The Long-term Characterization of Behavior Phenotypes in Children with Seizures Over 36 Months
Karina Morales1, Danielle Harvey2, David Dunn3, Jana Jones5, Anna Byars6, Joan Austin4, Bruce Hermann5, Temitayo Oyegbile-Chidi1
1Neurology, University of California Davis, 2Public Health Sciences, University of California Davis, 3Psychiatry and Neurology, Indiana University, 4Indiana University, 5Neurology, University of Wisconsin School of Medicine and Public Health, 6Pediatrics, Cincinnati Children’s Hospital at the University of Cincinnati
Objective:
This study aims to demonstrate the distinct behavioral patterns in youth with epilepsy from the persepective of a latent group analysis; as well as the presence, consistency, stability and progression of latent behavioral phenotypes in youth with new-onset epilepsy and sibling controls over a 36 month period.
Background:
Epilepsy comorbidities including behavioral problems have been well documented in children with new-onset and chronic epilepsy. Recent studies have also identified distinct behavioral patterns or phenotypes in youth with epilepsy, showing varying levels of vulnerability and resilience to these issues. Identifying youth with higher levels of vulnerability versus those with higher levels of resilience is necessary for more comprehensive neurologic care.
Design/Methods:
312 children (6-16 years) were recruited within 6 weeks of their first recognized seizure, along with 223 unaffected siblings. Each child’s behavior was recorded by parents and teachers frequently over 36 months using the child’s behavior checklist (CBCL); while each child completed self-report measures of depression (Child Depression Inventory (CDI-2)) over 36 months. Summary T-scores were evaluated longitudinally to identify clusters, with distinct behavioral trajectories over the 36-month period.
Results:
Latent trajectory modeling revealed three distinct behavioral phenotype clusters: Cluster 1 (~30%) displayed behavior similar to or better than controls, Cluster 2 (~50%) had moderate issues, and Cluster 3 (~20%) exhibited severe, clinically relevant problems. These clusters remained stable over 36 months, with parent, teacher, and child self-reports aligning consistently. Powerful predictors of cluster membership were seizure syndrome and sociodemographic disadvantage.
Conclusions:
The analytic approach used to assess the behavior of children with new-onset epilepsy has significant implications for identifying high-risk groups, understanding their behavioral course, and determining predictors of behavioral issues. Early investigation after seizure onset offers opportunities for timely intervention to improve behavioral outcomes in patients with epilepsy.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.