海马萎缩和定量脑电图标志物在颞叶癫痫与非颞叶癫痫轻度认知障碍中的比较。
Hippocampal atrophy and quantitative EEG markers in mild cognitive impairment in temporal lobe epilepsy versus extra-temporal lobe epilepsy.
机构信息
Department of Neurology, Mansoura Faculty of Medicine, Mansoura University, Mansoura, 35516, Dakahlia, Egypt.
出版信息
Neurol Sci. 2022 Mar;43(3):1975-1986. doi: 10.1007/s10072-021-05540-4. Epub 2021 Aug 18.
OBJECTIVE
Cognitive impairment in temporal lobe epilepsy is widely acknowledged as one of the most well-known comorbidities. This study aimed to explore cognitive impairment and to determine the potential clinical, radiological, and quantitative electroencephalography markers for cognitive impairment in temporal lobe epilepsy patients versus extra-temporal lobe epilepsy.
METHODS
Forty-five patients with temporal lobe epilepsy and forty-five patients with extra-temporal lobe epilepsy were recruited for an administered digit span test, verbal fluency test, mini-mental state examination, digital symbol test, and Montreal cognitive assessment. Also, they were subjected to magnetic resonance imaging assessment for hippocampal atrophy and a quantitative electroencephalography assessment for electroencephalography markers (median frequency, peak frequency, and the alpha-to-theta ratio).
RESULTS
Patients with extra-temporal lobe epilepsy showed non-significant higher epilepsy durations and a higher frequency of seizures. Temporal lobe epilepsy patients showed a more statistically significant family history of epilepsy (37.7%), more history of febrile convulsions (13.3%), higher hippocampal atrophy (17.8%), and lower cognitive scales, especially mini-mental state examination and Montreal cognitive assessment; lower digital symbol test, verbal fluency test, and backward memory of digit span test. Also, temporal lobe epilepsy patients had a strong negative correlation with electroencephalography markers: median frequency, peak frequency, and the alpha-to-theta ratio (r = - 0.68, P < 0.005 and r = - 0.64, P < 0.005 and r = - 0.66, P < 0.005 respectively).
CONCLUSION
Cognitive impairment in patients with temporal lobe epilepsy was correlated with hippocampal atrophy and quantitative electroencephalography abnormalities, especially peak frequency, median frequency, and alpha-to-theta ratio that could be used alone for the identification of early cognitive impairment.
TRIAL REGISTRATION
Clinicaltrials.gov: NCT04376671.
目的
颞叶癫痫中的认知障碍是众所周知的最常见的合并症之一。本研究旨在探讨认知障碍，并确定颞叶癫痫患者与颞叶外癫痫患者认知障碍的潜在临床、影像学和定量脑电图标志物。
方法
招募了 45 例颞叶癫痫患者和 45 例颞叶外癫痫患者，进行数字跨度测试、言语流畅性测试、简易精神状态检查、数字符号测试和蒙特利尔认知评估。还对他们进行了磁共振成像评估，以评估海马萎缩，以及进行定量脑电图评估，以评估脑电图标志物（中位数频率、峰值频率和α-θ 比）。
结果
颞叶外癫痫患者的癫痫持续时间和发作频率较高，但无统计学意义。颞叶癫痫患者有更显著的癫痫家族史（37.7%）、热性惊厥史（13.3%）、更高的海马萎缩（17.8%）和较低的认知量表，尤其是简易精神状态检查和蒙特利尔认知评估；数字符号测试、言语流畅性测试和数字跨度测试的倒背记忆得分较低。此外，颞叶癫痫患者与脑电图标志物呈强烈负相关：中位数频率、峰值频率和α-θ 比（r = -0.68，P < 0.005 和 r = -0.64，P < 0.005 和 r = -0.66，P < 0.005）。
结论
颞叶癫痫患者的认知障碍与海马萎缩和定量脑电图异常有关，尤其是峰值频率、中位数频率和α-θ 比，这些指标可单独用于识别早期认知障碍。
试验注册
Clinicaltrials.gov：NCT04376671。
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