Anna-Laura Potthoff, Lukas Tennie, Juri-Alexander Witt, Attila Rácz, Valeri Borger, Hartmut Vatter, Albert Becker, Rainer Surges, Matthias Schneider, Christoph Helmstaedter
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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.
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.