Neurocognitive correlates of self-identification in young children with epilepsy

Background. Epilepsy is one of the most common neurological disorders of childhood, structurally comprising not only seizures but also a complex of cognitive, emotional, personality, and social impairments. Early identification of neurocognitive correlates is a key predictor of a favorable outcome; however, objective diagnosis of complex mental phenomena for children aged 1–3 years remains a methodological challenge.

Objective. To identify specific neurocognitive correlates of self-identification development for young children with epilepsy.

Material and мethods. The study involved 34 children (18 diagnosed with epilepsy and 16 normotypical children). A multimethodological approach was used, including: 1) an original hardware and software system (HSS) for assessing the level of self-identification development based on sensitivity to visual cues in one’s own image; 2) functional near-infrared spectroscopy (fNIRS) to record oxygenation (HbO) and deoxygenation (HbR) in the occipital lobes; 3) neuropsychological tests of facial gnosis; 4) the DP-3 general development questionnaire. The theoretical basis was I.L. Brandl’s concept of self-identification and A. R. Luria’s structural-functional model.

Results. It was established that in children with epilepsy, the process of self-identification development is nonlinear and quasi-periodic, in contrast to the progressive development in the control group. In children with epilepsy and unstable self-identification, significant differences in neurocognitive markers were found between all subgroups (in terms of sensitivity to 1, 2, and 3 PAC markers), whereas in healthy children, clear differentiation was observed only upon transition to a stable level. The most significant intergroup differences between children with epilepsy and healthy controls were found in the subgroup with the most developed self-identification (sensitivity to 3 markers) based on general development (DP-3) and oxygenation (HbO).

Conclusion. The preliminary results support the hypothesis that epilepsy most disrupts the final, integrative stages of self-identification development, disrupting the coordination of complex perceptual, cognitive, and affective components of the self. The identified specificity —nonlinearity and premature differentiation of neurocognitive profiles — substantiates the need to develop targeted neurorehabilitation programs aimed at supporting sensory integration and self-identification consolidation. Further extensive studies are needed to assess cognitive impairment depending on the form and course of the disease, including taking into account specific genetic forms of epilepsy and the drug therapy used.

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