Isolated epileptiform activity in children and adolescents: prevalence, relevance, and implications for treatment.

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Title: Isolated epileptiform activity in children and adolescents: prevalence, relevance, and implications for treatment.
Authors: Swatzyna, Ronald J., Arns, Martijn, Tarnow, Jay D., Turner, Robert P., Barr, Emma, MacInerney, Erin K., Hoffman, Anne M., Boutros, Nash N.
Source: European Child & Adolescent Psychiatry. Apr2022, Vol. 31 Issue 4, p545-552. 8p. 3 Charts.
Subjects: Diagnosis of autism, Diagnosis of epilepsy, Diagnosis of mental depression, Biomarkers, Online information services, Electroencephalography, Epilepsy, Systematic reviews, Attention-deficit hyperactivity disorder, Epileptiform discharges, Mental depression, Autism, Disease prevalence, Anxiety disorders, MEDLINE, Comorbidity, Children, Adolescence
Abstract: In the field of psychiatry diagnoses are primarily based on the report of symptoms from either the patient, parents, or both, and a psychiatrist's observations. A psychiatric diagnosis is currently the most widely used basis for medication selection and the brain is seldom investigated directly as a source of those symptoms. This study addresses the request from the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC) for scientific research into neurological abnormalities that can be linked to psychiatric symptoms for the purpose of predicting medication response. One such neurological abnormality that has been the focus of many studies over the last three decades is isolated epileptiform discharges (IEDs) in children and adolescents without seizures. We conducted a systematic review of the literature to determine prevalence rates of IEDs within diagnostic categories. We then compared the prevalence of IEDs in the selected literature to our IRB-approved data archive. Our study found a consistent high prevalence of IEDs specifically for ADHD (majority > 25%) and ASD (majority > 59%), and consistent low prevalence rates were found for Depression (3%). If children and adolescents have failed multiple medication attempts, and more than one-third of them have IEDs, then an EEG would be justified within the RDoC paradigm. [ABSTRACT FROM AUTHOR]
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Database: Psychology and Behavioral Sciences Collection
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Abstract:In the field of psychiatry diagnoses are primarily based on the report of symptoms from either the patient, parents, or both, and a psychiatrist's observations. A psychiatric diagnosis is currently the most widely used basis for medication selection and the brain is seldom investigated directly as a source of those symptoms. This study addresses the request from the National Institute of Mental Health (NIMH) Research Domain Criteria Project (RDoC) for scientific research into neurological abnormalities that can be linked to psychiatric symptoms for the purpose of predicting medication response. One such neurological abnormality that has been the focus of many studies over the last three decades is isolated epileptiform discharges (IEDs) in children and adolescents without seizures. We conducted a systematic review of the literature to determine prevalence rates of IEDs within diagnostic categories. We then compared the prevalence of IEDs in the selected literature to our IRB-approved data archive. Our study found a consistent high prevalence of IEDs specifically for ADHD (majority > 25%) and ASD (majority > 59%), and consistent low prevalence rates were found for Depression (3%). If children and adolescents have failed multiple medication attempts, and more than one-third of them have IEDs, then an EEG would be justified within the RDoC paradigm. [ABSTRACT FROM AUTHOR]
ISSN:10188827
DOI:10.1007/s00787-020-01597-2