Neurophychological Progression in New Onset Epilepsy

新发癫痫的神经心理学进展

• 批准号: 6875607
• 负责人: Bruce Phillip Hermann
• 金额: $ 48.82万
• 依托单位: UNIVERSITY OF WISCONSIN-MADISON
• 依托单位国家: 美国
• 财政年份: 2003
• 资助国家: 美国
• 起止时间: 2003-04-01 至 2008-03-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6875607
• 关键词: adolescence (12-20); age difference; behavioral /social science research tag; brain morphology; child psychology; clinical research; cognition disorders; developmental neurobiology; disease /disorder etiology; disease /disorder onset; epilepsy; gender difference; human subject; image processing; interview; longitudinal human study; magnetic resonance imaging; mental disorders; middle childhood (6-11); neuroimaging; neuropathology; neuropsychological tests; neuropsychology; statistics /biometry

DESCRIPTION (provided by applicant): Our prior investigation of adults with chronic localization-related (temporal lobe) epilepsy and healthy controls has shown childhood onset epilepsy to be associated with a generalized adverse neurodevelopmental impact on brain structure and cognitive function (NS-37738). The purpose of this proposal is to directly characterize the timing, cause and consequences of this adverse neurodevelopmental impact. Using a combined cross-sectional and longitudinal design, 75 children (age 8-18) with new onset localization-related epilepsy will be compared to 75 age and gender matched controls. Cross-sectional and two-year longitudinal assessment of neuropsychological status and neuroimaging (quantitative MRI, diffusion tensor imaging, and magnetization transfer imaging) will be integrated with information regarding neurodevelopmental history, clinical epilepsy characteristics and psychiatric morbidity in order to clarify the timing, etiology and consequences of evident abnormalities in brain structure and cognition. We hypothesize the following: (1) children with new onset localization-related epilepsy will exhibit generalized cognitive impairment, generalized reduction in total brain tissue volumes (especially cerebral white matter volumes), and microstructural abnormalities in cerebral white matter compared to controls, (2) frequency of preexisting neurodevelopmental abnormalities will be significantly increased in children with new onset epilepsy compared to controls and will be associated with neuroimaging and cognitive abnormalities at epilepsy onset, (3) ongoing childhood onset epilepsy will be associated with lags in normal cognitive and brain development (especially cerebral white matter) and increased psychiatric morbidity compared to controls, and (4) earlier age of epilepsy onset will be the strongest predictor of lags in brain growth and cognitive development while seizure severity will be most strongly associated with increased psychiatric morbidity.

描述（由申请人提供）：我们之前对患有慢性定位相关（颞叶）癫痫的成人和健康对照组进行的调查表明，儿童期发作的癫痫与对大脑结构和认知功能的普遍不良神经发育影响有关（NS-37738） 。该提案的目的是直接描述这种不良神经发育影响的时间、原因和后果。采用横断面和纵向相结合的设计，将 75 名患有新发定位相关癫痫的儿童（8-18 岁）与 75 名年龄和性别匹配的对照组进行比较。对神经心理状态和神经影像（定量 MRI、扩散张量成像和磁化转移成像）的横断面和两年纵向评估将与神经发育史、临床癫痫特征和精神发病率的信息相结合，以澄清时间、病因以及大脑结构和认知明显异常的后果。 我们假设如下：（1）与对照组相比，新发定位相关性癫痫的儿童将表现出全身性认知障碍、脑组织总体积（特别是脑白质体积）普遍减少以及脑白质微结构异常，（2 ) 与对照组相比，新发癫痫儿童中先前存在的神经发育异常的频率将显着增加，并且与癫痫发作时的神经影像学和认知异常有关，(3) 持续的儿童期癫痫发作将与与对照组相比，正常认知和大脑发育（尤其是大脑白质）存在滞后，精神疾病发病率增加；（4）癫痫发作年龄较早是大脑生长和认知发育滞后的最强预测因素，而癫痫严重程度则是最重要的预测因素。与精神疾病发病率的增加密切相关。