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尼日利亚东南部一个城郊社区癫痫患者的癫痫发作频率及认知障碍风险

Seizure frequency and risk of cognitive impairment in people living with epilepsy in a sub-urban community in South Eastern Nigeria.

作者信息

Arinzechi Eugene O, Ogunrin Olubunmi A, Nwosu Cosmas M, Nwani Paul O, Enwereji Kelechi O, Asomugha Lasbrey A, Dimkpa Uchechukwu

机构信息

Department of Medicine, Neurology Unit, Nnamdi Azikiwe University Teaching, Nnewi, Nigeria.

Department of Medicine, Neurology Unit, University of Benin Teaching Hospital, Benin City, Nigeria.

出版信息

J Clin Neurosci. 2019 Jan;59:98-105. doi: 10.1016/j.jocn.2018.10.120. Epub 2018 Nov 13.

Abstract

This study is aimed at assessing the impact of seizure frequency on the cognitive performance of epileptic adult patients in a rural community in South Eastern Nigeria. A total of 51 patients with epilepsy (33 males and 18 females) with a mean age of 30.7 ± 12.1 years and 51 age and sex matched controls participated in this study. The cognitive performances of the people with epilepsy and controls were assessed using the Community Screening Interview for Dementia (CSID) and the computerized cognitive assessment test battery, the FePsy. The control group performed better in almost all the neurocognitive tests compared with the low seizure frequency (LSF) and high seizure frequency (HSF) groups. Analysis of covariance revealed that patients with LSF performed better (p = 0.04) in visual reaction time - dominant hand (VRT-D) compared with the HSF group. There was lack of significant differences in mean total CSID scores and mean sub-total scores for language, memory, orientation, attention, constructional praxis, auditory reaction time-dominant hand and non-dominant hand, VRT - non-dominant hand and figure recognition. HSF patients indicated significantly greater prevalence (80% vs. 20%; p = 0.020) and risk (OR, 8.0; 95% CI, 1.8-33.8)) of memory impairment, but not in the other neurocognitive domains compared with the LSF group. In conclusion, the present study indicated that adults with epilepsy performed poorly in a wide range of neurocognitive variables compared with the controls. However, no significant adverse effects of high seizure frequency were observed on almost all the neurocognitive variables.

摘要

本研究旨在评估癫痫发作频率对尼日利亚东南部一个农村社区成年癫痫患者认知表现的影响。共有51例癫痫患者(33例男性和18例女性)参与了本研究,他们的平均年龄为30.7±12.1岁,同时还有51例年龄和性别匹配的对照者。使用痴呆症社区筛查访谈(CSID)和计算机化认知评估测试组FePsy对癫痫患者和对照者的认知表现进行评估。与低发作频率(LSF)和高发作频率(HSF)组相比,对照组在几乎所有神经认知测试中表现更好。协方差分析显示,与HSF组相比,LSF组患者在优势手视觉反应时间(VRT-D)方面表现更好(p=0.04)。在CSID总分均值以及语言、记忆、定向、注意力、构建实践、优势耳和非优势耳听觉反应时间、非优势手VRT和图形识别等分项总分均值方面,没有显著差异。与LSF组相比,HSF患者记忆障碍的患病率(80%对20%;p=0.020)和风险(OR,8.0;95%CI,1.8 - 33.8)显著更高,但在其他神经认知领域则不然。总之,本研究表明,与对照组相比,成年癫痫患者在广泛的神经认知变量方面表现较差。然而,几乎在所有神经认知变量上均未观察到高发作频率的显著不良影响。

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