Correlation analysis of cognitive impairment in patients with focal epilepsy_Journal of Epilepsy

Authors：

YANG Xiting ¹ ,  YU Qing ¹ , CHEN Zhijuan ² , YANG Weidong ² , CHEN Ying ¹ , REN Mengruo ¹ , HAN Yenan ¹ , LV Hui ¹ , TAN Ke ³

1. Neurology Tianjin Medical University General Hospital, Tianjin 300052, China;
2. Neurosurgery, Tianjin Medical University General Hospital, Tianjin 300052, China;
3. Psychology, Tianjin University of Commerce, Tianjin 300134, China;

Corresponding author：

YU Qing, Email: yq_yuqing@163.com

Keywords：

Focal epilepsy; Cognitive function; Neuropsychological assessment; Correlation; Risk factors

DOI：

10.7507/2096-0247.20210017

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Objective Through neuropsychological assessment, explore the factors that may cause cognitive impairment in patients with focal epilepsy.Methods Collected 53 epilepsy patients in outpatients and inpatients of Tianjin Medical University General Hospital from March 2016 to January 2020, including 25 males and 28 females, with an average age of (23.58±13.24) years old, and the course of disease (6.49±7.39), all met the 2017 ILEA diagnostic criteria for focal epilepsy, and there was no history of progressive brain disease or brain surgery. Carry out relevant cognitive assessments for the enrolled patients, use SPSS statistical software to conduct Spearman correlation analysis on the cognitive functions of the study subjects, and further analyze the related factors of cognition through Logistic regression analysis to clarify the factors related to cognition whether it may be a risk factor for cognitive impairment in patients with focal epilepsy.Results Spearman correlation analysis showed that the FIQ of patients with focal epilepsy was related to education level, age of onset, seizure pattern, total number of seizures, AEDs and EEG interval discharge side (P<0.05). Binary Logistic regression analysis shows that among all cognitive-related factors, only the number of AEDs (P=0.003) and EEG interval discharge (P=0.013) are the risk of cognitive impairment in patients with focal epilepsy factor.Conclusion In the clinical treatment of epilepsy, seizures should be actively controlled, but the types of drugs should be minimized. When there are more than 3 kinds of drugs, surgical treatment or other non-surgical treatments can be considered. At the same time, the EEG should be reviewed regularly to understand the changes in epileptiform discharges between episodes.

Citation： YANG Xiting, YU Qing, CHEN Zhijuan, YANG Weidong, CHEN Ying, REN Mengruo, HAN Yenan, LV Hui, TAN Ke. Correlation analysis of cognitive impairment in patients with focal epilepsy. Journal of Epilepsy, 2021, 7(2): 98-103. doi: 10.7507/2096-0247.20210017 Copy

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2.	Agah E, Asgari-Rad N, Ahmadi M, et al. Evaluating executive function in patients with temporal lobe epilepsy using the frontal assessment battery. Epilepsy Research, 2017, 133: 22-27.
3.	Celiker Uslu S, Yuksel B, Tekin B, et al. Cognitive impairment and drug responsiveness in mesial temporal lobe epilepsy. Epilepsy & Behavior, 2019, 90: 162-167.
4.	杨二娟, 毓青, 白学军, 等. 颞叶和额叶癫痫认知功能特点的研究. 天津医科大学学报, 2013, 19(1): 70-72.
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6.	Mameniskiene R, Jatuzis D, Kaubrys G, et al. The decay of memory between delayed and long-term recall in patients with temporal lobe epilepsy. Epilepsy Behav, 2006, 8(1): 278-288.
7.	Kucukboyaci NE, Kemmotsu N, Leyden KM, et al. Integration of multimodal MRI data via PCA to explain language performance. Neuroimage Clin, 2014, 5: 197-207.
8.	Geldmacher DS. Visuospatial dysfunction in the neurodegenerative diseases. Front Biosci, 2003, 8: e428-e436.
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12.	Black LC, Schefft B K, Howe SR, et al. The effect of seizures on working memory and executive functioning performance. Epilepsy & Behavior, 2010, 17(3): 412-419.
13.	Loring DW, Marino S, Meador KJ. Neuropsychological and behavioral effects of antiepilepsy drugs. Neuropsychol Rev, 2007, 17(4): 413-425.
14.	Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8 Suppl 5): 21-26.
15.	Meador KJ. Cognitive and memory effects of the new antiepileptic drugs. Epilepsy Res, 2006, 68(1): 63-67.
16.	Barr WB. Understanding the Cognitive side effects of antiepileptic drugs: Can functional imaging be helpful? Epilepsy Currents, 2019, 19(1): 22-23.
17.	Kleen JK, Scott RC, Holmes GL, et al. Hippocampal interictal epileptiform activity disrupts cognition in humans. Neurology, 2013, 81(1): 18-24.
18.	Aldenkamp AP, Arends J. Effects of epileptiform EEG discharges on cognitive function: is the concept of "transient cognitive impairment" still valid? Epilepsy Behav, 2004, 5(Suppl 1): 25-34.
19.	Nicolai J, Ebus S, Biemans DPLJ, et al. The cognitive effects of interictal epileptiform EEG discharges and short nonconvulsive epileptic seizures. Epilepsia, 2012, 53(6): 1051-1059.
20.	Engel JJ. So what can we conclude-do seizures damage the brain? Prog Brain Res, 2002, 135: 509-512.
21.	Black LC, Schefft BK, Howe SR, et al. The effect of seizures on working memory and executive functioning performance. Epilepsy Behav, 2010, 17(3): 412-419.
22.	Hermann B, Seidenberg M, Bell B, et al. The neurodevelopmental impact of childhood-onset temporal lobe epilepsy on brain structure and function. Epilepsia, 2002, 43(9): 1062-1071.
23.	Hermann BP, Seidenberg M, Bell B. The neurodevelopmental impact of childhood onset temporal lobe epilepsy on brain structure and function and the risk of progressive cognitive effects. Prog Brain Res, 2002, 135: 429-438.
24.	Breuer L, Grevers E, Boon P, et al. Cognitive deterioration in adult epilepsy: clinical characteristics of "Accelerated Cognitive Ageing". Acta Neurol Scand, 2017, 136(1): 47-53.
25.	Sen A, Capelli V, Husain M. Cognition and dementia in older patients with epilepsy. Brain, 2018, 141(6): 1592-1608.
26.	Power KN, Gramstad A, Gilhus N E, et al. Cognitive function after status epilepticus versus after multiple generalized tonic-clonic seizures. Epilepsy Res, 2018, 140: 39-45.

1. Helmstaedter C, Witt J. Epilepsy and cognition -A bidirectional relationship? Seizure, 2017, 49: 83-89.
2. Agah E, Asgari-Rad N, Ahmadi M, et al. Evaluating executive function in patients with temporal lobe epilepsy using the frontal assessment battery. Epilepsy Research, 2017, 133: 22-27.
3. Celiker Uslu S, Yuksel B, Tekin B, et al. Cognitive impairment and drug responsiveness in mesial temporal lobe epilepsy. Epilepsy & Behavior, 2019, 90: 162-167.
4. 杨二娟, 毓青, 白学军, 等. 颞叶和额叶癫痫认知功能特点的研究. 天津医科大学学报, 2013, 19(1): 70-72.
5. Witt J, Helmstaedter C. Cognition in epilepsy. Current Opinion in Neurology, 2017, 30(2): 174-179.
6. Mameniskiene R, Jatuzis D, Kaubrys G, et al. The decay of memory between delayed and long-term recall in patients with temporal lobe epilepsy. Epilepsy Behav, 2006, 8(1): 278-288.
7. Kucukboyaci NE, Kemmotsu N, Leyden KM, et al. Integration of multimodal MRI data via PCA to explain language performance. Neuroimage Clin, 2014, 5: 197-207.
8. Geldmacher DS. Visuospatial dysfunction in the neurodegenerative diseases. Front Biosci, 2003, 8: e428-e436.
9. Cavanna AE, Trimble MR. The precuneus: a review of its functional anatomy and behavioural correlates. Brain, 2006, 129(Pt 3): 564-583.
10. Lordo DN, Van Patten R, Sudikoff EL, et al. Seizure-related variables are predictive of attention and memory in children with epilepsy. Epilepsy Behav, 2017, 73(1): 36-41.
11. Thompson PJ, Duncan JS. Cognitive decline in severe intractable epilepsy. Epilepsia, 2005, 46(11): 1780-1787.
12. Black LC, Schefft B K, Howe SR, et al. The effect of seizures on working memory and executive functioning performance. Epilepsy & Behavior, 2010, 17(3): 412-419.
13. Loring DW, Marino S, Meador KJ. Neuropsychological and behavioral effects of antiepilepsy drugs. Neuropsychol Rev, 2007, 17(4): 413-425.
14. Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8 Suppl 5): 21-26.
15. Meador KJ. Cognitive and memory effects of the new antiepileptic drugs. Epilepsy Res, 2006, 68(1): 63-67.
16. Barr WB. Understanding the Cognitive side effects of antiepileptic drugs: Can functional imaging be helpful? Epilepsy Currents, 2019, 19(1): 22-23.
17. Kleen JK, Scott RC, Holmes GL, et al. Hippocampal interictal epileptiform activity disrupts cognition in humans. Neurology, 2013, 81(1): 18-24.
18. Aldenkamp AP, Arends J. Effects of epileptiform EEG discharges on cognitive function: is the concept of "transient cognitive impairment" still valid? Epilepsy Behav, 2004, 5(Suppl 1): 25-34.
19. Nicolai J, Ebus S, Biemans DPLJ, et al. The cognitive effects of interictal epileptiform EEG discharges and short nonconvulsive epileptic seizures. Epilepsia, 2012, 53(6): 1051-1059.
20. Engel JJ. So what can we conclude-do seizures damage the brain? Prog Brain Res, 2002, 135: 509-512.
21. Black LC, Schefft BK, Howe SR, et al. The effect of seizures on working memory and executive functioning performance. Epilepsy Behav, 2010, 17(3): 412-419.
22. Hermann B, Seidenberg M, Bell B, et al. The neurodevelopmental impact of childhood-onset temporal lobe epilepsy on brain structure and function. Epilepsia, 2002, 43(9): 1062-1071.
23. Hermann BP, Seidenberg M, Bell B. The neurodevelopmental impact of childhood onset temporal lobe epilepsy on brain structure and function and the risk of progressive cognitive effects. Prog Brain Res, 2002, 135: 429-438.
24. Breuer L, Grevers E, Boon P, et al. Cognitive deterioration in adult epilepsy: clinical characteristics of "Accelerated Cognitive Ageing". Acta Neurol Scand, 2017, 136(1): 47-53.
25. Sen A, Capelli V, Husain M. Cognition and dementia in older patients with epilepsy. Brain, 2018, 141(6): 1592-1608.
26. Power KN, Gramstad A, Gilhus N E, et al. Cognitive function after status epilepticus versus after multiple generalized tonic-clonic seizures. Epilepsy Res, 2018, 140: 39-45.

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