Highlights
- •Children with functional seizures demonstrated poorer selective attention and cognitive inhibition as compared with matched controls when presented with seizure-related stimuli.
- •Children with functional seizures had poorer awareness that their control was being manipulated.
- •A majority of children with functional seizures reported experiencing premonitory symptoms prior to functional seizures.
Abstract
Purpose
To date, laboratory-based experimental behavioral methods have not been used to identify
factors associated with pediatric functional seizures (FS), leaving a critical gap
for effective treatment development.
Methods
Children ages 13–18 with video-EEG-confirmed FS were matched to controls (MCs) based
on income, sex, race, and age. A modified Stroop task which included a condition requiring
participants to report the ink colors in which seizure symptom words were written
(e.g., “shaking” in blue) measured selective attention and cognitive inhibition through
response time. The magic and turbulence task assessed sense of control in three conditions
(magic, lag, turbulence). Children with FS were asked to report premonitory symptoms
predicting FS.
Results
Participants included 26 children with FS and 26 MCs (Meanage=15.2, 74% female, 59% white). On Stroop, children with FS had a slower reaction time
(Mean=1193.83) than MCs (Mean=949.26, p = 0.022) for seizure symptom words. Children with FS had significantly poorer sense
of control in the turbulence condition of the magic and turbulence task (Mean=-3.99,
SD=8.83) than MCs (Mean=-11.51, SD=7.87; t(20)=-2.61, p =0.017). Children with FS (Mean=-1.80, SD=6.54) also had significantly poorer sense
of control in the magic condition than MCs (Mean=-5.57, SD=6.01; p =0.028). Ninety-eight percent of patients endorsed premonitory symptoms.
Conclusion
Compared with MCs, children with FS have (1) poorer selective attention and cognitive
inhibition when presented with seizure-related information and (2) lower sense of
control (i.e. poorer awareness that their control was manipulated). Premonitory symptoms
were common. Sense of control, selective attention, and inhibition may be novel treatment
targets for FS intervention.
Keywords
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Article info
Publication history
Published online: March 30, 2022
Accepted:
March 29,
2022
Received in revised form:
March 28,
2022
Received:
February 19,
2022
Identification
Copyright
© 2022 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.
