Brief computerized screening can help detect cognitive changes in children with epilepsy

Research presented at the 2015 American Epilepsy Society Annual Meeting in Philadelphia shows that early detection of cognitive difficulties using a brief computerized cognitive screening may help improve delays in intervention. Cognitive problems and behavioural problems in epilepsy are frequent.

Cognitive difficulties in children with epilepsy affect different domains, including memory, language, and executive function that occur during critical periods of development. However screening tools currently available do not adequately identify these children, resulting in a delay in intervention.

In their study Megan E. Bone, of the University of Pittsburgh School of Medicine, and colleagues evaluated the feasibility of the brief CNS Vital Signs (CNSVS) computerized cognitive battery for the detection of comorbidities in children with new-onset epilepsy.

They studied 33 patients (17 male; 26 generalized epilepsy, 7 focal epilepsy) aged 8-17 years with new-onset epilepsy and no previous antiepileptic drug treatment. Patients completed the CNSVS, which is completed in approximately 30 minutes, and parents completed the Strength and Difficulties Questionnaire, at two subsequent intervals (2-12 months = T2, 12-18 months= T3) during routine clinical appointments. Baseline scores were compared to subsequent scores using the Reliable Change Index (RCI).

All participants completed at least one follow up testing (mean follow-up time = 5.5 mo.), and 16 completed a third testing (mean total follow-up time = 14.5 mo.). Between baseline and first follow-up, 85% of patients had clinically significant changes in one of more cognitive domains including memory, psychomotor speed, reaction time, complex attention, and cognitive flexibility.

There was no apparent relationship between change in cognitive performance and seizure medication, epilepsy type, and seizure control. Composite memory, cognitive flexibility, reaction time, and complex attention showed the most change at both follow-up intervals, while no significant changes were observed for psychomotor speed.

In patients who improved or declined, change occurred at the first follow-up and remained stable thereafter. Parental concerns did not necessarily align with CNSVS score changes.

Citation: Bone ME, Triplett R, Rubin P, Asato MR. Abstract 1.293. Brief computerized screening detects cognitive changes in children with epilepsy. Presented at: American Epilepsy Society Annual Meeting; Dec 4-8, 2015; Philadelphia.

CNS Vital Signs (CNSVS) computerized cognitive battery