Department of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand.
Epileptic Disord. 2011 Dec;13(4):375-81. doi: 10.1684/epd.2011.0469.
This cross-sectional study examined the Montreal Cognitive Assessment (MoCA) performance in cryptogenic epileptic patients aged more than 15 years with normal global cognition according to the Mini-Mental State Examination (MMSE) score. We tested our hypothesis that the prevalence of mild cognitive impairment and associated patient correlation factors might be increased (score < 26) according to the MoCA, in spite of a normal MMSE score, and that cognitive impairment might occur in a range of domains of the MoCA. Eighty-five patients participated in this study. The mean MoCA score was 22.44 (± 4.32). In spite of a normal MMSE score, which was an inclusion criterion, cognitive impairment was detected in 60% patients based on the MoCA score. The variable that correlated with a higher risk of cognitive impairment was the number of antiepileptic drugs (polytherapy: OR 2.71; CI 1.03-7.15). The mean scores of visuospatial and executive function, naming ability, attention, language, abstraction, delayed recall and orientation among patients with mild cognitive impairment were significantly lower than those of patients with normal cognitive function. These findings suggest that mild cognitive impairment in cryptogenic epileptic patients is common. We suggest using MoCA as a screening test for patients with epilepsy.
本横断面研究考察了蒙特利尔认知评估(MoCA)在认知功能正常(根据 Mini-Mental State Examination [MMSE] 评分)的、年龄大于 15 岁的隐源性癫痫患者中的表现。我们测试了这样一个假设,即尽管 MMSE 评分正常,但根据 MoCA,轻度认知障碍的患病率及其相关患者相关因素可能会增加(评分<26),并且认知障碍可能发生在 MoCA 的多个领域。85 名患者参与了这项研究。MoCA 的平均得分为 22.44(±4.32)。尽管 MMSE 评分正常是纳入标准,但根据 MoCA 评分,60%的患者存在认知障碍。与认知障碍风险增加相关的变量是抗癫痫药物的数量(多药治疗:OR 2.71;CI 1.03-7.15)。轻度认知障碍患者的视空间和执行功能、命名能力、注意力、语言、抽象、延迟回忆和定向的平均得分明显低于认知功能正常的患者。这些发现表明,隐源性癫痫患者的轻度认知障碍很常见。我们建议使用 MoCA 作为癫痫患者的筛查测试。