Epilepsy & behavior : E&B · 2025
Application of the International Classification of Cognitive Disorders in Epilepsy (IC-CoDE) to youths with new and recent onset epilepsies.
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Almane Dace N, Busch Robyn M, Ferguson Lisa, Arenivas Ana, Reyes Anny, McDonald Carrie R, Kessler-Jones Alanna, Seidenberg Michael, Stafstrom Carl, Hsu David, Vogel Jack, Jones Jana E, Hermann Bruce P, IC-CODE Consortium
Аннотация
RATIONALE: The International Classification of Cognitive Disorder in Epilepsy (IC-CoDE) is an algorithmic approach to identifying cognitive phenotypes in epilepsy that to date has been investigated only in adults with temporal and frontal lobe epilepsy. The purpose of this investigation is to explore the applicability of IC-CoDE to youths with new and recent onset focal and generalized idiopathic epilepsies as well as the impact of modifications of cognitive domain construction on IC-CoDE outcomes.
METHOD: 222 youths (ages 8-18), including 134 with new/recent onset idiopathic epilepsies and 88 typically developing controls, were administered a comprehensive neuropsychological battery assessing 5 cognitive domains (language, visuospatial, memory, attention/processing speed, executive function). Along with the typical IC-CoDE cognitive domain construction, we also examined the impact of using just the two most sensitive tests from each of the 5 cognitive domains on IC-CoDE phenotype distributions, both approaches using -1.0 and -1.5 z-score thresholds as operational definitions of abnormality.
RESULTS: Youths with epilepsy exhibited significantly different distributions of IC-CoDE phenotypes at both the <-1.0 (p < 0.001) and <-1.5 (p < 0.01) z-score thresholds compared to controls. At the < -1.0 z threshold, the epilepsy versus control group comparison revealed the following outcomes: intact (59 % vs 89 %), single domain (25 % vs 8 %), bidomain (9 % vs 4 %) and generalized (7 % vs 0 %) impairment profiles. Lower overall proportions but with continuing greater abnormality and similar distribution in the epilepsy compared to control group was observed at the <-1.5 z threshold. Among single domain impairments, the most frequent were language, visuospatial and executive function, with memory the least frequently impaired. Using only the two most sensitive tests for domain construction yielded phenotype distributions that were not significantly different from the method of using all available tests at both the -1.0 and -1.5z thresholds.
CONCLUSIONS: IC-CoDE is applicable to neuropsychological data from youths with epilepsy and provides a new approach for describing the cognitive morbidity associated with diverse childhood epilepsies. Future multicenter collaborative research will be useful to determine the shared and unique cognitive phenotypes associated with discrete epilepsy syndromes, their predictors, and course.
METHOD: 222 youths (ages 8-18), including 134 with new/recent onset idiopathic epilepsies and 88 typically developing controls, were administered a comprehensive neuropsychological battery assessing 5 cognitive domains (language, visuospatial, memory, attention/processing speed, executive function). Along with the typical IC-CoDE cognitive domain construction, we also examined the impact of using just the two most sensitive tests from each of the 5 cognitive domains on IC-CoDE phenotype distributions, both approaches using -1.0 and -1.5 z-score thresholds as operational definitions of abnormality.
RESULTS: Youths with epilepsy exhibited significantly different distributions of IC-CoDE phenotypes at both the <-1.0 (p < 0.001) and <-1.5 (p < 0.01) z-score thresholds compared to controls. At the < -1.0 z threshold, the epilepsy versus control group comparison revealed the following outcomes: intact (59 % vs 89 %), single domain (25 % vs 8 %), bidomain (9 % vs 4 %) and generalized (7 % vs 0 %) impairment profiles. Lower overall proportions but with continuing greater abnormality and similar distribution in the epilepsy compared to control group was observed at the <-1.5 z threshold. Among single domain impairments, the most frequent were language, visuospatial and executive function, with memory the least frequently impaired. Using only the two most sensitive tests for domain construction yielded phenotype distributions that were not significantly different from the method of using all available tests at both the -1.0 and -1.5z thresholds.
CONCLUSIONS: IC-CoDE is applicable to neuropsychological data from youths with epilepsy and provides a new approach for describing the cognitive morbidity associated with diverse childhood epilepsies. Future multicenter collaborative research will be useful to determine the shared and unique cognitive phenotypes associated with discrete epilepsy syndromes, their predictors, and course.