Baxendale Sallie, McGrath Katherine, Donnachie Elizabeth, Wintle Sue, Thompson Pamela, Heaney Dominic
Department of Clinical and Experimental Epilepsy, Institute of Neurology, UCL, UK.
Epilepsy Society, Chalfont St Peter, Buckinghamshire, UK.
Epilepsy Behav. 2015 Apr;45:187-90. doi: 10.1016/j.yebeh.2015.01.032. Epub 2015 Mar 24.
In the general population, obesity is associated with accelerated age-related cognitive decline. The impact of obesity on cognitive function in neurological populations who already have a heightened risk of cognitive decline is unknown. This study explored the relationship between obesity and cognitive underfunction in people with medically intractable epilepsy.
Eighty-one consecutive patients admitted for evaluation for medically intractable epilepsy (36 females and 45 males) underwent tests of memory and intellectual function. Optimal level of function was assessed using the National Adult Reading Test - Revised. Measures of underfunction were calculated by subtracting current measures of intellectual ability from the NART IQ. Body mass index (BMI) was used as an index of obesity.
Twenty-nine people had a BMI in the healthy range (36%), 31 were overweight (38%), and 21 were obese (26%). The healthy weight, overweight, and obese groups did not differ in age at the time of assessment, age at seizure onset, or optimal level of function (NART IQ). The obese group had a greater degree of suboptimal processing speed and demonstrated a greater degree of underfunction on the Full Scale IQ (FSIQ) measure compared to the healthy weight group. Body mass index accounted for 14% of the variance in underfunction in processing speed and 10% of the variance in underfunction in FSIQ. Controlling for the effects of age, all measures of memory function were significantly correlated with BMI, with poorer scores associated with higher BMIs.
A small but significant proportion of the variance in memory function and intellectual underfunction in people with epilepsy is explained by BMI. Further work is needed to establish whether a reduction in BMI to within healthy limits is associated with improvements in cognitive function in this group.
在普通人群中，肥胖与年龄相关的认知衰退加速有关。肥胖对认知衰退风险已经增加的神经疾病人群认知功能的影响尚不清楚。本研究探讨了药物难治性癫痫患者中肥胖与认知功能低下之间的关系。
81例连续入院接受药物难治性癫痫评估的患者（36例女性和45例男性）接受了记忆和智力功能测试。使用修订版国家成人阅读测试评估最佳功能水平。功能低下的测量值通过从国家成人阅读测试智商中减去当前智力能力测量值来计算。体重指数（BMI）用作肥胖指标。
29人的BMI处于健康范围（36%），31人超重（38%），21人肥胖（26%）。健康体重、超重和肥胖组在评估时的年龄、癫痫发作起始年龄或最佳功能水平（国家成人阅读测试智商）方面没有差异。与健康体重组相比，肥胖组的次优处理速度程度更高，并且在全量表智商（FSIQ）测量中表现出更大程度的功能低下。体重指数在处理速度功能低下的方差中占14%，在FSIQ功能低下的方差中占10%。控制年龄因素后，所有记忆功能测量值均与BMI显著相关，得分越低与BMI越高相关。
癫痫患者记忆功能和智力功能低下的方差中有一小部分但显著比例可由BMI解释。需要进一步开展工作以确定将BMI降至健康范围内是否与该组认知功能改善相关。
