethodsA total of 77 JME participants, 19 unaffected siblings, and 44 unrelated controls, 12 to 25 years of age, were administered a comprehensive neuropsychological battery (intelligence, language, memory, executive function, and processing speed), which was subjected to factor analysis followed by K‐means clustering of the resultant factor scores. Identified cognitive phenotypes were characterized and related to clinical, family, sociodemographic, and cortical and subcortical imaging features.ResultsFactor analysis revealed three underlying cognitive dimensions (general ability, speed/response inhibition, and learning/memory), with JME participants performing worse than unrelated controls across all factor scores, and unaffected siblings performing worse than unrelated controls on the general mental ability and learning/memory factors, with no JME vs sibling differences. K‐means clustering of the factor scores revealed three latent groups including above average (31.4% of participants), average (52.1%), and abnormal performance (16.4%). Participant groups differed in their distributions across the latent groups (p < 0.001), with 23% JME, 22% siblings, and 2% unrelated controls in the abnormal performance group; and 18% JME, 21% siblings, and 59% unrelated controls in the above average group. Clinical epilepsy variables were unassociated with cluster membership, whereas family factors (lower parental education) and abnormally increased thickness and/or volume in the frontal, parietal, and temporal‐occipital regions were associated with the abnormal cognition group.SignificanceDistinct cognitive phenotypes characterize the spectrum of neuropsychological performance of patients with JME for which there is familial (sibling) aggregation. Phenotypic membership was associated with parental (education) and imaging characteristics (increased cortical thickness and volume) but not basic clinical seizure features.

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Disadvantage and neurocognitive comorbidities in childhood idiopathic epilepsies

Abstract: Objective: This study was undertaken to characterize the relationship between neighborhood disadvantage and cognitive function as well as clinical, sociodemographic, and family factors in children with new onset idiopathic epilepsy and healthy controls.

Cited by 3 publications

References 53 publications

The relevance of Spearman's g for epilepsy

The relevance of Spearman's g for epilepsy

Neighborhood disadvantage and intellectual development in youth with epilepsy

Latent cognitive phenotypes in juvenile myoclonic epilepsy: Clinical, sociodemographic, and neuroimaging associations

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