title: Neuropsychological profile in new-onset benign epilepsy with centrotemporal spikes (BECTS): Focusing on executive functions.
abstract: OBJECTIVE
  Increased evidence of subnormal neuropsychological functioning in new-onset childhood epilepsy has been obtained, although results are still rare and controversial. With a prospective study, we aimed to define the very early neuropsychological profile of children with benign epilepsy with centrotemporal spikes (BECTS), including executive functions (EF) because of their key role in learning. Additionally, we enrolled drug-naïve children, with a NREM sleep frequency of discharges <85% and with a Performance Intelligence Quotient equal or superior to 85, in order to exclude additional effects on the neuropsychological functioning.
  
  
  METHODS
  Fifteen school-aged children with BECTS (mean age: 8.8years, standard deviation [SD]: 2.4years) and fifteen healthy children (mean age: 9.2years, [SD]: 2.5years) were enrolled and assessed with a comprehensive neuropsychological battery. The assessment included domain-specific standardized tests of language, EF, academic skills, visuomotor and visuospatial skills, and short-term memory. A p-value<0.05 was considered significant.
  
  
  RESULTS
  Significant differences between patients and controls emerged with respect to 3 domains. Language was affected in color naming (p=.026), spoonerism (p=.003), and phonemic synthesis (p=.009). Executive functions appeared inadequate in the five point test with respect to the number of correct figures (p=.003) and errors (p=.008). In the domain of academic skills, significant differences between groups emerged regarding the number of mistakes in nonword writing (p=.001), nonword reading speed (p=.027), nonword reading number of mistakes (p=.019), and word reading errors (p=.023).
  
  
  CONCLUSIONS
  Results showed that children with new-onset BECTS may demonstrate a range of neuropsychological dysfunctions, particularly affecting executive attention, despite a normal IQ, a low frequency of NREM sleep discharges, and the absence of drugs. These difficulties indicate a frontal dysfunction with cascading effects on language and academic skills. The inclusion of EF in the assessment battery and in the intervention since the very onset is warranted in order to avoid further and persistent academic difficulties.
authors.affiliation: Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, via Altura 3, 40139 Bologna, Italy. Electronic address: melissa.filippini@libero.it.
authors.forename: Melissa
authors.initials: M
authors.lastname: Filippini
authors.affiliation: Health Medical Centre, via della Chiusetta 14, 17021 Alassio, Italy.
authors.forename: Eleonora
authors.initials: E
authors.lastname: Ardu
authors.affiliation: Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, via Altura 3, 40139 Bologna, Italy.
authors.forename: Silvia
authors.initials: S
authors.lastname: Stefanelli
authors.affiliation: Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, via Altura 3, 40139 Bologna, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Boni
authors.affiliation: Child Neurology Unit, IRCCS Istituto delle Scienze Neurologiche, via Altura 3, 40139 Bologna, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Gobbi
authors.affiliation: Health Medical Centre, via della Chiusetta 14, 17021 Alassio, Italy; DISFOR Psychology, University of Genoa, Polo M.T. Bozzo, vico S. Antonio 5/7, 16121 Genova, Italy.
authors.forename: Francesco
authors.initials: F
authors.lastname: Benso
mesh_terms: D000293:Adolescent; D001288:Attention / Q000502:physiology; D002648:Child; D002675:Child, Preschool; D004569:Electroencephalography / Q000379:methods; D019305:Epilepsy, Rolandic / Q000175:diagnosis* / Q000503:physiopathology / Q000523:psychology*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D006801:Humans; D007858:Learning / Q000502:physiology; D008297:Male; D008570:Memory, Short-Term / Q000502:physiology; D009483:Neuropsychological Tests; D011446:Prospective Studies; D011932:Reading
keywords: Benign epilepsy with centrotemporal spikes; Executive functions; Neuropsychological profile at the onset