Neuroscience Research Unit, University of Liverpool, Liverpool, UK.
Epilepsia. 2011 Jun;52(6):1084-91. doi: 10.1111/j.1528-1167.2011.03043.x. Epub 2011 Mar 31.
Cognitive impairment is a common comorbidity of epilepsy; however, relatively little research has been undertaken to investigate how cognitive problems develop in adults who are newly diagnosed. This study aimed to investigate changes in cognitive performance in adults with new-onset epilepsy 12 months after diagnosis compared with healthy volunteers.
One hundred forty-seven people with epilepsy (PWE) were assessed using a comprehensive neuropsychological test battery before they started treatment and after 12 months. Cognitive change scores were compared with 69 healthy volunteers who were also assessed at baseline and after 12 months.
At 12 month follow-up, PWE had significantly poorer change scores for 9 of the 16 variables. For the majority of these measures, PWE had subtle declines in performance, whereas healthy volunteers improved. Poorer performance on some measures was associated with treatment with topiramate, generalized seizures and, interestingly, achieving an immediate 12-month seizure remission.
After controlling for statistically confounding factors, people with newly diagnosed epilepsy had a different cognitive trajectory compared with healthy volunteers from the general population. Memory, psychomotor speed, and higher executive functioning were the domains most vulnerable to change over a 12-month period.
认知障碍是癫痫的常见合并症；然而，对于新诊断为癫痫的成年人中认知问题如何发展的研究相对较少。本研究旨在调查与健康志愿者相比，新诊断为癫痫的成年人在诊断后 12 个月时认知表现的变化。
147 名癫痫患者（PWE）在开始治疗前和 12 个月后使用全面的神经心理学测试组合进行评估。将认知变化评分与 69 名健康志愿者进行比较，这些志愿者也在基线和 12 个月后进行了评估。
在 12 个月的随访中，PWE 在 16 个变量中的 9 个变量的变化评分明显较差。对于这些措施中的大多数，PWE 的表现略有下降，而健康志愿者则有所提高。在某些措施上表现较差与使用托吡酯治疗、全身性发作有关，有趣的是，与立即达到 12 个月的癫痫缓解有关。
在控制统计学上混杂因素后，新诊断为癫痫的患者与来自普通人群的健康志愿者的认知轨迹不同。记忆、精神运动速度和更高的执行功能是在 12 个月期间最容易发生变化的领域。
