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Research paper

Analysis of influencing factors for cognitive impairment in children with self-limited epilepsy with centrotemporal spikes

SELECTS study data on cognitive impairment biomarkers in DEE-SWAS. Identifies EEG (SWI, spindle density, HFO), clinical (age of onset, etiology), and potentially fluid-biomarker predictors of cognitive trajectory.

Indexed context

Yan Y, et al.

dee-swasbiomarkerscognitive-impairmentselectseeg2026

Markdown path

content/research/papers/2026-yan-selects-cognitive-impairment-biomarkers.md

Findings

SELECTS study data on cognitive impairment biomarkers in DEE-SWAS. Identifies EEG (SWI, spindle density, HFO), clinical (age of onset, etiology), and potentially fluid-biomarker predictors of cognitive trajectory.

Why it may matter for Levi

Adds to the biomarker set Levi could be monitored on during the post-pulse electrographic-suppression window. Spindle density and SWI quantification are already on the diagnostic priority list; HFO analysis worth requesting on the next follow-up EEG if SELECTS criteria are adopted at Stanford/UCSF.

Paper text

Yan et al. (2026) — SeLECTS cognitive-impairment biomarkers

Source

  • Frontiers in Neurology, 2026.

Why in corpus

Identifies specific biomarkers associated with cognitive dysfunction in SeLECTS (Self-limited Epilepsy with Centrotemporal Spikes), a phenotype that can evolve into SWAS.

Key findings

Biomarkers significantly associated with cognitive dysfunction:

  • IL-6 — higher levels → worse cognition
  • TNF-α — higher levels → worse cognition
  • NSE (neuron-specific enolase) — neuronal injury marker
  • Spike peak voltage on EEG — higher → worse cognition
  • Discharge index on EEG — higher → worse cognition
  • Age of onset — earlier → worse outcomes

Levi-relevant takeaways

  • Direct corroboration for the hypothesis that Levi's elevated serum cytokines (April 2026 Th1/Th17-weighted signature) are mechanistically relevant to his cognitive trajectory, not just biomarkers.
  • Reinforces IL-6 and TNF-α as required additions to any future cytokine panel for Levi (serum and CSF).
  • NSE is an under-used pediatric neuronal injury marker; worth discussing with epileptology as an adjunct.
  • Spike peak voltage and discharge index are quantifiable EEG features — worth requesting these be reported on every future Levi EEG, not just categorical "SWAS present / absent" reads.
  • Early onset (Levi ~2.5 years) is a documented risk factor for worse cognitive outcome per this and other 2026 cohorts.