Abstracts

Rationale: There is limited population-based data on neurobehavioural comorbidities in early-onset epilepsy (EOE) (onset < age 5 years). Early identification increases the likelihood of optimum medical, social and educational management. NEUROPROFILES, an ongoing two year, population-based, case-control study aims to identify the spectrum of neurobehavioural comorbidities, their risk factors, and to explore neuroimaging and eye-tracker biomarkers. Methods: Since May 1, 2013 resident preschool children in South East Scotland with newly diagnosed EOE are being enrolled using active multi-source capture-recapture surveillance and offered detailed age-appropriate neuropsychological assessment including Bayley Scales of Infant and Toddler Development-III, Wechsler Preschool and Primary Scales of Intelligence-III, The NEPSY-II, ESSENCE-Q, Conners Early Childhood, Social Responsiveness Scale-2, the Adaptive Behaviour Assessment System-II, and ITSEA. Matched controls are being recruited through public advertisement. Eye-tracking and brain MRI correlates with psychometric findings are being examined for resident and non-resident children. Eye-tracking battery consists of documented (saccadic control & face scanning) and locally developed novel (working memory & social preference) tasks. Group comparisons were conducted using ANOVAs, t-tests or Mann-Whitney U/Wilcoxon signed-rank tests. Results: 26 children with EOE (incidence 57.5/100,000/year) have been identified (19M:7F; mean age 34 months, range 4-62). 17 EOE (65%, 95% CI 47-83) and 27 controls (12M:15F; mean age 33 months, range 3-59) have been assessed. Children with EOE were more likely to have a cognitive ability score <1.5SD below the mean vs controls (p=.04, phi= .4). Groups also differed in a test of immediate verbal recall (p<.01). Parents of children with EOE expressed a greater number of multi-domain behavioural concerns vs controls (3.4 vs 0.7, p<.01). Children with EOE also exhibited poorer adaptive behaviour (p=.02), social cognition (p<.01), social motivation (p=.04), and social communication (p=.04). Controls exhibited a saccadic inhibition effect (p<.01) not seen in EOE (p=.8) who also displayed abnormal face scanning behaviour compared to controls, who had clear preference for scanning eyes, nose, and mouth regions. Additionally, there was a trend toward children with EOE paying less attention during eye-tracking resulting in a smaller number of useable trials across tasks (63% vs 80%, p<.06). MRI data on all recruited subjects will be presented. Conclusions: NEUROPROFILES is the first UK prospective population-based study to focus on neurobehavioural comorbidities in EOE. Preliminary data suggest impaired neurodevelopment is detectable early in EOE, particularly in cognitive and social domains. Eye-gaze behaviour may potentially be indicative of deficits in attentional gaze behaviour. Neurobehavioural concerns are present at epilepsy onset suggesting factors contributing to the epilepsy itself may also contribute to the formulation and expression of comorbidities in EOE.