INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Majestic Complex (Posters 61-120) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #105 Examining Differences Among Cognitive and Motor Slowing Across Children Referred for Epilepsy Surgery Candidacy. Lauren Scimeca, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Alexandra Roussau, Palo Alto University, Palo Alto, United States Enrique Rojas, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Abigail Van Nuland, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Lizbeth Jordan, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Frank Zelko, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Priscilla Duong, Ann & Robert H. Lurie Children's Hospital, Chicago, United States Category: Epilepsy/Seizures Keyword 1: motor speed Keyword 2: cognitive processing Keyword 3: epilepsy / seizure disorders - surgical treatment Objective: Across many epilepsy types, processing speed challenges are often cited as the most prevalent finding when compared with broader cognitive functioning. Notably, the majority of previous research has measured processing speed via graphomotor tasks. Moreover, studies using the Wechsler scales tend to show the most impairments on the Coding subtest, which incorporates greater motor demands compared to its processing speed counterpart, Symbol Search. These findings are unsurprising considering that motor challenges are also a primary difficulty in children with epilepsy. However, it remains unclear whether there are differences between speeded performances in children with epilepsy. The current study aims to identify differences between performances on speeded tasks with high motor demands compared to speeded tasks with minimal motor demands while controlling for epilepsy factors. Participants and Methods: 585 patients were selected from the national Pediatric Epilepsy Research Consortium (PERC) database of patients who underwent pre-surgical evaluations. Mean age at the time of the evaluation was 13.08±3.61. Mean age of seizure onset was 7.32 ±4.81. The sample was 52% male, 75% White, 14% Hispanic, 7% Black, and 3% Asian. Most children were taking 3 ASMs (43%), and most children experienced weekly seizures (34%). Assessments were grouped by speeded tasks with high demands or low motor demands to create composite scores. The high motor demand grouping consisted of WISC/WAIS Coding, DKEF Trails Number Sequencing, DKEF Trails Motor Speed, and Grooved Pegboard. The minimal motor demand group consisted of WISC/WAIS Symbol Search, DKEFS Letter Fluency, DKEFS Category Fluency, DKEFS Color Naming, DKEFS Word Reading, CPT Hit Reaction Time, and TOL-C Total Execution Time. All assessment scores were converted into standard scores and composite scores were calculated by averaging the measures in each grouping. Results: An ANCOVA revealed that performances on speeded tasks with high motor demands (M = 79.31±17.97) were significantly lower than speeded motor tasks with low motor demands (M = 84.27±16.16) while controlling for age of onset, the number of ASMs taken, and seizure frequency, F(1,584) = 477.20, p<.001, η2=.33. The greater number of ASMs taken and younger age of onset were significantly related to poorer motor speeded performances (p<0.001, p<0.01, respectively). Conclusions: Children with intractable epilepsy undergoing pre-surgical evaluation performed slower across speeded measures, with poorer performances on tasks involving higher motor demands compared to minimal motor demands. This is consistent with previous findings that children tend to perform significantly worse on the WISC Coding than WISC Symbol Search and further suggests that cognitive and motor speed are distinct abilities, highlighting the need for purer measures of each construct. As such, slowed cognitive and/or motor processing likely has downstream effects on children’s ability to learn and their broader academic performances. Accordingly, these findings have implications for clinical recommendations as children may require differing supports for challenges related to cognitive versus motor speed. Future research should focus on how different aspects of slowed processing can have effects on academic functioning in children with intractable epilepsy.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Majestic Complex (Posters 61-120)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #105

Examining Differences Among Cognitive and Motor Slowing Across Children Referred for Epilepsy Surgery Candidacy.

Lauren Scimeca, Ann & Robert H. Lurie Children's Hospital, Chicago, United States
Alexandra Roussau, Palo Alto University, Palo Alto, United States
Enrique Rojas, Ann & Robert H. Lurie Children's Hospital, Chicago, United States
Abigail Van Nuland, Ann & Robert H. Lurie Children's Hospital, Chicago, United States
Lizbeth Jordan, Ann & Robert H. Lurie Children's Hospital, Chicago, United States
Frank Zelko, Ann & Robert H. Lurie Children's Hospital, Chicago, United States
Priscilla Duong, Ann & Robert H. Lurie Children's Hospital, Chicago, United States

Category: Epilepsy/Seizures

Keyword 1: motor speed
Keyword 2: cognitive processing
Keyword 3: epilepsy / seizure disorders - surgical treatment

Objective:

Across many epilepsy types, processing speed challenges are often cited as the most prevalent finding when compared with broader cognitive functioning. Notably, the majority of previous research has measured processing speed via graphomotor tasks. Moreover, studies using the Wechsler scales tend to show the most impairments on the Coding subtest, which incorporates greater motor demands compared to its processing speed counterpart, Symbol Search. These findings are unsurprising considering that motor challenges are also a primary difficulty in children with epilepsy. However, it remains unclear whether there are differences between speeded performances in children with epilepsy. The current study aims to identify differences between performances on speeded tasks with high motor demands compared to speeded tasks with minimal motor demands while controlling for epilepsy factors.

Participants and Methods:

585 patients were selected from the national Pediatric Epilepsy Research Consortium (PERC) database of patients who underwent pre-surgical evaluations. Mean age at the time of the evaluation was 13.08±3.61. Mean age of seizure onset was 7.32 ±4.81. The sample was 52% male, 75% White, 14% Hispanic, 7% Black, and 3% Asian. Most children were taking 3 ASMs (43%), and most children experienced weekly seizures (34%). Assessments were grouped by speeded tasks with high demands or low motor demands to create composite scores. The high motor demand grouping consisted of WISC/WAIS Coding, DKEF Trails Number Sequencing, DKEF Trails Motor Speed, and Grooved Pegboard. The minimal motor demand group consisted of WISC/WAIS Symbol Search, DKEFS Letter Fluency, DKEFS Category Fluency, DKEFS Color Naming, DKEFS Word Reading, CPT Hit Reaction Time, and TOL-C Total Execution Time. All assessment scores were converted into standard scores and composite scores were calculated by averaging the measures in each grouping.

Results:

An ANCOVA revealed that performances on speeded tasks with high motor demands (M = 79.31±17.97) were significantly lower than speeded motor tasks with low motor demands (M = 84.27±16.16) while controlling for age of onset, the number of ASMs taken, and seizure frequency, F(1,584) = 477.20, p<.001, η2=.33. The greater number of ASMs taken and younger age of onset were significantly related to poorer motor speeded performances (p<0.001, p<0.01, respectively).

Conclusions:

Children with intractable epilepsy undergoing pre-surgical evaluation performed slower across speeded measures, with poorer performances on tasks involving higher motor demands compared to minimal motor demands. This is consistent with previous findings that children tend to perform significantly worse on the WISC Coding than WISC Symbol Search and further suggests that cognitive and motor speed are distinct abilities, highlighting the need for purer measures of each construct. As such, slowed cognitive and/or motor processing likely has downstream effects on children’s ability to learn and their broader academic performances. Accordingly, these findings have implications for clinical recommendations as children may require differing supports for challenges related to cognitive versus motor speed. Future research should focus on how different aspects of slowed processing can have effects on academic functioning in children with intractable epilepsy.