癫痫对患者认知影响的研究现状及进展_Journal of Epilepsy

Authors：

尹江宁 ,  张鸿

中国医科大学附属盛京医院神经内科（沈阳 110004）;

Corresponding author：

张鸿, Email: zhangh.7211@163.com

Keywords：

癫痫; 认知障碍; 现状; 进展

DOI：

10.7507/2096-0247.20190036

Video：

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癫痫病因较复杂，与患者发病年龄、情绪、心理因素以及癫痫类型等密切相关。认知障碍会导致患者幼年时期学习能力下降，成年后严重影响其日常生活及工作，对患者及家属的身心造成了严重伤害，同时带来较重负担，极大影响了患者的心理状态。近年来，随着癫痫患者认知障碍的发病率逐渐升高，二者共病逐渐引起了广泛关注，癫痫共患认知障碍发病机制尚不明确，但其造成的严重影响值得临床重视。文章从癫痫引发认知损害的可能机制、癫痫发病形式、社会因素以及生理因素、癫痫对患者认知功能的影响等方面进行简要综述，旨在探索其发生认知功能损害的原因，为提高患者的生活质量提供参考依据。

Citation： 尹江宁, 张鸿. 癫痫对患者认知影响的研究现状及进展. Journal of Epilepsy, 2019, 5(3): 200-204. doi: 10.7507/2096-0247.20190036 Copy

1.	Lattanzi S, Brigo F, Trinka E, et al. Efficacy and safety of cannabidiol in epilepsy: a systematic review and meta-analysis. Drugs, 2018, 78(17): 1791-1804.
2.	Paudel YN, Shaikh MF, Chakraborti A, et al. HMGB1: A common biomarker and potential target for TBI, neuroinflammation, epilepsy, andcognitivedysfunction. Front Neurosci, 2018, 12: 628.
3.	Su DJ, Lu JF, Lin LJ, et al. SCN2A mutation in an infant presenting with migrating focal seizures and infantile spasm responsive to a ketogenic diet. Brain Dev, 2018, 40(8): 724-727.
4.	Salvato G, Scarpa P, Francione S, et al. Declarative long-term memory and the mesial temporal lobe: insights from a 5-year postsurgery follow-up study on refractory temporal lobe epilepsy. Epilepsy Behav, 2016, 64(Pt A): 102-109.
5.	Feldman L, Lapin B, Busch RM, et al. Evaluating subjective cognitive impairment in the adult epilepsy clinic: effects of depression, number of antiepileptic medications, and seizure frequency. Epilepsy Behav, 2018, 81: 18-24.
6.	Lee EH. Epilepsy syndromes during the first year of life and the usefulness of an epilepsy gene panel. Korean J Pediatr, 2018, 61(4): 101-107.
7.	陈珉, 傅建梅. 癫痫患者的认知功能评估. 中华全科医学, 2013, 11(3): 1674-4152.
8.	Ribierre T, Deleuze C, Bacq A, et al. Second-hit mosaic mutation in mTORC1 repressor DEPDC5 causes focal cortical dysplasia-associated epilepsy. J Clin Invest, 2018, 128(6): 2452-2458.
9.	Warburton A, Miyajima F, Shazadi K, et al. NRSF and BDNF polymorphisms as biomarkers of cognitive dysfunction in adults with newly diagnosed epilepsy. Epilepsy Behav, 2016, 54: 117-127.
10.	Baxendale S, McGrath K, Donnachie E, et al. The role of obesity in cognitive dysfunction in people with epilepsy. Epilepsy Behav, 2015, 45: 187-190.
11.	Tuchscherer V, Seidenberg M, Pulsipher D, et al. Extrahippocampal integrity in temporal lobe epilepsy and cognition: thalamus and executive functioning. EpilepsyBehav, 2010, 17(4): 478-482.
12.	Shetty AK. Hippocampal injury-induced cognitive and mood dysfunction, altered neurogenesis, and epilepsy: can early neural stem cell grafting intervention provide protection? Epilepsy Behav, 2014, 38: 117-124.
13.	Raimalwalla T, Udani V, Mhatre D. A Retrospective analysis of the long-term outcome of drug-resistant epilepsy in children treated inurban India. Child Neurol Open, 2018, 5: 2329048X18795277.
14.	Theodore WH, Wiggs EA, Martinez AR, et al. Serotonin 1A receptors, depression, and memory in temporal lobe epilepsy. Epilepsia, 2012, 53(1): 129-133.
15.	窦智, 陈颖, 蔡雁飞, 等. 药物难治性额叶、颞叶癫痫患者认知功能障碍特点及影响分析. 癫痫与神经电生理学杂志, 2018, 27(3): 142-145.
16.	de Vries PJ, Belousova E, Benedik MP, et al. TSC-associated neuropsychiatric disorders (TAND): findings from the TOSCA natural history study. Orphanet J Rare Dis, 2018, 13(1): 157.
17.	Han M, Kim S. Effects of antiepileptic drugs on language abilities in benign epilepsy of childhood with centrotemporal spikes. J Rare Dis, 2018, 13(1): 157.
18.	Michel M, Green CL, Lyons LC. PKA and PKC are required for long-term but not short-term in vivo operant memory inplysia. Learn Mem, 2010, 18(1): 19-23.
19.	El-Enin HA, Al-Shanbari AH. Nanostructured liquid crystalline formulation as a remarkable new drug delivery system of anti-epileptic drugs for treating children patients. Saudi Pharm J, 2018, 26(6): 790-800.
20.	Dutra MRH, Feliciano RDS, Jacinto KR, et al. Protective role of UCP2 in oxidative stress and apoptosis during the silent phase of an experimental model of epilepsy induced by pilocarpine. Oxid Med Cell Longev, 2018, 20: 6736721.
21.	Kingswood JC, d'Augères GB, Belousova E, et al. Tuberous sclerosis registry to increase disease awareness (TOSCA) - baseline data on 2093 patients. Orphanet J Rare Dis, 2017, 12(1): 2.
22.	deSena AD, Do T, Schulert GS. Systemic autoinflammation with intractable epilepsy managed with interleukin-1 blockade. J Neuroinflammation, 2018, 15(1): 38.
23.	van Scheppingen J, Mills JD, Zimmer TS, et al. MiR147b: a novel key regulator of interleukin 1 beta-mediated inflammation in human astrocytes. Glia, 2018, 66(5): 1082-1097.
24.	Zhou H, Wang N, Xu L, et al. The efficacy of gastrodin in combination with folate and vitamin B12 on patients with epilepsy after stroke and its effect on HMGB-1, IL-2 and IL-6 serum levels. Exp Ther Med, 2017, 14(5): 4801-4806.
25.	于晓赟, 刘松岩, 王立波, 等. 临床下痫样放电对成人癫痫患者认知功能的影响. 中华神经科杂志, 2018, 51(5): 349-354.
26.	Wijnen BFM, van Mastrigt GAPG, Evers SMAA, et al. Asystematic review of economic evaluations of treatments for patients with epilepsy. Epilepsia, 2017, 58(5): 706-726.
27.	Tigistu M, Azale T, Kebebe H, et al. Frequency of seizure attack and associated factors among patients with epilepsy at university of gondar referral hospital: a cross-sectional study, gondar, north west ethiopia, 2017. BMC Res Notes, 2018, 11(1): 652.
28.	Shatskikh TN, Raghavendra M, Zhao Q, et al. Electrical induction of spikes in the hippocampus impairs recognition capacity and spatial memory in rats. Epilepsy Behav, 2006, 9(4): 549-556.
29.	Schougaard LMV, de Thurah A, Bech P, et al. Test-retest reliability and measurement error of the danish WHO-5 well-being index in outpatients with epilepsy. HealthQual Life Outcomes, 2018, 16(1): 175.
30.	周艳辉, 周峰, 余丹, 等. 托吡酯治疗脑梗死后继发癫痫临床效果及认知功能分析. 解放军医药杂志, 2018, 30(2): 94-97.
31.	Cumbo E, Ligori LD. Levetiracetam, lamotrigine andphenobarbital in patients with epileptic seizures and alzheimer's disease. Epilepsy Behav, 2010, 17(4): 461-466.
32.	Tonekaboni SH, Beyraghi N, Tahbaz HS, et al. Neurocognitiveeffects of phenobarbital discontinuation in epileptic children. Epilepsy Behav, 2006, 8(1): 145-148.
33.	王珊丹, 杨昕. 左乙拉西坦、拉莫三嗪与奥卡西平在癫痫患儿中两年保留率及耐受性比较. 中国生化药物杂志, 2017, 37(8): 185-188.
34.	Xie W, Ross EE, Kramer MA, et al. Timing matters: impact of anticonvulsant drug treatment and spikes on seizure risk in benign epilepsy with centrotemporal spikes. Epilepsia Open, 2018, 22, 3(3): 409-417.
35.	Sever RW, Vivas AC, Vale FL, et al. Wada asymmetry in patients with drug-resistant mesial temporal lobe epilepsy: implications for postoperative neuropsychological outcomes. Epilepsia Open, 2018, 3(3): 399-408.
36.	Reilly C, Atkinson P, Memon, et al. Child and parental sleep in young children with epilepsy: a population-based case-control study. Epilepsia Open, 2018, 3(3): 383-391.
37.	Sakuma H, Tanuma N, Kuki I, et al. Intrathecal overproduction of proinflammatory cytokines and chemokines in febrile infection-related refractory status epilepticus. J Neurol Neurosurg Psychiatry, 2015, 86(7): 820-822.
38.	Liu J, Tong L, Song S, et al. Novel and de novo mutations in pediatric refractory epilepsy. Mol Brain, 2018, 11(1): 48.
39.	Balottin L, Mannarini S, Candeloro D, et al. Rorschach evaluation of personality and emotional characteristics in adolescents with migraine versus epilepsy and controls. Front Neurol, 2018, 9: 160.
40.	Boling W, Means M, Fletcher A, et al. Quality of life and stigma in epilepsy, perspectives from selected regions of asia and sub-saharan africa. Brain Sci, 2018, 8(4): pii: E59.
41.	Nakahara S, Adachi M, Ito H, et al. Hippocampal pathophysiology: commonality shared by temporal lobe epilepsy and psychiatric disorders. Neurosci J, 2018, 2018: 4852359.
42.	Choudhary S, Niranjan N, Khichar S, et al. Behavioral problems and intelligence quotient changes in pediatric epilepsy: a case-control study. J Neurosci Rural Pract, 2017, 8(4): 617-621.
43.	Leeman-Markowski BA, Schachter SC. Treatment of cognitive deficitsinepilepsy. Neurol Clin, 2016, 34(1): 183-204.
44.	Calhoun JD, Vanoye CG, Kok F, et al. Characterization of a KCNB1 variant associated with autism, intellectual disability, and epilepsy. Neurol Genet, 2017, 3(6): e198.
45.	IJff DM, Postulart D, Lambrechts DAJE, et al. Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: a randomized controlled trial. Epilepsy Behav, 2016, 60: 153-157.
46.	Allendorfer JB, Arida RM. Role of physical activity and exercise in alleviating cognitive impairment in people with epilepsy. Clin Ther, 2018, 40(1): 26-34.

1. Lattanzi S, Brigo F, Trinka E, et al. Efficacy and safety of cannabidiol in epilepsy: a systematic review and meta-analysis. Drugs, 2018, 78(17): 1791-1804.
2. Paudel YN, Shaikh MF, Chakraborti A, et al. HMGB1: A common biomarker and potential target for TBI, neuroinflammation, epilepsy, andcognitivedysfunction. Front Neurosci, 2018, 12: 628.
3. Su DJ, Lu JF, Lin LJ, et al. SCN2A mutation in an infant presenting with migrating focal seizures and infantile spasm responsive to a ketogenic diet. Brain Dev, 2018, 40(8): 724-727.
4. Salvato G, Scarpa P, Francione S, et al. Declarative long-term memory and the mesial temporal lobe: insights from a 5-year postsurgery follow-up study on refractory temporal lobe epilepsy. Epilepsy Behav, 2016, 64(Pt A): 102-109.
5. Feldman L, Lapin B, Busch RM, et al. Evaluating subjective cognitive impairment in the adult epilepsy clinic: effects of depression, number of antiepileptic medications, and seizure frequency. Epilepsy Behav, 2018, 81: 18-24.
6. Lee EH. Epilepsy syndromes during the first year of life and the usefulness of an epilepsy gene panel. Korean J Pediatr, 2018, 61(4): 101-107.
7. 陈珉, 傅建梅. 癫痫患者的认知功能评估. 中华全科医学, 2013, 11(3): 1674-4152.
8. Ribierre T, Deleuze C, Bacq A, et al. Second-hit mosaic mutation in mTORC1 repressor DEPDC5 causes focal cortical dysplasia-associated epilepsy. J Clin Invest, 2018, 128(6): 2452-2458.
9. Warburton A, Miyajima F, Shazadi K, et al. NRSF and BDNF polymorphisms as biomarkers of cognitive dysfunction in adults with newly diagnosed epilepsy. Epilepsy Behav, 2016, 54: 117-127.
10. Baxendale S, McGrath K, Donnachie E, et al. The role of obesity in cognitive dysfunction in people with epilepsy. Epilepsy Behav, 2015, 45: 187-190.
11. Tuchscherer V, Seidenberg M, Pulsipher D, et al. Extrahippocampal integrity in temporal lobe epilepsy and cognition: thalamus and executive functioning. EpilepsyBehav, 2010, 17(4): 478-482.
12. Shetty AK. Hippocampal injury-induced cognitive and mood dysfunction, altered neurogenesis, and epilepsy: can early neural stem cell grafting intervention provide protection? Epilepsy Behav, 2014, 38: 117-124.
13. Raimalwalla T, Udani V, Mhatre D. A Retrospective analysis of the long-term outcome of drug-resistant epilepsy in children treated inurban India. Child Neurol Open, 2018, 5: 2329048X18795277.
14. Theodore WH, Wiggs EA, Martinez AR, et al. Serotonin 1A receptors, depression, and memory in temporal lobe epilepsy. Epilepsia, 2012, 53(1): 129-133.
15. 窦智, 陈颖, 蔡雁飞, 等. 药物难治性额叶、颞叶癫痫患者认知功能障碍特点及影响分析. 癫痫与神经电生理学杂志, 2018, 27(3): 142-145.
16. de Vries PJ, Belousova E, Benedik MP, et al. TSC-associated neuropsychiatric disorders (TAND): findings from the TOSCA natural history study. Orphanet J Rare Dis, 2018, 13(1): 157.
17. Han M, Kim S. Effects of antiepileptic drugs on language abilities in benign epilepsy of childhood with centrotemporal spikes. J Rare Dis, 2018, 13(1): 157.
18. Michel M, Green CL, Lyons LC. PKA and PKC are required for long-term but not short-term in vivo operant memory inplysia. Learn Mem, 2010, 18(1): 19-23.
19. El-Enin HA, Al-Shanbari AH. Nanostructured liquid crystalline formulation as a remarkable new drug delivery system of anti-epileptic drugs for treating children patients. Saudi Pharm J, 2018, 26(6): 790-800.
20. Dutra MRH, Feliciano RDS, Jacinto KR, et al. Protective role of UCP2 in oxidative stress and apoptosis during the silent phase of an experimental model of epilepsy induced by pilocarpine. Oxid Med Cell Longev, 2018, 20: 6736721.
21. Kingswood JC, d'Augères GB, Belousova E, et al. Tuberous sclerosis registry to increase disease awareness (TOSCA) - baseline data on 2093 patients. Orphanet J Rare Dis, 2017, 12(1): 2.
22. deSena AD, Do T, Schulert GS. Systemic autoinflammation with intractable epilepsy managed with interleukin-1 blockade. J Neuroinflammation, 2018, 15(1): 38.
23. van Scheppingen J, Mills JD, Zimmer TS, et al. MiR147b: a novel key regulator of interleukin 1 beta-mediated inflammation in human astrocytes. Glia, 2018, 66(5): 1082-1097.
24. Zhou H, Wang N, Xu L, et al. The efficacy of gastrodin in combination with folate and vitamin B12 on patients with epilepsy after stroke and its effect on HMGB-1, IL-2 and IL-6 serum levels. Exp Ther Med, 2017, 14(5): 4801-4806.
25. 于晓赟, 刘松岩, 王立波, 等. 临床下痫样放电对成人癫痫患者认知功能的影响. 中华神经科杂志, 2018, 51(5): 349-354.
26. Wijnen BFM, van Mastrigt GAPG, Evers SMAA, et al. Asystematic review of economic evaluations of treatments for patients with epilepsy. Epilepsia, 2017, 58(5): 706-726.
27. Tigistu M, Azale T, Kebebe H, et al. Frequency of seizure attack and associated factors among patients with epilepsy at university of gondar referral hospital: a cross-sectional study, gondar, north west ethiopia, 2017. BMC Res Notes, 2018, 11(1): 652.
28. Shatskikh TN, Raghavendra M, Zhao Q, et al. Electrical induction of spikes in the hippocampus impairs recognition capacity and spatial memory in rats. Epilepsy Behav, 2006, 9(4): 549-556.
29. Schougaard LMV, de Thurah A, Bech P, et al. Test-retest reliability and measurement error of the danish WHO-5 well-being index in outpatients with epilepsy. HealthQual Life Outcomes, 2018, 16(1): 175.
30. 周艳辉, 周峰, 余丹, 等. 托吡酯治疗脑梗死后继发癫痫临床效果及认知功能分析. 解放军医药杂志, 2018, 30(2): 94-97.
31. Cumbo E, Ligori LD. Levetiracetam, lamotrigine andphenobarbital in patients with epileptic seizures and alzheimer's disease. Epilepsy Behav, 2010, 17(4): 461-466.
32. Tonekaboni SH, Beyraghi N, Tahbaz HS, et al. Neurocognitiveeffects of phenobarbital discontinuation in epileptic children. Epilepsy Behav, 2006, 8(1): 145-148.
33. 王珊丹, 杨昕. 左乙拉西坦、拉莫三嗪与奥卡西平在癫痫患儿中两年保留率及耐受性比较. 中国生化药物杂志, 2017, 37(8): 185-188.
34. Xie W, Ross EE, Kramer MA, et al. Timing matters: impact of anticonvulsant drug treatment and spikes on seizure risk in benign epilepsy with centrotemporal spikes. Epilepsia Open, 2018, 22, 3(3): 409-417.
35. Sever RW, Vivas AC, Vale FL, et al. Wada asymmetry in patients with drug-resistant mesial temporal lobe epilepsy: implications for postoperative neuropsychological outcomes. Epilepsia Open, 2018, 3(3): 399-408.
36. Reilly C, Atkinson P, Memon, et al. Child and parental sleep in young children with epilepsy: a population-based case-control study. Epilepsia Open, 2018, 3(3): 383-391.
37. Sakuma H, Tanuma N, Kuki I, et al. Intrathecal overproduction of proinflammatory cytokines and chemokines in febrile infection-related refractory status epilepticus. J Neurol Neurosurg Psychiatry, 2015, 86(7): 820-822.
38. Liu J, Tong L, Song S, et al. Novel and de novo mutations in pediatric refractory epilepsy. Mol Brain, 2018, 11(1): 48.
39. Balottin L, Mannarini S, Candeloro D, et al. Rorschach evaluation of personality and emotional characteristics in adolescents with migraine versus epilepsy and controls. Front Neurol, 2018, 9: 160.
40. Boling W, Means M, Fletcher A, et al. Quality of life and stigma in epilepsy, perspectives from selected regions of asia and sub-saharan africa. Brain Sci, 2018, 8(4): pii: E59.
41. Nakahara S, Adachi M, Ito H, et al. Hippocampal pathophysiology: commonality shared by temporal lobe epilepsy and psychiatric disorders. Neurosci J, 2018, 2018: 4852359.
42. Choudhary S, Niranjan N, Khichar S, et al. Behavioral problems and intelligence quotient changes in pediatric epilepsy: a case-control study. J Neurosci Rural Pract, 2017, 8(4): 617-621.
43. Leeman-Markowski BA, Schachter SC. Treatment of cognitive deficitsinepilepsy. Neurol Clin, 2016, 34(1): 183-204.
44. Calhoun JD, Vanoye CG, Kok F, et al. Characterization of a KCNB1 variant associated with autism, intellectual disability, and epilepsy. Neurol Genet, 2017, 3(6): e198.
45. IJff DM, Postulart D, Lambrechts DAJE, et al. Cognitive and behavioral impact of the ketogenic diet in children and adolescents with refractory epilepsy: a randomized controlled trial. Epilepsy Behav, 2016, 60: 153-157.
46. Allendorfer JB, Arida RM. Role of physical activity and exercise in alleviating cognitive impairment in people with epilepsy. Clin Ther, 2018, 40(1): 26-34.

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