Abstracts

[ldquo]Executive function[rdquo] is an umbrella term for a set of self-regulatory processes that impact day-to-day adaptive behavior. The objective of this study is to contrast domains of executive functioning in normal controls and a sample of newly diagnosed children and adolescents with epilepsy. The parents of 43 newly identified pediatric epilepsy patients (mean duration 10.3 months; mean age 12.7 years) and 33 age equivalent healthy controls (mean age 13.2 years) completed the Brief Rating Inventory of Executive Functioning (BRIEF). The BRIEF assesses the child[apos]s proficiency in 10 subdomains of executive functioning: emotional control, initiation, inhibition, inconsistency, self-monitoring, negativity, planning and organization, organization of materials, shift, and working memory. Global measures including behavioral regulation, global executive functioning and metacognition are also calculated. The newly diagnosed epilepsy group showed more disruption than controls on all global measures of the BRIEF: Behavioral Regulation Index (p=.003), Global Executive Composite (p[lt].001), Metacognition Index (p[lt].001). They also showed more difficulties than controls on 8 of 10 domains of the BRIEF including: Emotional Control (p=.004), Initiate (p[lt].001), Monitor (p=.003), Negativity (p=.007), Organization of Materials (p=.003), Plan/Organize (p[lt].001), Shift (p[lt].001), and Working Memory (p[lt].001). Furthermore, compared to controls, the pediatric epilepsy patients were three times as likely to achieve scores within the clinical or at risk ranges on the BRIEF. There were no differences between patients with localization-related versus generalized epilepsy syndromes. Compared to same aged controls, newly identified pediatric epilepsy patients were reported to have more difficulties across nearly all domains of executive functioning, with a higher percentage of subjects falling within the clinically significant range. These findings suggest that even early in the disease course, areas of executive functioning are vulnerable in pediatric epilepsy. The broader implications of parent-reported impairments in executive dysfunction for future social, cognitive, and emotional functioning remain to be explored. (Supported by NIH grant NS044351 (BH, MS) and MO1 RR03186 (GCRC).)