Abstracts

Rationale: Poor social skills are consistently found in pediatric epilepsy. Subtle to mild cognitive, academic, and linguistic/ communication deficits; stigma; and bullying are associated with these social difficulties. Similar findings in pediatric central nervous system disorders (head trauma, neurofibromatosis, and cancer) imply a role for biological factors. Therefore, this study compared the relationship between social skills and fronto-temporal volumes (FTC) in children with epilepsy to matched healthy controls (HC). Methods: 47 children with localization related epilepsy with complex partial seizures (CPS), 24 children with absence epilepsy (CAE), and 36 HC subjects underwent MRI scans at 1.5T. Tissue was segmented and frontal parcellations of inferior frontal gyrus (IFG), orbital frontal gyrus (OFG), dorsolateral prefrontal cortex (DLPFC)), and temporal lobe (TL) gray and white volumes (GMV, WMV) were computed. Parent Child Behavior Checklist provided social problems and peer interaction scores. A social composite Z score was constructed by taking an average of the z-transformed peer interaction and social problems scores. Social problems scores were inverted so that increasing scores represented fewer problems. ANCOVAs, controlling for age and gender, determined group differences in social scores and FTV. General linear models, with FTV as the dependent variables and group, social score, and interaction of group and social scores as predictors, were estimated to determine group differences in the relationships between FTV and social scores. Results: Significantly higher mean social problem scores (p< .0001) and lower peer interaction scores (p=.0001) were observed in the epilepsy groups compared to the HC group but there were no significant differences on these scores between the epilepsy groups and on FTV between the three groups. The social Z score correlated significantly and negatively with DLPFC GMV (r =-.45, p<.02) and TL GMV (r =-.51, p< .006) in the HC but not in the CPS and CAE groups. There was a significant group x social score interaction for TL GMV (F(2, 89)=4.19, p<.02) and a trend for DLPFC GMV (F(2, 89)=2.66, p<.08). Smaller left (t=2.4, p<.03) and right TL GMV (t=2.9, p<.005) were significantly associated with higher social Z scores in the HC. In the CPS group, larger left (t=2.32, p<.03) and right DLPFC GMV (t=2.78, p<.02) were significantly related to higher social Z scores. Although not statistically significant, like the CPS group, the CAE group showed a positive association of social scores with DLPFC and TL GMV. The peer interaction score alone accounted for these findings. Conclusions: This is the first study to demonstrate that poor peer interaction in children with epilepsy with average intelligence reflects structural abnormalities in brain regions involved in executive function, language, and social communication. Studies on larger samples are needed to determine if the deficits in executive function, language, and social communication in children with epilepsy drive this finding.