Neuropsychological evaluation of post-traumatic epilepsy_Journal of Epilepsy

Authors：

HU Xu , XU Xiaomei , DONG Jirong , XU Feng , SUN Shibai , WANG Dan ,  WANG Yuhai

Department of Neurosurgery, 904th Hospital of PLA (Former 101th hospital of PLA), Wuxi 214044, China;

Corresponding author：

WANG Yuhai, Email: wangyuhai67@126.com

Keywords：

Post-traumatic epilepsy; Neuropsychological tests; Cognitive impairment; Memory impairment

DOI：

10.7507/2096-0247.20220014

Video：

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Objective To analyze of the extent of neuropsychological damage in post-traumatic epilepsy patients. Methods One hundred and thirty-five patients treated at the Department of Neurosurgery, the 904th Hospital of PLA from January 2016 to December 2018 were analyzed retrospectively, including 94 males and 41 females, with an average age of (32.94 ± 9.51) years. They were divided into 3 groups: 40 patients with post-traumatic epilepsy (epilepsy group): 53 trauma patients without post-traumatic epilepsy (trauma group) and 42 patients with health examination (control group). Neuropsychological assessment using the following scales: Mini-mental State Examination (MMSE): Montreal Cognitive Assessment-Basic (MoCA-B): Audio Verbal Memory Test (AVMT): Rey-Osterrieth Complex Figure Test (CFT): Trail Making Test (TMT): Hamilton Depression Scale (HAMD): Activity of Daily Living (ADL). Results The results of one-way ANOVA showed that there was significant difference between all scales of epilepsy group, trauma group and control group (P<0.01). MMSE and MoCA-B scores: Compared with trauma group, epilepsy group decreased significantly, but there was no significant difference between groups (P>0.05); Memory and spatial structure ability: AVMT short/long delayed memory, CFT recall and copy test results showed that epilepsy group decreased more significantly than trauma group, and there was statistical significance between groups (P<0.05); Executive ability: TMT-A and TMT-B showed that epilepsy group spent longer time than trauma group, and there was significant difference between groups (P<0.01); Depressive symptoms: HAMD scale showed significant difference between epilepsy group and trauma group (P<0.01): while there was no statistical difference between trauma group and control group (P>0.05); Activity of daily living: ADL scale results showed that there was no significant difference between epilepsy group and trauma group (P>0.05). Conclusion Post-traumatic epilepsy can aggravate the cognitive impairment of patients, mainly in the decline of memory, spatial structure and executive ability, and prone to depressive symptoms. At the same time of treating epilepsy seizures, patients with post-traumatic epilepsy should be screened and assessed early in neuropsychology to improve their quality of life and return to society as soon as possible.

Citation： HU Xu, XU Xiaomei, DONG Jirong, XU Feng, SUN Shibai, WANG Dan, WANG Yuhai. Neuropsychological evaluation of post-traumatic epilepsy. Journal of Epilepsy, 2022, 8(1): 57-61. doi: 10.7507/2096-0247.20220014 Copy

1.	Wilson L, Stewart W, Dams-O’Connor K, et al. The chronic and evolving neurological consequences of traumatic brain injury. The Lancet Neurology, 2017, 16(10): 813-825.
2.	Semple BD, Zamani A, Rayner G, et al. Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy. Neurobiology of Disease, 2019, 123: 27-41.
3.	Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 2005, 46(4): 470-472.
4.	郭起浩, 吕传真, 洪震. 听觉词语记忆测验在中国老人中的试用分析. 中国心理卫生杂志, 2001, 15(1): 13-15.
5.	郭起浩, 吕传真, 洪震. Rey-Osterrith复杂图形测验在中国正常老人中的应用. 中国临床心理学杂志, 2000, 8(4): 205-207.
6.	陆骏超, 郭起浩, 洪震. 连线测验(中文修订版)在早期识别阿尔兹海默病中的作用. 中国临床心理学杂志, 2006, 14(2): 118-120.
7.	Lowenstein DH. Epilepsy after head injury: an overview. Epilepsia, 2009, 50(1): 4-9.
8.	Berg AT, Caplan R, Hesdorffer DC. Psychiatric and neurodevelopmental disorders in childhood-onset epilepsy. Epilepsy & Behavior, 2011, 20(3): 550-555.
9.	郭韬, 张波, 武江, 等. 药物难治性额叶、颞叶癫痫患者认知功能评估及影响因素对照分析. 中华神经医学杂志, 2016, 15(10): 1004-1010.
10.	中国痴呆与认知障碍指南写作组. 2018中国痴呆与认知障碍诊治指南(一): 痴呆及其分类诊断标准. 中华医学杂志, 2018, 98(13): 965-970.
11.	Sen A, Capelli V, Husain M. Cognition and dementia in older patients with epilepsy. Brain, 2018, 141(6): 1592-1608.
12.	赵永青, 武慧丽, 王学玲, 等. 外伤性癫痫危险因素分析. 中华神经外科杂志, 2011, 27(6): 699-702.
13.	Raymont V, Salazar AM, Lipsky R, et al. Correlates of posttraumatic epilepsy 35 years following combat brain injury. Neurology, 2010, 75(3): 224-229.
14.	Bushnik T, Englander J, Wright J, et al. Traumatic Brain Injury With and Without Late Posttraumatic Seizures. Journal of Head Trauma Rehabilitation, 2012, 27(6): E36-E44.
15.	Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic Epilepsy: Neuroradiologic and Neuropsychological Assessment of Long-term Outcome. Epilepsia, 2003, 44(4): 569-574.
16.	史伟雄, 郭起浩, 洪震, 等. 轻度认知功能损害患者的听觉词语记忆特点. 中华老年医学杂志, 2006, 25(2): 93-96.
17.	Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
18.	郭翠萍, 席春华, 朱幼玲, 等. 轻度认知功能损害患者的执行能力和工作记忆研究. 中华神经科杂志, 2009, 42(4): 237-240.
19.	Ventre-Dominey J, Bailly A, Lavenne F, et al. Double dissociation in neural correlates of visual working memory: A PET study. Cognitive Brain Research, 2005, 25(3): 747-759.
20.	Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 7: 00089.
21.	Tellez-Zenteno JF, Patten SB, Jetté N, et al. Psychiatric Comorbidity in Epilepsy: A Population-Based Analysis. Epilepsia, 2007, 48(12): 2336-2344.
22.	陈湛愔, 陈文荣, 林海峰, 等. 癫痫患者人格个性因素对情感障碍和认知障碍影响的研究. 中华行为医学与脑科学杂志, 2009, 18(10): 876-879.

1. Wilson L, Stewart W, Dams-O’Connor K, et al. The chronic and evolving neurological consequences of traumatic brain injury. The Lancet Neurology, 2017, 16(10): 813-825.
2. Semple BD, Zamani A, Rayner G, et al. Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy. Neurobiology of Disease, 2019, 123: 27-41.
3. Fisher RS, van Emde Boas W, Blume W, et al. Epileptic seizures and epilepsy: definitions proposed by the International League Against Epilepsy (ILAE) and the International Bureau for Epilepsy (IBE). Epilepsia, 2005, 46(4): 470-472.
4. 郭起浩, 吕传真, 洪震. 听觉词语记忆测验在中国老人中的试用分析. 中国心理卫生杂志, 2001, 15(1): 13-15.
5. 郭起浩, 吕传真, 洪震. Rey-Osterrith复杂图形测验在中国正常老人中的应用. 中国临床心理学杂志, 2000, 8(4): 205-207.
6. 陆骏超, 郭起浩, 洪震. 连线测验(中文修订版)在早期识别阿尔兹海默病中的作用. 中国临床心理学杂志, 2006, 14(2): 118-120.
7. Lowenstein DH. Epilepsy after head injury: an overview. Epilepsia, 2009, 50(1): 4-9.
8. Berg AT, Caplan R, Hesdorffer DC. Psychiatric and neurodevelopmental disorders in childhood-onset epilepsy. Epilepsy & Behavior, 2011, 20(3): 550-555.
9. 郭韬, 张波, 武江, 等. 药物难治性额叶、颞叶癫痫患者认知功能评估及影响因素对照分析. 中华神经医学杂志, 2016, 15(10): 1004-1010.
10. 中国痴呆与认知障碍指南写作组. 2018中国痴呆与认知障碍诊治指南(一): 痴呆及其分类诊断标准. 中华医学杂志, 2018, 98(13): 965-970.
11. Sen A, Capelli V, Husain M. Cognition and dementia in older patients with epilepsy. Brain, 2018, 141(6): 1592-1608.
12. 赵永青, 武慧丽, 王学玲, 等. 外伤性癫痫危险因素分析. 中华神经外科杂志, 2011, 27(6): 699-702.
13. Raymont V, Salazar AM, Lipsky R, et al. Correlates of posttraumatic epilepsy 35 years following combat brain injury. Neurology, 2010, 75(3): 224-229.
14. Bushnik T, Englander J, Wright J, et al. Traumatic Brain Injury With and Without Late Posttraumatic Seizures. Journal of Head Trauma Rehabilitation, 2012, 27(6): E36-E44.
15. Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic Epilepsy: Neuroradiologic and Neuropsychological Assessment of Long-term Outcome. Epilepsia, 2003, 44(4): 569-574.
16. 史伟雄, 郭起浩, 洪震, 等. 轻度认知功能损害患者的听觉词语记忆特点. 中华老年医学杂志, 2006, 25(2): 93-96.
17. Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
18. 郭翠萍, 席春华, 朱幼玲, 等. 轻度认知功能损害患者的执行能力和工作记忆研究. 中华神经科杂志, 2009, 42(4): 237-240.
19. Ventre-Dominey J, Bailly A, Lavenne F, et al. Double dissociation in neural correlates of visual working memory: A PET study. Cognitive Brain Research, 2005, 25(3): 747-759.
20. Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 7: 00089.
21. Tellez-Zenteno JF, Patten SB, Jetté N, et al. Psychiatric Comorbidity in Epilepsy: A Population-Based Analysis. Epilepsia, 2007, 48(12): 2336-2344.
22. 陈湛愔, 陈文荣, 林海峰, 等. 癫痫患者人格个性因素对情感障碍和认知障碍影响的研究. 中华行为医学与脑科学杂志, 2009, 18(10): 876-879.

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