Neighborhood disadvantage and intellectual development in youth with epilepsy

William A Schraegle; David A Hsu; Dace N Almane; Carson Gundlach; Carl E Stafstrom; Michael Seidenberg; Jana E Jones; Bruce P Hermann

doi:10.1016/j.yebeh.2023.109492

Neighborhood disadvantage and intellectual development in youth with epilepsy

Epilepsy Behav. 2023 Dec:149:109492. doi: 10.1016/j.yebeh.2023.109492. Epub 2023 Nov 10.

Authors

William A Schraegle¹, David A Hsu², Dace N Almane², Carson Gundlach², Carl E Stafstrom³, Michael Seidenberg⁴, Jana E Jones², Bruce P Hermann⁵

Affiliations

¹ Departments of Neurology and Pediatrics, Dell Medical School, The University of Texas, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
² Department of Neurology, University of Wisconsin, School of Medicine and Public Health, USA.
³ Department of Neurology, Johns Hopkins University, USA.
⁴ Department of Psychology, Rosalind Franklin University of Medicine and Science, USA.
⁵ Department of Neurology, University of Wisconsin, School of Medicine and Public Health, USA. Electronic address: hermann@neurology.wisc.edu.

PMID: 37951133
DOI: 10.1016/j.yebeh.2023.109492

Abstract

Rationale: Recent cross-sectional investigations have demonstrated an adverse impact of socioeconomic disadvantage on cognition and behavior in youth and adults with epilepsy. The goal of this study is to investigate the impact of disadvantage on prospective intellectual development in youth with epilepsy.

Method: Participants were youth, aged 8-18 years, with recent onset epilepsy (n = 182) and healthy first-degree cousin controls (n = 106). The Wechsler Abbreviated Scale of Intelligence (WASI) was administered at baseline and 2 years later. The Neighborhood Atlas identified each family's Area Deprivation Index via state deciles and national percentiles. WASI data were analyzed by mixed group by time ANOVAs followed by regression analysis to identify other baseline predictors of time 2 outcomes.

Results: Youth with epilepsy demonstrated significant interactions between group and time for both verbal (F = 4.02, df = 1,215, p =.05) and nonverbal (F = 4.57, df = 1,215, p =.04) reasoning, demonstrating that disadvantage was associated with slower cognitive development compared to advantaged youth with epilepsy. Similar interactions were not observed for controls.

Conclusions: In youth with new and recent onset epilepsies, neighborhood-level disadvantage is associated with a negative impact on the development of verbal and nonverbal reasoning skills.

Keywords: Development; Disadvantage; IQ; Intelligence; Prospective.

MeSH terms

Adolescent
Adult
Cognition
Cross-Sectional Studies
Epilepsy*
Humans
Neighborhood Characteristics
Prospective Studies