title: Parental education predicts change in intelligence quotient after childhood epilepsy surgery.
abstract: OBJECTIVE
  To know whether change in the intelligence quotient (IQ) of children who undergo epilepsy surgery is associated with the educational level of their parents.
  
  
  METHODS
  Retrospective analysis of data obtained from a cohort of children who underwent epilepsy surgery between January 1996 and September 2010. We performed simple and multiple regression analyses to identify predictors associated with IQ change after surgery. In addition to parental education, six variables previously demonstrated to be associated with IQ change after surgery were included as predictors: age at surgery, duration of epilepsy, etiology, presurgical IQ, reduction of antiepileptic drugs, and seizure freedom. We used delta IQ (IQ 2 years after surgery minus IQ shortly before surgery) as the primary outcome variable, but also performed analyses with pre- and postsurgical IQ as outcome variables to support our findings. To validate the results we performed simple regression analysis with parental education as the predictor in specific subgroups.
  
  
  RESULTS
  The sample for regression analysis included 118 children (60 male; median age at surgery 9.73 years). Parental education was significantly associated with delta IQ in simple regression analysis (p = 0.004), and also contributed significantly to postsurgical IQ in multiple regression analysis (p = 0.008). Additional analyses demonstrated that parental education made a unique contribution to prediction of delta IQ, that is, it could not be replaced by the illness-related variables. Subgroup analyses confirmed the association of parental education with IQ change after surgery for most groups.
  
  
  CONCLUSIONS
  Children whose parents had higher education demonstrate on average a greater increase in IQ after surgery and a higher postsurgical--but not presurgical--IQ than children whose parents completed at most lower secondary education. Parental education--and perhaps other environmental variables--should be considered in the prognosis of cognitive function after childhood epilepsy surgery.
authors.affiliation: Sector of Neuropsychology for Children and Adolescents, Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands; Bio Research Center for Children, Arnhem, The Netherlands.
authors.forename: Joost
authors.initials: J
authors.lastname: Meekes
authors.forename: Monique M J
authors.initials: MM
authors.lastname: van Schooneveld
authors.forename: Olga B
authors.initials: OB
authors.lastname: Braams
authors.forename: Aag
authors.initials: A
authors.lastname: Jennekens-Schinkel
authors.forename: Peter C
authors.initials: PC
authors.lastname: van Rijen
authors.forename: Marc P H
authors.initials: MP
authors.lastname: Hendriks
authors.forename: Kees P J
authors.initials: KP
authors.lastname: Braun
authors.forename: Onno
authors.initials: O
authors.lastname: van Nieuwenhuizen
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D004522:Educational Status; D004827:Epilepsy / Q000453:epidemiology / Q000523:psychology* / Q000601:surgery*; D005260:Female; D006801:Humans; D007360:Intelligence; D007361:Intelligence Tests; D008297:Male; D010287:Parent-Child Relations; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D016896:Treatment Outcome
keywords: Cognitive change; Intelligence quotient; Parental education; Prognosis