Age at onset of epilepsy shapes neurocognitive profiles in focal cortical dysplasia.

IF 4.8 2区 医学 Q1 CLINICAL NEUROLOGY
Anna-Laura Potthoff, Lukas Tennie, Juri-Alexander Witt, Attila Rácz, Valeri Borger, Hartmut Vatter, Albert Becker, Rainer Surges, Matthias Schneider, Christoph Helmstaedter
{"title":"Age at onset of epilepsy shapes neurocognitive profiles in focal cortical dysplasia.","authors":"Anna-Laura Potthoff, Lukas Tennie, Juri-Alexander Witt, Attila Rácz, Valeri Borger, Hartmut Vatter, Albert Becker, Rainer Surges, Matthias Schneider, Christoph Helmstaedter","doi":"10.1007/s00415-025-13090-4","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Focal cortical dysplasia (FCD) is a common developmental brain disorder frequently associated with refractory epilepsy and neurocognitive comorbidities. This study examines the neurocognitive profiles of patients with FCD, with particular attention to histopathological classification, age at onset of epilepsy (AOE), FCD lateralization and localization, and antiseizure medication (ASM) load.</p><p><strong>Methods: </strong>This study was conducted on 98 patients with FCD (type IIa: n = 26, type IIb: n = 59) who had undergone surgical treatment for epilepsy. Patients underwent comprehensive presurgical neuropsychological assessments for intelligence (IQ) and six cognitive domains.</p><p><strong>Results: </strong>Patients with FCD type IIb significantly more often exhibited an earlier AOE (< 6 years, 65.5% vs. 38.5%, p = 0.021) and a longer duration of epilepsy at the time of cognitive testing (mean ± SD, 18.8 ± 13.61 vs. 11.88 ± 9.09 years, p = 0.008) compared to patients with FCD type IIa. The most notable differences in cognitive performance were observed between patients with early (< 6 years) and late AOE (≥ 6 years) for IQ and motor functions. In these domains, patients with early AOE consistently scored lower (IQ: 2.24 ± 1.17 vs. 2.79 ± 0.83, p = 0.021, impaired patients: 36% vs.15.8%; motor function: 1.46 ± 1.05 vs. 2.25 ± 0.95, p = 0.002, impaired patients: 74.4% vs. 43.8%). Differences in cognitive performance were not linked to FCD type, lateralization, localization, or ASM load.</p><p><strong>Conclusion: </strong>Our findings indicate that the AOE emerged as the determining factor for cognitive performance in refractory epilepsy patients due to FCD. As expected in cases of early childhood onset epilepsies, a neurodevelopmental disruption particularly of IQ and motor function was seen.</p>","PeriodicalId":16558,"journal":{"name":"Journal of Neurology","volume":"272 5","pages":"373"},"PeriodicalIF":4.8000,"publicationDate":"2025-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12049294/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Neurology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s00415-025-13090-4","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Background: Focal cortical dysplasia (FCD) is a common developmental brain disorder frequently associated with refractory epilepsy and neurocognitive comorbidities. This study examines the neurocognitive profiles of patients with FCD, with particular attention to histopathological classification, age at onset of epilepsy (AOE), FCD lateralization and localization, and antiseizure medication (ASM) load.

Methods: This study was conducted on 98 patients with FCD (type IIa: n = 26, type IIb: n = 59) who had undergone surgical treatment for epilepsy. Patients underwent comprehensive presurgical neuropsychological assessments for intelligence (IQ) and six cognitive domains.

Results: Patients with FCD type IIb significantly more often exhibited an earlier AOE (< 6 years, 65.5% vs. 38.5%, p = 0.021) and a longer duration of epilepsy at the time of cognitive testing (mean ± SD, 18.8 ± 13.61 vs. 11.88 ± 9.09 years, p = 0.008) compared to patients with FCD type IIa. The most notable differences in cognitive performance were observed between patients with early (< 6 years) and late AOE (≥ 6 years) for IQ and motor functions. In these domains, patients with early AOE consistently scored lower (IQ: 2.24 ± 1.17 vs. 2.79 ± 0.83, p = 0.021, impaired patients: 36% vs.15.8%; motor function: 1.46 ± 1.05 vs. 2.25 ± 0.95, p = 0.002, impaired patients: 74.4% vs. 43.8%). Differences in cognitive performance were not linked to FCD type, lateralization, localization, or ASM load.

Conclusion: Our findings indicate that the AOE emerged as the determining factor for cognitive performance in refractory epilepsy patients due to FCD. As expected in cases of early childhood onset epilepsies, a neurodevelopmental disruption particularly of IQ and motor function was seen.

癫痫发病年龄影响局灶性皮质发育不良患者的神经认知特征。
背景:局灶性皮质发育不良(FCD)是一种常见的脑发育障碍,常与难治性癫痫和神经认知合并症相关。本研究考察了FCD患者的神经认知特征,特别关注组织病理学分类、癫痫发病年龄(AOE)、FCD偏侧和局部化以及抗癫痫药物(ASM)负荷。方法:对98例经手术治疗癫痫的FCD患者(IIa型26例,IIb型59例)进行研究。患者术前接受全面的智力(IQ)和六个认知领域的神经心理学评估。结果:IIb型FCD患者明显更早出现AOE(结论:我们的研究结果表明,AOE是FCD所致难治性癫痫患者认知表现的决定性因素。正如预期的那样,在儿童早期癫痫发作的病例中,可以看到神经发育中断,特别是智商和运动功能。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Journal of Neurology
Journal of Neurology 医学-临床神经学
CiteScore
10.00
自引率
5.00%
发文量
558
审稿时长
1 months
期刊介绍: The Journal of Neurology is an international peer-reviewed journal which provides a source for publishing original communications and reviews on clinical neurology covering the whole field. In addition, Letters to the Editors serve as a forum for clinical cases and the exchange of ideas which highlight important new findings. A section on Neurological progress serves to summarise the major findings in certain fields of neurology. Commentaries on new developments in clinical neuroscience, which may be commissioned or submitted, are published as editorials. Every neurologist interested in the current diagnosis and treatment of neurological disorders needs access to the information contained in this valuable journal.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信