Hermann Bruce P, Sager Mark A, Koscik Rebecca L, Young Kate, Nakamura Keith
Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, U.S.A.
Epilepsia. 2017 Nov;58(11):e152-e156. doi: 10.1111/epi.13891. Epub 2017 Sep 4.
We examined cognition in aging persons with chronic epilepsy; characterized targeted vascular, inflammatory, and metabolic risk factors associated with abnormal cognitive aging in the general population; and examined associations between cognition and vascular, inflammatory, and metabolic health. Participants included 40 persons with chronic localization-related epilepsy and 152 controls, aged 54.6 and 55.3, respectively. Participants underwent neuropsychological assessment, clinical examination, and fasting blood evaluation for quantification of vascular status (systolic and diastolic blood pressure, obesity/body mass index [BMI], total and high-density lipoprotein [HDL] cholesterol level, and homocysteine), inflammatory markers (high sensitivity C-reactive protein [hs-CRP], and interleukin-6 [IL-6]), and metabolic status (insulin resistance [Homeostatic Model Assessment of Insulin Resistance (HOMA-IR)], glucose). Epilepsy participants exhibited impairment across all cognitive factor scores (all p's < 0.0001); abnormalities in BMI (p = 0.049), hs-CRP (p = 0.046), HOMA-IR (p = 0.0040), and fasting glucose (p = 0.03), with significant relationships between higher HOMA-IR with poorer Immediate Memory (p = 0.03) and Visuospatial Ability (0.03); elevated hs-CRP with poorer Visuospatial (p = 0.035) and Verbal Ability (p = 0.06); elevated BMI with poorer Speed/Flexibility (p = 0.04), Visuospatial (p = 0.001) and Verbal Ability (p = 0.02); and lower HDL with poorer Verbal Learning/Delayed Memory (p = 0.01), Speed/Flexibility (p = 0.043), and Working Memory (p = 0.008). Aging persons with chronic epilepsy exhibit multiple abnormalities in metabolic, inflammatory, and vascular health that are associated with poorer cognitive function.
我们研究了患有慢性癫痫的老年人的认知情况；确定了与普通人群认知老化异常相关的靶向血管、炎症和代谢风险因素；并研究了认知与血管、炎症和代谢健康之间的关联。参与者包括40名患有慢性局灶性癫痫的人和152名对照者，年龄分别为54.6岁和55.3岁。参与者接受了神经心理学评估、临床检查以及空腹血液评估，以量化血管状况（收缩压和舒张压、肥胖/体重指数[BMI]、总胆固醇和高密度脂蛋白[HDL]胆固醇水平以及同型半胱氨酸）、炎症标志物（高敏C反应蛋白[hs-CRP]和白细胞介素-6[IL-6]）以及代谢状况（胰岛素抵抗[胰岛素抵抗稳态模型评估（HOMA-IR）]、血糖）。癫痫参与者在所有认知因子得分上均表现出受损（所有p值<0.0001）；BMI（p = 0.049）、hs-CRP（p = 0.046）、HOMA-IR（p = 0.0040）和空腹血糖（p = 0.03）存在异常，较高的HOMA-IR与较差的即刻记忆（p = 0.03）和视觉空间能力（0.03）之间存在显著关系；hs-CRP升高与较差的视觉空间能力（p = 0.035）和语言能力（p = 0.06）相关；BMI升高与较差的速度/灵活性（p = 0.04）、视觉空间能力（p = 0.001）和语言能力（p = 0.02）相关；较低的HDL与较差的语言学习/延迟记忆（p = 0.01）、速度/灵活性（p = 0.043）和工作记忆（p = 0.008）相关。患有慢性癫痫的老年人在代谢、炎症和血管健康方面表现出多种异常，这些异常与较差的认知功能相关。
