Prediction of the risk of development of autistic spectrum disorders in children with epileptic encephalopathies
DOI:
https://doi.org/10.15574/SP.2023.136.42Keywords:
children, epileptic encephalopathies, autism spectrum disorders, prognosing, electroencephalography, magnetic resonance tractographyAbstract
Predicting the risk of developing autism spectrum disorders (ASD) in children with epileptic encephalopathies (EE) is an important task, which makes it possible to identify the most significant risk factors and develop ways of their modification.
Purpose - to develop a model for predicting the risk of developing ASD in young children with EE.
Materials and methods. 75 children aged 0-3 years with the onset of epileptic seizures in the first year of life, clinical manifestations of EE were examined. The most informative clinical, neurophysiological, and neuroimaging indicators for predicting the risk of clinical manifestations of ASD were determined: age of onset of epileptic seizures, index of spike-wave activity during NREM sleep, frequency and amplitude of alpha rhythm, frequency and amplitude of epileptiform activity, fractional anisotropy and mean diffusion coefficient in the Broca’s center, fractional anisotropy in the Wernicke center and knee of the corpus callosum. The multiple linear regression method was used to predict the risk of developing ASD symptoms.
Results. A model for predicting the risk of developing clinical manifestations of ASD in children with EE has been developed. It was established that the risk of developing clinical manifestations of ASD increases with a decrease in the age of onset of epileptic seizures, decrease in the frequency and amplitude of the alpha rhythm according to electroencephalography (EEG) data, increase of the index of spike-wave activity, frequency and amplitude of epileptiform activity, increase in the index of fractional anisotropy in the anterior part of the arcuate tract, decrease in the average diffusion coefficient in the area of the Broca’s center, fractional anisotropy in the Wernicke center and the knee of the corpus callosum according to magnetic resonance tractography.
Conclusions. A regression model for predicting the risk of clinical manifestations of ASD in children with EE was developed with an average error of approximation of 13.2% and a coefficient of determination of 0.74, which is recommended for use in clinical practice in order to form groups of children at high risk of ASD. Such children require further dynamic monitoring and early intervention by specialists of a multidisciplinary team for timely identification and correction of ASD symptoms
The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies.
No conflict of interests was declared by the author.
References
Aoki Y, Abe O, Nippashi Y, Yamasue H. (2013). Comparison of white matter integrity between autism spectrum disorder subjects and typically developing individuals: a meta-analysis of diffusion tensor imaging tractography studies. Molecular autism. 4(1): 25. https://doi.org/10.1186/2040-2392-4-25; PMid:23876131 PMCid:PMC3726469
Berg AT, Berkovic SF, Brodie MJ, Buchhalter J, Cross JH, van Emde Boas W et al. (2010). Revised terminology and concepts for organization of seizures and epilepsy: Report of the ILAE Commission on Classification and Terminology. Epilepsia. 51: 676-685. https://doi.org/10.1111/j.1528-1167.2010.02522.x; PMid:20196795
Cheung C, Chua SE, Cheung V, Khong PL, Tai KS, Wong TK et al. (2009). White matter fractional anisotrophy differences and correlates of diagnostic symptoms in autism. Journal of child psychology and psychiatry, and allied disciplines. 50 (9): 1102-1112. https://doi.org/10.1111/j.1469-7610.2009.02086.x; PMid:19490309
Fisher RS, Scharfman HE, de Curtis M. (2014). How can we identify ictal and interictal abnormal activity? Advances in experimental medicine and biology. 813: 3-23. https://doi.org/10.1007/978-94-017-8914-1_1; PMid:25012363 PMCid:PMC4375749
Hrdlicka M, Sanda J, Urbanek T, Kudr M, Dudova I, Kickova S et al. (2019). Diffusion Tensor Imaging And Tractography In Autistic, Dysphasic, And Healthy Control Children. Neuropsychiatric disease and treatment. 15: 2843-2852. https://doi.org/10.2147/NDT.S219545; PMid:31632032 PMCid:PMC6781738
Kyrylova LH, Miroshnykov OO. (2016). Doslidzhennia rozmiriv mozolystoho tila v ditei z rozladamy autystychnoho spektra. International neurological journal. 6: 20-27.
Kyrylova LH, Miroshnykov OO. (2022). Klinichna otsinka efektyvnosti neiroprotektornoi terapii v ditei z porushenniamy movlennievoho y kohnityvnoho rozvytku.International neurological journal. 18 (4): 17-23. https://doi.org/10.22141/2224-0713.18.4.2022.954
Lee BH, Smith T, Paciorkowski AR. (2015). Autism spectrum disorder and epilepsy: Disorders with a shared biology. Epilepsy & behavior : E&B. 47: 191-201. https://doi.org/10.1016/j.yebeh.2015.03.017; PMid:25900226 PMCid:PMC4475437
Parisi P, Spalice A, Nicita F, Papetti L, Ursitti F, Verrotti A et al. (2010). "Epileptic encephalopathy" of infancy and childhood: electro-clinical pictures and recent understandings. Current neuropharmacology. 8 (4): 409-421. https://doi.org/10.2174/157015910793358196; PMid:21629447 PMCid:PMC3080596
Shaikh Z, Torres A, Takeoka M. (2019). Neuroimaging in Pediatric Epilepsy. Brain sciences. 9 (8): 190. https://doi.org/10.3390/brainsci9080190; PMid:31394851 PMCid:PMC6721420
Srivastava S, Sahin M. (2017). Autism spectrum disorder and epileptic encephalopathy: common causes, many questions. Journal of neurodevelopmental disorders. 9: 23. https://doi.org/10.1186/s11689-017-9202-0; PMid:28649286 PMCid:PMC5481888
Stafstrom CE, Kossoff EM. (2016). Epileptic Encephalopathy in Infants and Children. Epilepsy currents. 16 (4): 273-279. https://doi.org/10.5698/1535-7511-16.4.273; PMid:27582673 PMCid:PMC4988066
Stenshorne I, Syvertsen M, Ramm-Pettersen A, Henning S, Weatherup E, Bjørnstad A et al. (2022). Monogenic developmental and epileptic encephalopathies of infancy and childhood, a population cohort from Norway. Frontiers in pediatrics. 10: 965282. https://doi.org/10.3389/fped.2022.965282; PMid:35979408 PMCid:PMC9376386
Thomas RP, Milan S, Naigles L, Robins DL, Barton ML, Adamson LB, Fein DA. (2022). Symptoms of autism spectrum disorder and developmental delay in children with low mental age. The Clinical neuropsychologist. 36 (5): 1028-1048. https://doi.org/10.1080/13854046.2021.1998634; PMid:34762009 PMCid:PMC9210070
Ashmawi NS, Hammoda MA. (2022). Early Prediction and Evaluation of Risk of Autism Spectrum Disorders. Cureus, 14(3), e23465. https://doi.org/10.7759/cureus.23465
Tuchman R, Moshé SL, Rapin I. (2009). Convulsing toward the pathophysiology of autism. Brain & development. 31(2): 95-103. https://doi.org/10.1016/j.braindev.2008.09.009; PMid:19006654 PMCid:PMC2734903
Allen LA, Harper RM, Vos SB, Scott CA, Lacuey N, Vilella L et al. (2020). Peri-ictal hypoxia is related to extent of regional brain volume loss accompanying generalized tonic-clonic seizures. Epilepsia. 61(8): 1570-1580. https://doi.org/10.1111/epi.16615; PMid:32683693 PMCid:PMC7496610
Hrdlicka M, Sanda J, Urbanek T, Kudr M, Dudova I, Kickova S et al. (2019). Diffusion Tensor Imaging And Tractography In Autistic, Dysphasic, And Healthy Control Children. Neuropsychiatric disease and treatment. 15: 2843-2852. https://doi.org/10.2147/NDT.S219545; PMid:31632032 PMCid:PMC6781738
Downloads
Published
Issue
Section
License
Copyright (c) 2023 Modern pediatrics. Ukraine
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
The policy of the Journal “MODERN PEDIATRICS. UKRAINE” is compatible with the vast majority of funders' of open access and self-archiving policies. The journal provides immediate open access route being convinced that everyone – not only scientists - can benefit from research results, and publishes articles exclusively under open access distribution, with a Creative Commons Attribution-Noncommercial 4.0 international license (СС BY-NC).
Authors transfer the copyright to the Journal “MODERN PEDIATRICS. UKRAINE” when the manuscript is accepted for publication. Authors declare that this manuscript has not been published nor is under simultaneous consideration for publication elsewhere. After publication, the articles become freely available on-line to the public.
Readers have the right to use, distribute, and reproduce articles in any medium, provided the articles and the journal are properly cited.
The use of published materials for commercial purposes is strongly prohibited.
