Cognitive outcome after epilepsy surgery in children: A controlled longitudinal study

Valentina Sibilia, Carmen Barba, Tiziana Metitieri, Giovanni Michelini, Flavio Giordano, Lorenzo Genitori, Renzo Guerrini

Research output: Contribution to journalArticle

6 Citations (Scopus)

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 2 years (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.

Original languageEnglish
Pages (from-to)23-30
Number of pages8
JournalEpilepsy and Behavior
Volume73
DOIs
Publication statusPublished - Aug 1 2017

Fingerprint

Longitudinal Studies
Epilepsy
Intelligence
Control Groups
Seizures
Age of Onset
Reading
Language

Keywords

  • Behavioral outcome
  • Cognitive outcome
  • Epilepsy surgery

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology
  • Behavioral Neuroscience

Cite this

Cognitive outcome after epilepsy surgery in children : A controlled longitudinal study. / Sibilia, Valentina; Barba, Carmen; Metitieri, Tiziana; Michelini, Giovanni; Giordano, Flavio; Genitori, Lorenzo; Guerrini, Renzo.

In: Epilepsy and Behavior, Vol. 73, 01.08.2017, p. 23-30.

Research output: Contribution to journalArticle

Sibilia V, Barba C, Metitieri T, Michelini G, Giordano F, Genitori L et al. Cognitive outcome after epilepsy surgery in children: A controlled longitudinal study. Epilepsy and Behavior. 2017 Aug 1;73:23-30. https://doi.org/10.1016/j.yebeh.2017.03.001
Sibilia, Valentina ; Barba, Carmen ; Metitieri, Tiziana ; Michelini, Giovanni ; Giordano, Flavio ; Genitori, Lorenzo ; Guerrini, Renzo. / Cognitive outcome after epilepsy surgery in children : A controlled longitudinal study. In: Epilepsy and Behavior. 2017 ; Vol. 73. pp. 23-30.
@article{8b8edb401e94455da80d21c7416557e6,
title = "Cognitive outcome after epilepsy surgery in children: A controlled longitudinal study",
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 2 years (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.",
keywords = "Behavioral outcome, Cognitive outcome, Epilepsy surgery",
author = "Valentina Sibilia and Carmen Barba and Tiziana Metitieri and Giovanni Michelini and Flavio Giordano and Lorenzo Genitori and Renzo Guerrini",
year = "2017",
month = "8",
day = "1",
doi = "10.1016/j.yebeh.2017.03.001",
language = "English",
volume = "73",
pages = "23--30",
journal = "Epilepsy and Behavior",
issn = "1525-5050",
publisher = "Academic Press Inc.",

}

TY - JOUR

T1 - Cognitive outcome after epilepsy surgery in children

T2 - A controlled longitudinal study

AU - Sibilia, Valentina

AU - Barba, Carmen

AU - Metitieri, Tiziana

AU - Michelini, Giovanni

AU - Giordano, Flavio

AU - Genitori, Lorenzo

AU - Guerrini, Renzo

PY - 2017/8/1

Y1 - 2017/8/1

N2 - 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 2 years (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.

AB - 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 2 years (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.

KW - Behavioral outcome

KW - Cognitive outcome

KW - Epilepsy surgery

UR - http://www.scopus.com/inward/record.url?scp=85020426585&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85020426585&partnerID=8YFLogxK

U2 - 10.1016/j.yebeh.2017.03.001

DO - 10.1016/j.yebeh.2017.03.001

M3 - Article

AN - SCOPUS:85020426585

VL - 73

SP - 23

EP - 30

JO - Epilepsy and Behavior

JF - Epilepsy and Behavior

SN - 1525-5050

ER -