Analysis of influencing factors for cognitive impairment in children with self-limited epilepsy with centrotemporal spikes

TL;DR

This study identifies factors like inflammation markers and EEG features that predict cognitive impairment in children with a specific type of epilepsy.

Contribution

The study identifies novel biomarkers and EEG indicators for predicting cognitive impairment in children with SeLECTS.

Findings

Elevated IL-6, TNF-α, and NSE levels are risk factors for cognitive impairment in SeLECTS children.

Older age of onset is a protective factor against cognitive impairment in these children.

Combining IL-6, TNF-α, and NSE markers improves prediction accuracy for cognitive impairment.

Abstract

This study aimed to analyze the influencing factors of cognitive impairment in children with Self-limited Epilepsy with Centrotemporal Spikes (SeLECTS) to provide a scientific basis for clinical intervention.

We retrospectively analyzed the clinical data of children diagnosed with SeLECTS at our hospital between January 2020 and December 2024. Intelligence scale assessments were collected, and patients were divided into cognitive dysfunction and non-cognitive dysfunction groups based on the results. Data on age, seizure frequency, spike peak voltage, electroencephalogram (EEG) discharge index, and laboratory indicators were obtained for both groups. The predictive value of EEG and laboratory indicators for cognitive impairment in SeLECTS patients was evaluated using Receiver Operating Characteristic (ROC) curve analysis and multivariate logistic regression.

A total of 106 SeLECTS children were included, of whom 35 (33.02%) exhibited cognitive dysfunction. Compared to the non-cognitive dysfunction group, the cognitive dysfunction group had a younger age of onset and higher levels of interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α), neuron-specific enolase (NSE), spike peak voltage, and a greater proportion with a discharge index >10% (p < 0.05). The areas under the ROC curve (AUC) for IL-6, TNF-α, and NSE in assessing cognitive impairment were 0.842, 0.833, and 0.855, respectively. The combined AUC of these three markers was 0.928, which was significantly higher than that of IL-6 (Z = 2.297, p = 0.022), TNF-α (Z = 2.296, p = 0.022), and NSE (Z = 2.108, p = 0.035) individually. The AUC values for spike peak voltage and discharge index were 0.620 and 0.637, respectively, while their combined AUC was 0.696. Elevated IL-6, TNF-α, and NSE levels were identified as risk factors for cognitive impairment in SeLECTS children (p < 0.05), whereas older age of onset was a protective factor (p < 0.05).

IL-6, TNF-α, NSE, spike peak voltage, discharge index, and age of onset are associated with cognitive impairment in SeLECTS children and may serve as valuable potential biomarkers, providing insights for early intervention.

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