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Advisor(s)
Abstract(s)
Introdução: A epilepsia autolimitada com pontas centrotemporais (ECTS) é uma
das epilepsias focais mais frequentes em crianças e jovens. Por ser uma epilepsia que
apresenta uma remissão anterior aos 16 anos de idade, com uma manifestação clínica
de baixa frequência e que ocorre geralmente durante o período noturno, foi
considerada benigna durante vários anos. Os défices cognitivos desta patologia têm
vindo a ser conhecidos, mas no caso dos vários domínios das funções executivas
(controlo inibitório, memória de trabalho, flexibilidade cognitiva, fluência verbal e
funções executivas superiores) a informação é escassa.
Metodologia: A presente revisão sistemática com meta-análise foi realizada
através da literatura disponível nas bases de dados PubMed e Scopus e da pesquisa
manual de literatura cinzenta, tendo em conta os seguintes critérios de elegibilidade:
(1) artigos originais de investigação publicados em revistas com revisão de pares; (2)
estudos que apresentem resultados de avaliações realizadas com testes
neuropsicológicos e/ou escalas que permitam aceder ao funcionamento executivo dos
sujeitos; (3) estudos que apresentam avaliação de crianças diagnosticadas com ECTS. 43
estudos reuniram critérios para a revisão sistemática, 20 dos quais foram agrupados em
cinco meta-análises correspondentes a cada um dos domínios das funções executivas.
A qualidade dos estudos foi avaliada através da escala Newcastle-Ottawa e a qualidade
de evidência da meta-análise através da ferramenta GRADEpro.
Resultados e Conclusões: Os resultados da presente meta-análise são os
primeiros a demonstrarem a presença de défices nas funções executivas nestas crianças.
As crianças com ECTS apresentam desempenhos mais fracos em todos os domínios das
funções executivas, exepto na memória de trabalho, quando comparadas com o grupo
controlo. No entanto, uma vez que a qualidade de evidência das várias metanálise foi
classificada como muito baixa, os resultados devem ser interpretados com alguma
precaução.
Introduction: Self-limited epilepsy with centrotemporal spikes (ECTS) is one of the most frequent child focal epilepsies. Because remission usually occurs before 16 years old and patients present infrequent clinical manifestation that occurs mainly during sleep ECTS was considered benign for a long time. Nowadays the cognitive deficits associated to ECTS became more relevant however little efforts were made to gather knowledge about the functioning of executive function specific domains (inhibitory control, working memory, cognitive flexibility, verbal fluency and executive function of higher-order). Methodology: This investigation was performed through the available literature present at PubMed and Scopus databases and manual searching of grey literature according to the following eligibility criteria: 1) original articles published at journals with peer review; 2) studies that have available assessment of the executive function of the subjects; 3) Studies that present assessment of children with ECTS. 43 studies accomplish criteria for systematic review and 20 of those were pooled at five metanalysis correspondent to each executive function domain. The study quality was measured through the Newcastle-Ottawa Scale and the evidence quality with the GRADEpro tool. Results and Conclusions: The present systematic review is the first one demonstrating the existence of executive function deficits in these children. According to the metanalysis results, the children with ECTS present a weaker performance in all executive function domains except at working memory when compared with a control group. However, because the quality of evidence was characterized as very low, precaution at the interpretation of results should exist.
Introduction: Self-limited epilepsy with centrotemporal spikes (ECTS) is one of the most frequent child focal epilepsies. Because remission usually occurs before 16 years old and patients present infrequent clinical manifestation that occurs mainly during sleep ECTS was considered benign for a long time. Nowadays the cognitive deficits associated to ECTS became more relevant however little efforts were made to gather knowledge about the functioning of executive function specific domains (inhibitory control, working memory, cognitive flexibility, verbal fluency and executive function of higher-order). Methodology: This investigation was performed through the available literature present at PubMed and Scopus databases and manual searching of grey literature according to the following eligibility criteria: 1) original articles published at journals with peer review; 2) studies that have available assessment of the executive function of the subjects; 3) Studies that present assessment of children with ECTS. 43 studies accomplish criteria for systematic review and 20 of those were pooled at five metanalysis correspondent to each executive function domain. The study quality was measured through the Newcastle-Ottawa Scale and the evidence quality with the GRADEpro tool. Results and Conclusions: The present systematic review is the first one demonstrating the existence of executive function deficits in these children. According to the metanalysis results, the children with ECTS present a weaker performance in all executive function domains except at working memory when compared with a control group. However, because the quality of evidence was characterized as very low, precaution at the interpretation of results should exist.
Description
Keywords
Epilepsia autolimitada com pontas centrotemporais Funções executivas Controlo inibitório Memória de trabalho Flexibilidade cognitiva Self-limited epilepsy with centrotemporal spikes Executive functions Inhibitory control Working memory Cognitive flexibility