Neuropsychological Impairment In Children Research Articles

Therapeutic Strategies in Children with Epilepsy: A Quality-of-Life-Related Perspective.

Back ground: Children with epilepsy are affected by several factors, including clinical and social variables. Among these variables, cognitive decline and behavioral disturbances, perceptions of stigma, and fatigue can lead to reductions in quality of life (QOL). Epileptic activities, including seizure severity, frequent seizures, and status epilepticus (SE), have been identified as important predictors of QOL. In addition, the frequency of interictal epileptiform discharges (IEDs) on electroencephalogram (EEG) may also be an important predictor of QOL, because IEDs can lead to cognitive decline and behavioral disturbances. Moreover, frequent seizures and/or IEDs may play a role in emotional mediators, such as stigma and fatigue, in childhood epilepsy. Seizure severity and/or IEDs are, therefore, important QOL-related factors in childhood epilepsy. Seizure severity as a QOL-related factor: Frontal lobe dysfunctions, such as cognitive decline and behavioral disturbances, can result in reduced QOL for both the child and their family. Frontal and prefrontal lobe growth disturbances can be present during active-phase epilepsy in some children with neuropsychological impairments. Recovery from prefrontal lobe growth disturbances may depend on the active seizure period. Children with a shorter active seizure period can recover from disturbances in prefrontal lobe growth more rapidly. In contrast, recovery may be delayed in children with a longer active seizure period. Moreover, frequent seizures can lead to seizure-associated headaches, perceptions of self-stigma and parental stigma, and fatigue. Accordingly, severe seizures can lead to neuropsychological impairments in association with prefrontal lobe growth disturbances in children with epilepsy. EEG abnormalities as QOL-related factors: IEDs on EEG, representing persistent pathological neuronal discharges, may be associated with several pathological aspects. Frontal IEDs can be a risk factor for recurrent seizures, cognitive decline, and behavioral disturbances, and they may also play a role as emotional mediators similar to stigma. In addition, behavioral disturbances may result in the presence of secondary bilateral synchrony (SBS) on EEG. Behavioral disturbances can be improved in association with a reduction in IEDs in children with frontal IEDs and SBS. Therefore, EEG abnormalities, such as frontal IEDs and SBS, can also lead to neuropsychological impairments in children with epilepsy. Therapeutic strategies in children with epilepsy: Seizure severity and IEDs on EEG may be associated with neuropsychological impairments, leading to QOL reduction. Therapeutic management may be desirable to reduce seizures and EEG abnormalities, such as frontal IEDs and SBS, as early as possible to improve QOL in children with epilepsy. During antiseizure medication (ASM) selection and adjustment, physicians should strategize the therapeutic approach to controlling seizures and suppressing EEG abnormalities in children with epilepsy. Among various ASMs, novel ASMs, such as levetiracetam and perampanel, may suppress both clinical seizures and IEDs on EEG; thus, these novel ASMs may represent an important addition to the treatments available for epileptic children presenting with frontal IEDs and SBS.

Prognostic factors for long-term outcome in children with fetal alcohol spectrum disorders

IntroductionKnown protective factors for long-term outcome in children with fetal alcohol spectrum disorders (FASD) are early diagnosis and a stable, non-violent supportive environment. Which factors contribute to the stability of care is not yet known. Thus, the aim of our study was to evaluate whether the age at diagnosis and the complexity of brain dysfunction play a role for placement changes in children with FASD. Materials and methodsAn online survey was conducted among caregivers and professionals caring for children with FASD and seeking help at the German FASD Competence Centre Bavaria (N = 232). The survey collected information about diagnosis, brain dysfunctions, behavioural factors influencing everyday life and changes of placement. The association of timing of diagnosis, brain dysfunctions and neurobehavioral impairment with changes of placement (<2 vs. 2 or more changes) was evaluated via logistic regression models. ResultsAbout 50% of the children received their diagnosis of FASD after the age of 5 years. The complexity of brain dysfunctions in children with FASD affecting everyday life was high. 15% of the children experienced four or more changes of placement. Children with more neuropsychological impairments experienced more changes of placement (OR: 2.53, 95% CI: 1.36–4.71). ConclusionsEven though our results need to be interpreted with caution due to methodological limitations such as the use of a convenience sample and limited statistical power, they imply that severely affected children with FASD experience a less stable environment. These children may therefore be at high risk for a negative prognosis. To warrant a better prognosis for the affected children, professionals urgently need to pay attention to early recognition and the complexity of neuropsychological impairments in children with FASD as well as to the support that caregivers urgently need.

Когнитивные нарушения у детей с детской абсансной эпилепсией (обзор литературы)

The review is devoted to common epilepsy of childhood — childhood absence epilepsy. This epileptic syndrome debuts at pre-school age and is characterized by frequent seizures which may be underestimated by doctors due to the clinical features of a seizure. The seizures can debilitate a child and restrict socialization, as specific comorbidities in cognitive field are very common for child absence epilepsy. The etiology of neropsychiatric comorbidities is different. Seizures, epileptic discharges, as well as interictal epileptiform activity in the brain may cause neuropsychological impairments in children. Antiepileptic drugs are important in the development of neuropsychological impairments. The aim of this review was to actualize information on childhood absence epilepsy and stress the necessity to pay practitioner’s attention to common comorbidities in cognitive field.

Neuropsychological Impairment in Children With Class 1 Congenital Heart Disease.

Children with congenital heart disease (CHD) are at increased risk of neuropsychological impairments, but few studies are available on the nonlinguistic neuropsychological abilities of children with CHD. We conducted neuropsychological evaluations using the NEPSY II on a cohort of 17 school-age Italian children with diagnoses of Class 1 CHD, no genetic or chromosomal abnormalities, and normal intelligence scores, and we compared them with 34 matched controls. Children with CHD in this study had undergone at least one cardiac surgery with cardiopulmonary bypass support. We found that children with CHD scored significantly lower than their matched controls on memory and learning domain tasks, and they displayed subtle attention/executive dysfunctions and deficits in sensorimotor skills.

Vagus nerve stimulation for 6- to 12-year-old children with refractory epilepsy: Impact on seizure frequency and parenting stress index

ObjectivesRefractory epilepsy (RE) is frequently associated with neuropsychological impairment in children and may disrupt their social development. Vagus nerve stimulation (VNS) had been reported to have beneficial effects on behavioral outcomes. The aim of this study was to compare Parenting Stress Index (PSI) scores before and after VNS device implantation in children with RE, especially those who experienced seizure frequency reduction. MethodsWe conducted a one-group pretest–posttest study in school age children with RE. Seizure frequency and PSI were recorded at 12months after VNS device implantation. ResultsTreatment with VNS was significantly associated with reduced seizure frequency and parental stress as measured by PSI. Factors contributing to seizure frequency included idiopathic/cryptogenic etiology and neurobehavioral comorbidities. In children with reduced seizure frequency, statistically significant improvements in the child domain of the PSI on the subscales of mood and reinforces parent were found. In the parent domain, the scores for social isolation were reduced. ConclusionsTreatment with VNS was significantly associated with reduced seizure frequency and improved PSI scores, especially within the child domain on the mood and reinforces parent subscales. These findings suggest that VNS reduced not only seizure frequency but also the psychological burden on children with RE.

Mapping the Network of Neuropsychological Impairment in Children with Autism Spectrum Disorder: A Graph Theoretical Analysis.

Children with autism spectrum disorder (ASD) exhibit social-communicative impairments. Less is known about the neuropsychological profile of ASD, although cognitive and neuropsychological deficits are evident. We modelled neuropsychological function in 20 children with ASD and 20 sex, age and IQ matched typically-developing controls (ages 7-14) as a network of interacting parameters. Graph theoretical analysis was applied to identify critical topographic regions within this network. Two areas were significantly stronger hubs in typically-developing children, the ability to shift attention (p < 0.001) and overall executive function (p < 0.001). Planning/organization was a stronger hub in the cognitive networks of children with ASD (p = 0.001). We show that ASD is not only characterized by impairments in various neurocognitive domains, but also alterations in their interaction.

A rating measure of ADHD-related neuropsychological impairment in children and adolescents: Data from the Cognition and Motivation in Everyday Life (CAMEL) Scale from population and clinical samples

ABSTRACTA new parent-completed questionnaire, the Cognition and Motivation in Everyday Life (CAMEL) scale, was developed to provide a comprehensive assessment of neuropsychological impairment in children related to attention-deficit/hyperactivity disorder (ADHD) across diverse cognitive, motivational and energetic domains. Its psychometric properties were investigated. A total of 60 items were generated to cover a wide range of putative ADHD-related neuropsychological processes. A clinical (n = 142) and community (n = 810) sample of parents with children between 6 and 16 years of age completed the questionnaire. Data on ADHD symptoms were also collected with a commonly-used, validated parent rating scale to explore the associations between CAMEL scores and dimensional measures of child ADHD and conduct problems. Factor analysis identified six factors which we labeled (i) Cognition, (ii) Self-Direction and Organization, (iii) Effort Engagement, (iv) Arousal Regulation, (v) Motivational Responsiveness, and (vi) Cautiousness. Self-Direction and Organization and Arousal Regulation were the strongest predictors for ADHD symptomatology. Self-Direction and Organization was strongly associated with inattention and Arousal Regulation with hyperactivity-impulsivity symptoms. Parents distinguished between broad neuropsychological domains in reliable and plausible ways, making distinctions between key aspects of functioning. However, the boundaries between these domains did not map directly onto the distinctions drawn within traditional models of ADHD deficits. Further research is required to examine the predictive validity and cost-effectiveness of the CAMEL scale compared to direct objective testing using laboratory measures in predicting prognosis and treatment outcome.

Improving Educational Outcomes in Fetal Alcohol Spectrum Disorder Through Interagency Collaboration

Children with fetal alcohol spectrum disorders (FASD) demonstrate a significant array of neurocognitive impairments including deficits in intelligence, attention, processing speed, executive functions, language functions, visual-spatial abilities, memory, and academic achievement. Neuropsychological impairments in children and adolescents with prenatal exposure to alcohol follow a continuum from no identifiable effects at one end to pervasive impairments across areas at the other end (i.e., Spohr, Willms and Steinhausen 1993; Streissguth, Randels and Smith 1991). Due to the continuum of impairments, interagency collaboration was developed to address the special educational needs of the children. The current paper has several purposes: (1) to allow school district staff who were offered an opportunity to share their perspectives and expertise on FASD and special need issues facing their students diagnosed with FASD; (2) to identify the school and social challenges faced by students diagnosed with FASD; (3) to describe the collaborative interagency program and potential impact on classroom ecology; and (4) to determine if the interagency collaboration had an effect on intervention practices of educators within the classroom.

Real-time effects of centrotemporal spikes on cognition in rolandic epilepsy: An EEG-fMRI study.

To identify the real-time effects of interictal rolandic spikes (or centrotemporal spikes [CTS]) on language, behavior, and cognitive function in patients with rolandic epilepsy (RE). We studied 22 medication-naive patients with RE using EEG-fMRI with a 3T MRI scanner. We used simultaneous EEG to define the pre-CTS, CTS, and post-CTS periods. We analyzed the dynamic functional connectivity maps of the rolandic network during the 3 interictal CTS periods. The analysis of dynamic changes revealed positive correlations between the bilateral rolandic areas and the left inferior frontal gyrus (IFG; Broca area), the left inferior parietal lobe and the supramarginal gyrus (areas responsible for receptive language function), and the right IFG and left caudate. Anti-correlations were found in the default mode network (bilateral superior frontal gyrus, left middle frontal gyrus, left middle temporal gyrus, and right precuneus). Interictal CTS directly disrupts the functional brain networks responsible for language, behavior, and cognition in children with typical RE. It is important to suppress discharges to reduce the risk of neuropsychological impairments in children with RE.

Empirical Derivation and Validation of a Clinical Case Definition for Neuropsychological Impairment in Children and Adolescents.

Neuropsychological assessment aims to identify individual performance profiles in multiple domains of cognitive functioning; however, substantial variation exists in how deficits are defined and what cutoffs are used, and there is no universally accepted definition of neuropsychological impairment. The aim of this study was to derive and validate a clinical case definition rule to identify neuropsychological impairment in children and adolescents. An existing normative pediatric sample was used to calculate base rates of abnormal functioning on eight measures covering six domains of neuropsychological functioning. The dataset was analyzed by varying the range of cutoff levels [1, 1.5, and 2 standard deviations (SDs) below the mean] and number of indicators of impairment. The derived rule was evaluated by bootstrap, internal and external clinical validation (orthopedic and traumatic brain injury). Our neuropsychological impairment (NPI) rule was defined as "two or more test scores that fall 1.5 SDs below the mean." The rule identifies 5.1% of the total sample as impaired in the assessment battery and consistently targets between 3 and 7% of the population as impaired even when age, domains, and number of tests are varied. The NPI rate increases in groups known to exhibit cognitive deficits. The NPI rule provides a psychometrically derived method for interpreting performance across multiple tests and may be used in children 6-18 years. The rule may be useful to clinicians and scientists who wish to establish whether specific individuals or clinical populations present within expected norms versus impaired function across a battery of neuropsychological tests.

Examining the frontal subcortical brain vulnerability hypothesis in children with neurofibromatosis type 1: Are T2-weighted hyperintensities related to executive dysfunction?

It was hypothesized that neuropsychological impairments in children with neurofibromatosis type I (NF1) are associated with brain areas of increased T2-weighted signal intensity on MRI. Systematic and extensive examination of this hypothesis remains however scarce, particularly regarding executive dysfunction whereas hyperintensities are located preferentially in frontal-sub-cortical networks. In this study, we compared the executive functioning profile with characteristics of brain hyperintensities in children with NF1. A sample of 36 school-age children with NF1 (7-12 years) underwent a detailed examination of executive function, including performance-based tests and child's behavior rating in daily life. Executive function measures were compared with the characteristics of the T2-weighted hyperintensities on parallel MRI scans. The presence, number, and size of hyperintensities in the whole brain were considered as well as their main cerebral locations. Executive dysfunction including traditional cognitive and ecological measures in children with NF1 is not significantly influenced by T2-weighted hyperintensities, in terms of presence or not, number, size, and location, whether in the whole brain or according to involved specific brain areas. T2-weighted hyperintensities, as they are currently measured, cannot be used as a strong indicator of executive dysfunction in children with NF1. Based on the available NF1 cognitive impairment pathogenesis models, a critical discussion on anatomical-functional relationships between hyperintensities and neuropsychological profile is proposed, especially the executive dysfunction.

Does comorbid bipolar disorder increase neuropsychological impairment in children and adolescents with ADHD?

To assess differences in executive functioning between children and adolescents with attention-deficit/hyperactivity disorder (ADHD) comorbid or not with bipolar disorder (BD), and to study the neuropsychological profile of subjects with the comorbidity in a clinical sample from a developing country. Case-control study comparing 23 participants with BD + ADHD and 85 ADHD-only subjects aged 6 to 17 years old. Both groups were drug-free. Executive function domains were assessed with the Stroop Test, the Wisconsin Card Sorting Test, and the Continuous Performance Test II. The group with juvenile BD + ADHD showed a significantly worse performance on the Stroop task, including time in color (p = 0.002), time in color-word (p < 0.001), interference, number or errors in color and color-word (p = 0.001), and number of errors in word cards (p = 0.028). No between-group differences were found in other tests. Our findings suggest that ADHD-only and ADHD + BD do not show differences in inhibitory control and set-shifting domains. However, children and adolescents with BD and comorbid ADHD show greater impairment in processing speed and interference control. This suggests a potentially higher impairment in the dorsolateral prefrontal cortex and may be a potential neuropsychological signature of juvenile BD comorbid with ADHD.

Neuropsychological Findings in Childhood Narcolepsy

Narcolepsy with cataplexy is a severely disabling disorder very often arising in childhood. Data on neuropsychological impairment in children are scant. We administered standardized neuropsychological tests to 13 children with narcolepsy with cataplexy. Overall, our patients displayed multiple patterns of cognitive and behavioral dysfunction, and often academic failure (7 cases out of 13). All children had a normal full intelligence quotient (IQ), but 3 patients presented a significantly higher and 2 a significantly lower Verbal IQ compared to Performance IQ, respectively. Mean sleep latency was significantly correlated (P < .05) to alertness functions. Eight patients displayed behavioral problems: emotional symptoms and conduct problems prevailed. Childhood narcolepsy with cataplexy represents a risk factor for subtle and heterogeneous cognitive impairments potentially resulting in academic failure, despite the normal IQ. These children also have a certain psychopathological risk. All this seems to be at least partially detached from the direct effects of daytime sleepiness.

Neuropsychological impairment in children with Rolandic epilepsy and in their siblings

To assess and characterize a possible neurocognitive endophenotype associated with Rolandic epilepsy (RE), a clinical study was carried out to evaluate the neuropsychological profile of children with RE at onset and of their healthy siblings.Seventeen subjects were recruited (10 boys and 7 girls): nine patients affected by RE and eight siblings who underwent clinical and neuropsychological evaluations. All patients and only two siblings showed centrotemporal spikes on the electroencephalographic recording. Eighteen age- and sex-matched healthy children were assessed as controls.A significant impairment was found in language domain, attentional functioning, and short- and long-term verbal memory in both patients and siblings. A positive correlation between verbal comprehension and working memory scores was found in both groups.A similar neuropsychological profile of RE, which affected patients and their siblings with impairment in the same developing areas, supports the hypothesis of a specific neurocognitive phenotype in RE.

Abnormal white matter correlates with neuropsychological impairment in children with localization‐related epilepsy

The white matter (WM) is considered critical for linking cortical processing networks necessary for cognition. The aim of this study was to assess diffusion tensor imaging (DTI) measures of regional WM in children with nonlesional localization-related epilepsy in comparison to controls, and to determine the relation between lobar WM and neuropsychological performance. Forty children with nonlesional localization-related epilepsy and 25 healthy controls with no neurological or psychiatric disorders and normal magnetic resonance imaging (MRI) were recruited. All patients and controls underwent neuropsychological testing that evaluated intelligence, language, memory, executive function, and motor function, as well as DTI to assess regional WM measures of fractional anisotropy (FA) and mean diffusivity (MD). The regional FA and MD were compared between patients and controls, and correlated with neuropsychological function. The relations between regional FA and MD with age at seizure onset and duration of epilepsy were assessed. Twenty-one patients had left-sided and 19 patients had right-sided epilepsy. There were no significant differences in seizure-related variables including age at seizure onset, duration of epilepsy, seizure frequency, and number of antiepileptic medications, as well as no significant differences in neuropsychological function and DTI measures of white matter in left-sided compared to right-sided epilepsy. Therefore, all the patients with epilepsy were treated as one group. Patients with epilepsy performed significantly worse on intelligence (p < 0.001), language (p < 0.001), and executive function (p = 0.001) evaluation than controls. Patients had significantly reduced FA in left frontal (p = 0.015), right frontal (p = 0.004), left temporal (p = 0.039), right temporal (p = 0.003), right parietal (p = 0.014), and right occipital (p = 0.025) WM relative to controls. There were no significant regional WM differences (all p > 0.05) in MD between patients and controls. There was a significant positive correlation between right temporal FA with language (r = 0.535, p < 0.001) and executive function (r = 0.617, p < 0.001), as well as between body of corpus callosum FA with intelligence (r = 0.536, p < 0.001) and language (r = 0.529, p < 0.001) in patients. Left parietal MD was significantly correlated with language (r = -0.545, p < 0.001) in patients. FA of right temporal WM was significantly associated with age at seizure onset (t = 4.97, p < 0.001). There was widespread regional WM abnormality in children with nonlesional localization-related epilepsy, which was associated with impaired neuropsychological function. The impairment in WM may reflect disruption in the connectivity for cortical processing networks, which is necessary for the development of cognition.

Effects of levetiracetam on seizure frequency and neuropsychological impairments in children with refractory epilepsy with secondary bilateral synchrony

PurposeIn epilepsy with continuous spikes and waves during slow sleep (CSWS), which is a representative epileptic syndrome of secondary bilateral synchrony (SBS), the urgent suppression of this electroencephalographic (EEG) abnormality may be necessary to prevent the progression of neuropsychological impairments. The purpose of this study was to determine the efficacy of levetiracetam (LEV) on SBS, seizure frequency, and neuropsychological impairments in children with refractory epilepsy. MethodsEleven (seven male and four female) patients with refractory epilepsy with SBS on EEG, aged between 4.7 years and 11.3 years, were included in this study. After a 3-month baseline period, the patients were given LEV at an initial dose of 10mg/kg/day for the first week, followed at increments of 5mg/kg/day every week, up to 20mg/kg/day. The LEV dose was then adjusted up to a maximum of 60mg/kg/day, according to the clinician's judgment. EEG recordings and clinical evaluations were performed every 3 months, focusing on SBS. The occurrence of SBS was then scored, and the relationship between the score and the response to LEV treatment was evaluated. In comparison with the baseline SBS frequency, the EEG response to LEV treatment was classified, and responders were identified as having a ≥50% reduction in SBS frequency. In addition, in comparison with the baseline seizure frequency, response to LEV treatment was classified. Responders were identified as patients with complete cessation (100% seizure control) and a response of ≥50% reduction in seizures. Furthermore, neuropsychological impairments such as hyperactivity, impulsiveness, and inattention were evaluated before and after LEV treatment. ResultsEight patients (72.7%) were considered responders. In addition, all eight patients were also considered responders for clinical seizures. Furthermore, 7 of 8 (87.5%) patients with response showed decreased hyperactivity and impulsivity after LEV administration. ConclusionsThe present data clearly indicate the usefulness of LEV in reducing both SBS on EEG and seizure frequency. LEV represents an important addition to the treatments available for refractory childhood epilepsies with SBS on EEG.

Neurocognitive Profile in a Case of Maple Syrup Urine Disease

Maple Syrup Urine Disease (MSUD) is a metabolic disease with associated enzyme deficiency and an inability to break down amino acids. Neurotoxic levels can occur resulting in neurological sequelae. Information regarding cognitive functions has suggested greater verbal than visuospatial abilities. Specific neuropsychological functions have not been studied. The objective of this study is to examine the neuropsychological profile in a case of MSUD. We present a case study of a 7-year-old female who has a history of late diagnosis (7 days of age) and poor metabolic control. Consistent with existing literature, a profile of stronger verbal reasoning and memory skills compared with visual-perceptual and nonverbal memory was revealed. Additional weaknesses were demonstrated with attention, emerging executive functions, and fine motor control. The results suggest that while previously described nonverbal reasoning and visuospatial impairments are present, there is likely a more complex pattern of neuropsychological impairments in children with MSUD, especially those with poor metabolic control.

Screening for neuropsychological impairment in children using Reitan and Wolfson's preliminary neuropsychological test battery

This study examined the efficacy of two screening batteries developed by Reitan and Wolfson [Reitan, R. M., & Wolfson, D. (2006). Issues in neuropsychology: Where have we succeeded? Where have we failed? What are the clinical and forensic implications? Presented at the 26th annual conference of the National Academy of Neuropsychology] for predicting neuropsychological impairment on the Halstead–Reitan Neuropsychological Test Battery for Older Children (ages 9–14) and the Reitan–Indiana Neuropsychological Test Battery (ages 5–8). Sixty-eight subjects were selected from archival data collected from cases in a private practice setting. Using Reitan and Wolfson's recommended screening battery neuropsychological deficit scale score (SBNDS) cut-off of 16/17 correctly classified 82.5% of older children as normal or impaired according to total GNDS scores. The screening battery for young children ( n = 28) resulted in 100% correct classification using Reitan and Wolfson's recommended SBNDS cut-off of 22/23.

Are Neuropsychological Impairments in Children with Early-Treated Phenylketonuria (PKU) Related to White Matter Abnormalities or Elevated Phenylalanine Levels?

This study aimed to enhance our understanding of neuropsychological functioning in children with early-treated phenylketonuria (PKU) and assess the relative impact of white matter abnormalities (WMA) and neurotransmitter deficiencies on cognitive functions in this population. The study consisted of 33 children with early-treated PKU and 34 healthy control children aged between 7 to 18 years. All children had a neuropsychological evaluation that included measures of general intelligence, attention, processing speed, memory and learning, executive function, and academic achievement. Children in the PKU group also had a magnetic resonance (MR) brain scan. When compared with the control group, the PKU group exhibited global cognitive impairment including lower IQ, attention problems, slow information processing, reduced learning capacity, mild executive impairments, and educational difficulties. Children in the PKU group with extensive WMA (n = 14) displayed significant impairments across all cognitive domains. Metabolic control correlated weakly to moderately with attention, executive, and memory/learning factors. Within the PKU group, regressions revealed that executive function and attention factors were independently related to severity of WM pathology and age, while the memory and learning factor was independently related to metabolic control and age. It is concluded that children with early-treated PKU exhibit a global pattern of impairment, with a particular deficit in processing speed. WM pathology extending into frontal and subcortical regions correlates with the greatest deficits and a profile of impairment consistent with diffuse WM damage. Our findings also offer some support for dopamine depletion in the prefrontal cortex, however adverse consequences as a result of norepinephrine and serotonin deficiencies should not be discounted.

ESP07 Neuropsychological impairment in children with rolandic epilepsy

ESP07 Neuropsychological impairment in children with rolandic epilepsy