Children with new-onset epilepsies often exhibit co-morbidities including cognitive dysfunction, which adversely affects academic performance. Application of unsupervised machine learning techniques has demonstrated the presence of discrete cognitive phenotypes at or near the time of diagnosis, but there is limited knowledge of their longitudinal trajectories. Here we investigate longitudinally the presence and progression of cognitive phenotypes and academic status in youth with new-onset seizures as sibling controls. 282 subjects (6–16 years) were recruited within 6 weeks of their first recognized seizure along with 167 unaffected siblings. Each child underwent a comprehensive neuropsychological assessment at baseline, 18 and 36 months later. Factor analysis of the neuropsychological tests revealed four underlying domains – language, processing speed, executive function, and verbal memory. Latent trajectory analysis of the mean factor scores over 36 months identified clusters with prototypical cognitive trajectories. Three unique phenotypic groups with distinct cognitive trajectories over the 36-month period were identified: , , and phenotypes. The Resilient phenotype exhibited the highest neuropsychological factor scores and academic performance that were all similar to controls; while the Impaired phenotype showed the polar opposite with the worst performances across all test metrics. These findings remained significant and stable over 36 months. Multivariate logistic regression indicated that age of onset, EEG, neurological examination, and sociodemographic disadvantage were associated with phenotype classification. This study demonstrates the presence of diverse latent cognitive trajectory phenotypes over 36 months in youth with new-onset seizures that are associated with a stable neuropsychological and academic performance longitudinally.

中文翻译：

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36 个月以上癫痫发作儿童认知表型的长期特征

新发癫痫的儿童经常表现出合并症，包括认知功能障碍，这会对学习成绩产生不利影响。无监督机器学习技术的应用已证明在诊断时或诊断附近存在离散认知表型，但对其纵向轨迹的了解有限。在这里，我们纵向研究以兄弟姐妹为对照的新发癫痫青少年的认知表型和学业状况的存在和进展。 282 名受试者（6-16 岁）在首次发现癫痫发作后 6 周内被招募，还有 167 名未受影响的兄弟姐妹。每个孩子在基线、18 个月和 36 个月后都接受了全面的神经心理学评估。神经心理学测试的因素分析揭示了四个潜在领域——语言、处理速度、执行功能和言语记忆。对 36 个月内平均因子得分的潜在轨迹分析确定了具有原型认知轨迹的聚类。确定了 36 个月期间具有不同认知轨迹的三个独特表型组： 、 和 表型。弹性表型表现出最高的神经心理学因素得分和学业成绩，与对照组相似；而受损表型则表现出截然相反的情况，在所有测试指标中表现最差。这些发现在 36 个月内保持显着且稳定。多变量逻辑回归表明，发病年龄、脑电图、神经系统检查和社会人口学劣势与表型分类相关。这项研究表明，新发癫痫发作的青少年在 36 个月内存在多种潜在认知轨迹表型，这些表型与稳定的神经心理学和学业成绩纵向相关。