title: The role of executive functioning in memory performance in pediatric focal epilepsy.
abstract: Learning and memory are essential for academic success and everyday functioning, but the pattern of memory skills and its relationship to executive functioning in children with focal epilepsy is not fully delineated. We address a gap in the literature by examining the relationship between memory and executive functioning in a pediatric focal epilepsy population.
  
  
  
  Seventy children with focal epilepsy and 70 typically developing children matched on age, intellectual functioning, and gender underwent neuropsychological assessment, including measures of intelligence (Wechsler Abbreviated Scale of Intelligence [WASI]/Differential Ability Scales [DAS]), as well as visual Children's Memory Scale (CMS Dot Locations) and verbal episodic memory (Wide Range Assessment of Memory and Learning [WRAML] Story Memory and California Verbal Learning Test for Children [CVLT-C]). Executive functioning was measured directly (WISC-IV Digit Span Backward; Clinical Evaluation of Language Fundamentals, Fourth Edition (CELF-IV) Recalling Sentences) and by parent report (Behavior Rating Inventory of Executive Function [BRIEF]).
  
  
  
  Children with focal epilepsy had lower delayed free-recall scores than controls across visual and verbal memory tasks (p = 0.02; partial η2= 0.12). In contrast, recognition memory performance was similar for patients and controls (p = 0.36; partial η2= 0.03). Children with focal epilepsy demonstrated difficulties in working memory (p = 0.02; partial η2= 0.08) and planning/organization (p = 0.02) compared to controls. Working memory predicted 9-19% of the variance in delayed free recall for verbal and visual memory; organization predicted 9-10% of the variance in verbal memory. Patients with both left and right focal epilepsy demonstrated more difficulty on verbal versus visual tasks (p = 0.002). Memory performance did not differ by location of seizure foci (temporal vs. extratemporal, frontal vs. extrafrontal).
  
  
  
  Children with focal epilepsy demonstrated memory ability within age-level expectations, but delayed free recall was inefficient compared to typically developing controls. Memory difficulties were not related to general cognitive impairment or seizure localization. Executive functioning accounted for significant variance in memory performance, suggesting that poor executive control negatively influences memory retrieval.
authors.affiliation: Department of Neurosciences, Children's National Health System, Washington, District of Columbia, U.S.A.|NINDS Clinical Epilepsy Section, NIH, Bethesda, Maryland, U.S.A.
authors.forename: Leigh N
authors.initials: LN
authors.lastname: Sepeta
authors.affiliation: University of California, San Diego, San Diego, California, U.S.A.
authors.forename: Kaitlin Blackstone
authors.initials: KB
authors.lastname: Casaletto
authors.affiliation: Feinberg School of Medicine, Northwestern University, Chicago, Illinois, U.S.A.
authors.forename: Virginia
authors.initials: V
authors.lastname: Terwilliger
authors.affiliation: Department of Neurosciences, Children's National Health System, Washington, District of Columbia, U.S.A.
authors.forename: Joy
authors.initials: J
authors.lastname: Facella-Ervolini
authors.affiliation: Department of Neurosciences, Children's National Health System, Washington, District of Columbia, U.S.A.
authors.forename: Maegan
authors.initials: M
authors.lastname: Sady
authors.affiliation: Yale School of Medicine, Yale University, New Haven, Connecticut, U.S.A.
authors.forename: Jessica
authors.initials: J
authors.lastname: Mayo
authors.affiliation: Department of Neurosciences, Children's National Health System, Washington, District of Columbia, U.S.A.|NINDS Clinical Epilepsy Section, NIH, Bethesda, Maryland, U.S.A.
authors.forename: William D
authors.initials: WD
authors.lastname: Gaillard
authors.affiliation: Department of Neurosciences, Children's National Health System, Washington, District of Columbia, U.S.A.|NINDS Clinical Epilepsy Section, NIH, Bethesda, Maryland, U.S.A.
authors.forename: Madison M
authors.initials: MM
authors.lastname: Berl
mesh_terms: D000293:Adolescent; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000209:etiology*; D004569:Electroencephalography; D004828:Epilepsies, Partial / Q000150:complications*; D056344:Executive Function / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007360:Intelligence; D008297:Male; D008569:Memory Disorders / Q000209:etiology*; D009483:Neuropsychological Tests; D018709:Statistics, Nonparametric; D014706:Verbal Learning / Q000502:physiology
keywords: Epilepsy; Executive functioning; Pediatric; Verbal memory; Visual memory