Theory Of Mind In Children With Idiopathic Generalized Epilepsy And Relations With Ecological Executive Function

Objective: Epilepsy is a common neurological disorder with a core feature of cognitive impairments.Previous studies showed that patients with focal epilepsy have deficits in both theory of mind and executive function.However,there are few studies about theory of mind of patients with idiopathic generalized epilepsy,especially in pediatric populations with epilepsy.The purpose of this study was to examine the characteristics of theory of mind and executive function,including some of their subcomponents,and explore the relationship between them in Chinese children with idiopathic generalized epilepsy.Methods: A cross-sectional study was conducted to select 54 epileptic children(aged9-14 years)in the First Affiliated Hospital of Anhui Medical University.37 healthychildren with average achievement in regular schools were strictly matched patients in the experimental group with regard to age,sex,and educational level.Both groups completed ToM tests,namely,second-order false belief tasks(FBTs)and faux pas tasks(FPTs).Their caregivers completed the Behavior Rating Inventory of Executive Function(BRIEF)at the same time.Results:(1)The scores of children with epilepsy in second-order false belief tasks and faux pas tasks were lower than those of the control group(p < 0.05).The score of epileptic group in Global Executive Composite(GEC),Behavior Regulation Index(BRI),Metacognition Index(MI),inhibition,shifting,emotional control,task initiation,working memory,planning/organizing,organization of materials,and monitoring were higher than those of the control group(p < 0.05).(2)Pearson's correlation analysis revealed that several subcomponents of EF(inhibition,emotional control,initiation,working memory,and monitoring)were unequally correlated with FBTs and FPTs.(3)Regression analysis showed that ToM had associations with inhibition,working memory,and duration of seizures.(4)ANOVA indicated that children with newly diagnosed epilepsy displayed significant deficits in FBT,FPT,and distinct subscales of EF.Conclusion: Our results revealed significant impairments in ToM and EF in children and adolescents with IGE compared with healthy controls.We found significant correlations between ToM and two subcomponents of EF(inhibition and working memory)in children with IGE.Additionally,the duration of seizures affected ToM in patients but was a less powerful predictor than the two subcomponents of EF.Even for children with newly diagnosed epilepsy and without medication,the deficits in ToM and some distinct subscales of EF were apparent.