Analysis of risk factors for cognitive dysfunction in patients with epilepsy_Journal of Epilepsy

Authors：

QIN Jin ¹ , LUO Xiaomei ¹ , LI Haoyang ¹ , LI Jimeng ¹ , WEI Shili ¹ ,  ZHANG Qing ²

1. Ningxia Medical University, Yinchuan 750004, China;
2. Department of Neurology, General Hospital of Ningxia Medical University, Yinchuan 750004, China;

Corresponding author：

ZHANG Qing, Email: nxzhangqing@aliyun.com

Keywords：

Epilepsy; Cognitive dysfunction; Risk factor

DOI：

10.7507/2096-0247.20190030

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Objective To analyze the risk factors of cognitive dysfunction in patients with epilepsy, and provide evidence for clinical prevention and treatment.Methods During the period from January 1, 2018 to January 31, 2019, 101 patients with epilepsy who were admitted to the epilepsy specialist clinic of the General Hospital of Ningxia Medical University were included in this study. The cognitive function of the patients was evaluated by the Mini-mental State Examination (MMSE) scale and patients were divided into cognitive impairment group and normal cognitive function group according to the MMSE. Single factor and logistic regression analysis were used to find the differences of influencing factors between the two groups.Results ① There were 27 cases of cognitive dysfunction in 101 patients with epilepsy, the incidence of cognitive impairment was 26.7%; ② Univariate analysis showed that the course of disease, frequency of seizures, seizure forms, anti-epileptic drugs (AEDs) and abnormal rate of electroencephalogram (EEG) existed significant differences between the two groups (P<0.05). ③ Logistic regression showed that course of disease, frequency of seizures and AEDs multidrug therapy were independent risk factors for cognitive dysfunction in patients with epilepsy (P<0.05).Conclusion Course of disease, frequency of seizures and AEDs multidrug therapy are independent risk factors for cognitive dysfunction in patients with epilepsy.

Citation： QIN Jin, LUO Xiaomei, LI Haoyang, LI Jimeng, WEI Shili, ZHANG Qing. Analysis of risk factors for cognitive dysfunction in patients with epilepsy. Journal of Epilepsy, 2019, 5(3): 170-175. doi: 10.7507/2096-0247.20190030 Copy

1.	徐沛, 苏佩清, 颜丙春. 癫痫合并认知功能障碍的研究及治疗进展. 中华老年心脑血管病杂志, 2018, 20(2): 216-219.
2.	Nehra A, Tripathi M, Bhatia R, et al. Is epilepsy a cause of cognitive decline in developing brain. Activitas Nervosa Superior, 2013, 55(3): 112-117.
3.	Singh H, Ghacibeh GA. Epilepsy and cognition. Epilepsy Behav, 2015, 47: 158-162.
4.	Kanner AM. Management of psychiatric and neurological comorbidities in epilepsy. Nat Rev Neurol, 2016, 12(2): 106.
5.	陈万红, 杨昉, 戴征, 等. 情绪健康和生活质量对癫痫后轻微认知功能障碍的影响. 医学研究生学报, 2017, 30(4): 384-388.
6.	Chen C, Dong YH, Merchant R, et al. The Montreal cognitive assessment (MoCA) is superior to the mini-mental state examination (MMSE) in detecting patient's with moderate cognitive impairment, no-dementia (CIND) and at high risk of dementia. Alzheimers Dement, 2011, 7(4): S240-S241.
7.	Cheung M, Chan AS, Chan Y, et al. Effects of illness duration on memory processing of patients with temporal lobe epilepsy. Epilepsia, 2006, 47(8): 1320-1328.
8.	Ghacibeh GA, Fields C. Interictal epileptiform activity and autism. Epilepsy Behav, 2015, 47: 158-162.
9.	White JR, Walczak TS, Marino SE, et al. Zonisamide discontinuation due to psychiatric and cognitive adverse events: a case-control study. Neurology, 2010, 75(6): 513-518.
10.	Helmstaedter C, Witt JA. The longer-term cognitive effects of adjunctive antiepileptic treatment with lacosamide in comparison with lamotrigine and topiramate in a naturalistic outpatient setting. Epilepsy Behav, 2013, 26(2): 182-187.
11.	Witt JA, Elger CE, Helmstaedter C. Adverse cognitive effects of antiepileptic pharmacotherapy: each additional drug matters. Eur Neuropsy chopharmacol, 2015, 25(11): 1954-1959.
12.	Cormack F, Cross JH, Isaacs E, et al. The development of intellectual abilities in pediatric temporal lobe epilepsy. Epilepsia, 2007, 48(1): 201-204.
13.	Berl M, Terwilliger V, Scheller A, et al. Speed and complexity characterize attention problems in children with localization-related epilepsy. Epilepsia, 2015, 56(6): 833-840.
14.	Vasconcellos E, Wyllie E, Sullivan S, et al. Mental retardation in pediatric candidates for epilepsy surgery: the role of early seizure onset. Epilepsia, 2001, 42(2): 268-274.
15.	Gulati S, Yoganathan S, Chakrabarty B. Epilepsy, cognition and behavior. Indian J Pediatr, 2014, 81(10): 1056-1062.
16.	Motamedi G, Meador K. Epilepsy and cognition. Epilepsy Behav, 2003, 4(Suppl 2): 25-38.
17.	Ashjazadeh N, Yadollahikhales G, Ayoobzadehshirazi A, et al. Comparison of the health-related quality of life between epileptic patients with partial and generalized seizure. Iran J Neurol, 2014, 13(2): 94-100.
18.	Patel N, Ram D, Swiderska N, et al. Febrile seizures. BMJ, 2015: 351.
19.	Fuentes A, Smith ML. Patterns of verbal learning and memory in children with intractable temporal lobe or frontal lobe epilepsy. Epilepsy Behav, 2015, 53(2): 58-65.
20.	Lv Y, Wang Z, Cui L, et al. Cognitive correlates of interictal epileptiform discharges in adult patients with epilepsy in China. Epilepsy Behav, 2013, 29(1): 205-210.
21.	Stoub TR, Chicharro AV, Grote CL, et al. Disconnection of hippocampal networks contributes to memory dysfunction in individuals with temporal lobe epilepsy. Hippocampus, 2019, 29(5): 451-457.

1. 徐沛, 苏佩清, 颜丙春. 癫痫合并认知功能障碍的研究及治疗进展. 中华老年心脑血管病杂志, 2018, 20(2): 216-219.
2. Nehra A, Tripathi M, Bhatia R, et al. Is epilepsy a cause of cognitive decline in developing brain. Activitas Nervosa Superior, 2013, 55(3): 112-117.
3. Singh H, Ghacibeh GA. Epilepsy and cognition. Epilepsy Behav, 2015, 47: 158-162.
4. Kanner AM. Management of psychiatric and neurological comorbidities in epilepsy. Nat Rev Neurol, 2016, 12(2): 106.
5. 陈万红, 杨昉, 戴征, 等. 情绪健康和生活质量对癫痫后轻微认知功能障碍的影响. 医学研究生学报, 2017, 30(4): 384-388.
6. Chen C, Dong YH, Merchant R, et al. The Montreal cognitive assessment (MoCA) is superior to the mini-mental state examination (MMSE) in detecting patient's with moderate cognitive impairment, no-dementia (CIND) and at high risk of dementia. Alzheimers Dement, 2011, 7(4): S240-S241.
7. Cheung M, Chan AS, Chan Y, et al. Effects of illness duration on memory processing of patients with temporal lobe epilepsy. Epilepsia, 2006, 47(8): 1320-1328.
8. Ghacibeh GA, Fields C. Interictal epileptiform activity and autism. Epilepsy Behav, 2015, 47: 158-162.
9. White JR, Walczak TS, Marino SE, et al. Zonisamide discontinuation due to psychiatric and cognitive adverse events: a case-control study. Neurology, 2010, 75(6): 513-518.
10. Helmstaedter C, Witt JA. The longer-term cognitive effects of adjunctive antiepileptic treatment with lacosamide in comparison with lamotrigine and topiramate in a naturalistic outpatient setting. Epilepsy Behav, 2013, 26(2): 182-187.
11. Witt JA, Elger CE, Helmstaedter C. Adverse cognitive effects of antiepileptic pharmacotherapy: each additional drug matters. Eur Neuropsy chopharmacol, 2015, 25(11): 1954-1959.
12. Cormack F, Cross JH, Isaacs E, et al. The development of intellectual abilities in pediatric temporal lobe epilepsy. Epilepsia, 2007, 48(1): 201-204.
13. Berl M, Terwilliger V, Scheller A, et al. Speed and complexity characterize attention problems in children with localization-related epilepsy. Epilepsia, 2015, 56(6): 833-840.
14. Vasconcellos E, Wyllie E, Sullivan S, et al. Mental retardation in pediatric candidates for epilepsy surgery: the role of early seizure onset. Epilepsia, 2001, 42(2): 268-274.
15. Gulati S, Yoganathan S, Chakrabarty B. Epilepsy, cognition and behavior. Indian J Pediatr, 2014, 81(10): 1056-1062.
16. Motamedi G, Meador K. Epilepsy and cognition. Epilepsy Behav, 2003, 4(Suppl 2): 25-38.
17. Ashjazadeh N, Yadollahikhales G, Ayoobzadehshirazi A, et al. Comparison of the health-related quality of life between epileptic patients with partial and generalized seizure. Iran J Neurol, 2014, 13(2): 94-100.
18. Patel N, Ram D, Swiderska N, et al. Febrile seizures. BMJ, 2015: 351.
19. Fuentes A, Smith ML. Patterns of verbal learning and memory in children with intractable temporal lobe or frontal lobe epilepsy. Epilepsy Behav, 2015, 53(2): 58-65.
20. Lv Y, Wang Z, Cui L, et al. Cognitive correlates of interictal epileptiform discharges in adult patients with epilepsy in China. Epilepsy Behav, 2013, 29(1): 205-210.
21. Stoub TR, Chicharro AV, Grote CL, et al. Disconnection of hippocampal networks contributes to memory dysfunction in individuals with temporal lobe epilepsy. Hippocampus, 2019, 29(5): 451-457.

Journal of Epilepsy

Analysis of risk factors for cognitive dysfunction in patients with epilepsy

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