Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy_Journal of Epilepsy

Authors：

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

Department of Neurosurgery, 904th Hospital of PLA, Wuxi 214044, China;

Corresponding author：

WANG Yuhai, Email: wangyuhai67@126.com

Keywords：

Post-traumatic epilepsy; Cognitive impairment; Risk factors

DOI：

10.7507/2096-0247.202209008

Video：

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Objective To analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. Methods From January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. Results The results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). Conclusion Post-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.

Citation： HU Xu, DONG Jirong, XU Feng, SUN Shibai, XU Xiaomei, WANG Yuhai. Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy. Journal of Epilepsy, 2023, 9(1): 26-32. doi: 10.7507/2096-0247.202209008 Copy

1.	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.
2.	Liu SY, Han XM, Yan YY, et al. Quality of life and its influencing factors in patients with post-traumatic epilepsy. Chinese Journal of Traumatology, 2011, 14(2): 100-103.
3.	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.
4.	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.
5.	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.
6.	Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia, 1999, 40(5): 584-589.
7.	Englander J, Bushnik T, Duong TT, et al. Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Archives of Physical Medicine and Rehabilitation, 2003, 84(3): 365-373.
8.	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.
9.	Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia, 2003, 44(4): 569-574.
10.	虞培敏, 郭起浩, 丁玎, 等. 癫痫患者认知功能影响因素的研究. 中国临床神经科学, 2007, 15(1): 41-45.
11.	刘阳, 孙涛, 徐文中, 等. 75例癫痫患者认知功能与影响因素分析. 临床神经外科杂志, 2014, 11(6): 409-411.
12.	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.
13.	Elger CE, Helmstaedter C, Kurthen M. Chronic epilepsy and cognition. The Lancet Neurology, 2004, 3(11): 663-672.
14.	Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8): S21-26.
15.	Piccenna L, Shears G, O’Brien TJ. Management of post-traumatic epilepsy: an evidence review over the last 5 years and future directions. Epilepsia Open, 2017, 2(2): 123-144.
16.	Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 18(7): 89.
17.	Rosenbaum RS, Moscovitch M, Foster JK, et al. Patterns of autobiographic memory loss in medial-temporal lobe amnesic patients. Journal of Cognitive Neuroscience, 2008, 20(8): 1490-1506.
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.	Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
20.	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.
21.	Helmstaedter C, Witt JA, Ortinski P, et al. Comments on cognitive side effects of antiepileptic drugs. Epilepsy & Behavior, 2004, 5(Suppl. 1): 60-65. Epilepsy & Behavior, 2014, 40: 29-31.

1. 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.
2. Liu SY, Han XM, Yan YY, et al. Quality of life and its influencing factors in patients with post-traumatic epilepsy. Chinese Journal of Traumatology, 2011, 14(2): 100-103.
3. 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.
4. 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.
5. 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.
6. Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia, 1999, 40(5): 584-589.
7. Englander J, Bushnik T, Duong TT, et al. Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Archives of Physical Medicine and Rehabilitation, 2003, 84(3): 365-373.
8. 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.
9. Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia, 2003, 44(4): 569-574.
10. 虞培敏, 郭起浩, 丁玎, 等. 癫痫患者认知功能影响因素的研究. 中国临床神经科学, 2007, 15(1): 41-45.
11. 刘阳, 孙涛, 徐文中, 等. 75例癫痫患者认知功能与影响因素分析. 临床神经外科杂志, 2014, 11(6): 409-411.
12. 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.
13. Elger CE, Helmstaedter C, Kurthen M. Chronic epilepsy and cognition. The Lancet Neurology, 2004, 3(11): 663-672.
14. Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8): S21-26.
15. Piccenna L, Shears G, O’Brien TJ. Management of post-traumatic epilepsy: an evidence review over the last 5 years and future directions. Epilepsia Open, 2017, 2(2): 123-144.
16. Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 18(7): 89.
17. Rosenbaum RS, Moscovitch M, Foster JK, et al. Patterns of autobiographic memory loss in medial-temporal lobe amnesic patients. Journal of Cognitive Neuroscience, 2008, 20(8): 1490-1506.
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. Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
20. 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.
21. Helmstaedter C, Witt JA, Ortinski P, et al. Comments on cognitive side effects of antiepileptic drugs. Epilepsy & Behavior, 2004, 5(Suppl. 1): 60-65. Epilepsy & Behavior, 2014, 40: 29-31.

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