DDL - UMR 5596
ISH - Bat C
14 avenue Berthelot
69007 Lyon
Tél : 04 72 72 64 12
Fax : 04 72 72 65 90
Contact

Development Neurocognition Disorders

Themes and actions

 You are here : Home /  Research /  DENDY /  Themes and actions  / Action

Team webmaster : Sophie KERN, Alice Catherine ROY

The effect of idiopathic benign childhood partial epilepsy on cognitive development


  Contact person
Nathalie BEDOIN

Scientific framework and objectives

The main feature of idiopathic benign childhood partial epilepsy is the presence of abnormal EEG activity, whereas seizures are extremely rare. Although this syndrome is considered benign regarding seizure outcome and spontaneous remission with puberty, the deleterious effect of sub-clinical paroxysmal activity should be investigated, since its relation to neuropsychological deficits and learning disabilities has been reported in a growing number of studies. We are assessing the impact of sub-clinical discharges upon cerebral organisation, hemispheric specialisation, and cognitive mechanisms. Special emphasis is laid on cognitive processes known to be crucial for basic learning at school, and favouring scholastic and social success and/or integration. Additionally, we focus on processes, which are sub-served by lateralised cerebral areas, because the paroxysmal activity is sometimes higher over one cerebral hemisphere. The topography of paroxysmal discharges in benign idiopathic childhood epilepsy is of special concern to study their specific impact. They can be assumed to mainly disturb those cognitive mechanisms underlain by cerebral areas suffering EEG abnormalities, and/or to disturb the development of hemispheric specialisation associated with them. This study may improve our understanding of behavioural and learning problems frequently reported in children with this benign syndrome, and show new ways to fit teaching aids. This research is conducted in collaboration with Hospital Debrousse (Lyon): Vania Herbillon (Neuropsychologist), Dr Christophe Rousselle (Neuropaediatrician and child psychiatrist), Dr Karine Ostrowsky (Neurologist), Dr Dorothée Ville (Neuropaediatrician) and the Hospital of Strasbourg (Dr Edouard Hirsch). It is involved in the CTRS project « Cognitive Development and Epilepsy », is supported by IDEE (Institut des Epilepsies de l’Enfant et de l’Adolescent) and Hospices Civils de Lyon (HCL), Centres Hospitaliers Universitaires (Grenoble, Strasbourg, Paris-Necker), INSERM, CNRS et CEA. We have elaborated new neuropsychological tests to investigate language, visual-spatial processes, visual attentional processes and visual mental imagery in children, to assess the ability and the functional hemispheric asymmetry for these functions. One important part of our work is also to test large sets of children without pathology (100 children in each age bracket) to set the standards for these clinical tests. Regarding pathology, on the one hand, benign idiopathic childhood epilepsy with centro-temporal spikes (BECT) is of first concern to us, and the crucial role of the right versus left hemispheric prevalence of spikes is considered. We investigate the impact of the major lateralisation of spikes on the speed and accuracy to perform verbal, visual spatial, and attentional tasks, and on the functional hemispheric asymmetry which is classically associated with these processes. On the other hand, benign childhood epilepsy with occipital paroxysms (CEOP) is of central concern. The occipito-parietal distribution of discharges suggests that visual-spatial orientation deficits and visual mental imagery disturbance may occur. Such hypothesis have still not been tested. Additionally, the normal development of these functions has scarcely been studied. Therefore, we elaborate new tests: a visual attentional orientation test (attention disengagement and shifting) adapted to children, and a series of tasks investigating visual mental image generation, retention, and rotation. Despite their implicit role, visual spatial orientation and mental imagery are involved in many scholastic activities (mental arithmetic, drawing, geometry…). The recording of EEG activity and the time course of events will be synchronized in the orientation task to study the effect of a sub-clinical spike-wave in CEOP on attentional disengagement, in function of the localisation of the dipole (posterior parietal area, or not). The impact of discharges will be compared taking into account the moment at which they occur (before, during, or after the target presentation, in valid and invalid cuing conditions) to contribute to elucidate the nature of the disturbance (perceptive, attentional or general disturbance). Finally, fMRI experiments are currently designed to assess the dynamics of functional cerebral specialisation in children presenting with idiopathic childhood epilepsy, in a longitudinal study. According to the results obtained in children with centro-temporal spikes, we showed that 1/ visual-spatial deficits occurred in children with right-sided focus but not in case of left-sided focus, 2/ the typical left hemisphere advantage was not reported in verbal outcomes of children with left-sided focus, 3/ local and global processing of hierarchical visual stimuli were respectively impaired in case of left and right epileptic focus. These results highlight the impact of the epileptic focus topography on lateralised cognitive mechanisms and on hemispheric functional specialisation. A longitudinal study is in progress to assess whether specific impairments or functional hemispheric lateralisation abnormalities persist after remission, which is an important clinical issue.


  Financial support
  • CTRS
    Cognitive Development and Epilepsy (P.I. Philippe Ryvlin)
    Ministère de l’Education Nationale, de l’Enseignement Supérieur et de la Recherche
    2008-2010

  Publications
  • Bedoin, N., Herbillon, V., Lamoury, I., Arthaud-Garde, P., Ostrowski, K., de Bellescize, J., Kéo Kosal, P., Damon, G., Rousselle, C., 2006, "Hemispheric lateralization of cognitive functions in children with centrotemporal spikes (BECT)", Epilepsy and Behavior, 9:2, pp. 268-274
  • Bedoin, N., Herbillon, V., Lamoury, I., Rousselle, C., 2003, "Effets des pointes inter-ictales sur la spécialisation inter-hémisphérique", actes de 8èmes Journées Lyonnaises d'Epileptologie, Lyon, spetembre 2003
  • Bedoin, N., Lamoury, I., Herbillon, I., 2003, "Effects of benign childhood epilepsy with centro-temporal spikes (EPR) on hemispheric specialisation for spatial, verbal and visuo-attentional processing", proc. of 12ty Conference of the European Society for COgnitive Psychology (ESCOP 12), Granada, Spain, 2003, September
  • Lamoury, I., Herbillon, V., Bedoin, N., Rousselle, C., des Portes, V., 2002, "Déficits neuropsychologiques et dominance hémisphérique dans le cadre de l'épilepsie partielle idiopathique à paroxysmes rolandiques", proc. of 7th Congrès de la Société Européenne de Neurologie Pédiatrique, Paris, France, 2002, December
  • Lamoury, I., Herbillon, V., Bedoin, N., Rousselle, C., des Portes, V., 2002, "Déficits neuropsychologiques et dominance hémisphérique dans le cadre de l'épilepsie partielle idiopathique à paroxysmes rolandiques", actes de Congrès de la Société Française de Neurologie Pédiatrique, Paris, France, 2002, December
  • Lopez, C., Bedoin, N., Herbillon, V., Ostrowsky, K., Rousselle, C., 2007, "Impact des pointes inter-critiques latéralisées dans l'épilepsie de l'enfance (BECT) : déficits cognitifs et perturbations de la spécialisation hémisphérique", proc. of Journées de la Société de Neuropsychologie de Langue Française, Tours, mai 2007
  • Lopez, C., Herbillon, V., Bedoin, N., Lamoury, I., Ostrowsky, K., Damon, G., Montelescaut, M., Arthaud-Garde, P., Ville, D., des Portes, V., Rousselle, C., 2007, "Approche longitudinale de l’impact des pointes inter-critiques latéralisées sur les mécanismes cognitifs et sur le spécialisation hémispéhrique : effets transitoires ou durables ? ", actes de Journées Françaises de l’Epilepsie, Nice, 08-10 novembre 2007
  • Lopez, C., Bedoin, N., Herbillon, V., 2007, "Effets des pointes inter-critiques sur le développement cognitif dans les épilepsies bénignes", actes de Journées Scientifiques du Centre IDEE (Institut des Epilepsies de l’Enfant et de l’Adolescent) et du CTRS Epilepsie, Aix-les-Bains, 20-22 septembre 2007

ASLAN -  Université de Lyon -  CNRS -  Université Lumière Lyon 2 -  MSH-LSE -  IXXI -  DDL :  Contact |  Terms of use |