Benign Epilepsy of Childhood with Centrotemporal Spikes - Delineating the Executive Profile

Abstract

Benign Epilepsy of Childhood with Centrotemporal Spikes, or Rolandic Epilepsy (RE), is a focal and genetically determined epilepsy, previously described as a benign epilepsy. The term benign was abandoned because, despite the complete remission of seizures in 80% of cases, there are cognitive deficits and psychiatric disorders that can compromise the quality of life and school performance of these patients. The most frequent psychiatric comorbidity is the Attention Deficit Hyperactivity Disorder (ADHD). One of the most important cognitive functions, Executive Functions (EF), in its cool (mental flexibility, mental screening and abstraction ability) and hot (hot FE - decision-making, social cognition and inhibitory control) domains can be altered in both RE and in ADHD. Despite the high prevalence of this syndrome, the psychiatric disorder and the EF, especially hot EF, are poorly investigated and described. In addition, with the few studies addressing this issue, it is not possible to describe whether the executive deficits are related to clinical epilepsy, ongoing epileptiform activity, the psychiatric comorbidity or all of these factors. The main purpose of this study is to analyze the executive profile - hot and cool - in children and adolescents with RE. In order to analyze the influence of all possible clinical variables, we intend to conduct a study of cohort, transversal, non-randomized and controlled with double pairing. In this study, the cognitive profile of children and adolescents of both genders, aged from 6 to 16 years will be evaluated through comparative analysis with four groups: Group I (RE with ADHD), Group II (RE without ADHD), Group III (with ADHD, but without epilepsy) and Group IV (control group: without epilepsy, without ADHD and without any neurological or psychiatric diagnosis). Patients will be evaluated by an epileptologist (responsible for the study) and a psychiatrist (patients from the ADHD Clinic in childhood coordinated by Prof. Guilherme V. Polanczyk). Neuropsychological assessment will consist of a large battery with 22 instruments for accurate investigation of EF in their multiple domains (attention, working memory, organization and visual planning, cold EF, hot EF), intellectual potential and academic performance.