Executive functions disorders in children with frontal and temporal epilepsy

Abstract

Introduction: Children with focal epilepsy often present with executive functions (EFs) deficits. EFs deficits can contribute to adaptive challenges and have a negative impact on academic achievement. The purpose of this study was to investigate the EFs profiles of children diagnosed with frontal lobe epilepsy or temporal lobe epilepsy. Also, we aimed to examine the impact of medical and sociodemographic features on executive functioning and to compare the results of performance-based tests and ratings measures.

Method: EFs were assessed using performance based-tests and rating scales. The Child Executive Functions Battery (CEF-B) and the Behavior Rating Inventory of Executive Function (BRIEF) for parents and teachers were used.

Results: Fifty children aged 6-16 years participated in the study, 28 diagnosed with frontal lobe epilepsy and 22 diagnosed with temporal lobe epilepsy. Results showed that approximately 30 % of both groups of epilepsy patients had significant deficits in EFs compared to normative data. Deficits were observed across various domains of EFs (inhibition, working memory, flexibility and planning). Most patients exhibited deficits in one or two of the 4 domains. Worse executive performances were significantly associated with older age at assessment time, longer duration of epilepsy, higher seizure frequency, earlier age at onset and higher number of anti-seizure medication. Additionally, correlation and congruence analyses showed significant discrepancies between the performance-based and rating measures of executive functioning.

Conclusion: Our findings provide substantial evidence of significant executive deficits in children with FLE and TLE and support the clinical validity of the CEF-B battery in this population. The low level of agreement between performance tests and daily life questionnaires suggests that the two methods are complementary for understanding children's executive functioning. Comprehensive assessment and targeted interventions to address EFs difficulties are recommended for this particular population.

Keywords: Everyday life; Executive Functions; Frontal Lobe Epilepsy; Performance-based tests; Temporal Lobe Epilepsy.