Hamedi Nastaran, García-Salinas Jesús S, Berry Brent M, Worrell Gregory A, Kucewicz Michal T
Brain and Mind Electrophysiology Laboratory, Multimedia Systems Department, BioTechMed Center, Gdansk University of Technology, Gdansk, Poland.
Department of Neurology, Mayo Clinic, Rochester, Minnesota, USA.
Epilepsia. 2025 Apr;66(4):1274-1287. doi: 10.1111/epi.18246. Epub 2025 Jan 6.
Cognitive deficits are one of the most debilitating comorbidities in epilepsy and other neurodegenerative, neuropsychiatric, and neurodevelopmental brain disorders. Current diagnostic and therapeutic options are limited and lack objective measures of the underlying neural activities. In this study, electrophysiological biomarkers that reflect cognitive functions in clinically validated batteries were determined to aid diagnosis and treatment in specific brain regions.
We employed the Cambridge Neuropsychological Test Automated Battery (CANTAB) tasks to probe memory and executive functions in 86 patients with epilepsy undergoing clinical electroencephalography (EEG) monitoring. EEG electrode signals during performance of particular battery tasks were decomposed to identify specific frequency bands and cortical areas that differentiated patients with impaired, normal, and good standardized performance according to their age and gender.
The anterior prefrontal cortical EEG power in the theta frequency band was consistently lower in patients with impaired memory and executive function performance (z-score < -1). This effect was evident in all four behavioral measures of executive, visual, spatial, and working memory functions and was confined to the cortical area of all four frontal pole electrodes (Nz, Fpz, Fp1, and Fp2).
Theta EEG power in the anterior prefrontal cortex provides simple, accessible, and objective electrophysiological measure of memory and executive functions in epilepsy. Our results suggest a feasible clinical biomarker for diagnosis, monitoring, and treatment of cognitive deficits with emerging targeted neuromodulation approaches.
认知缺陷是癫痫以及其他神经退行性、神经精神性和神经发育性脑部疾病中最具致残性的合并症之一。目前的诊断和治疗选择有限，且缺乏对潜在神经活动的客观测量方法。在本研究中，确定了在经过临床验证的测试组合中反映认知功能的电生理生物标志物，以辅助特定脑区的诊断和治疗。
我们采用剑桥神经心理测试自动组合（CANTAB）任务，对86例正在接受临床脑电图（EEG）监测的癫痫患者的记忆和执行功能进行探测。在执行特定测试组合任务期间的EEG电极信号被分解，以识别根据年龄和性别区分表现受损、正常和良好标准化表现患者的特定频段和皮质区域。
记忆和执行功能表现受损的患者（z分数＜-1），其前额叶皮质θ频段的EEG功率持续较低。这种效应在执行、视觉、空间和工作记忆功能的所有四项行为测量中都很明显，并且局限于所有四个额极电极（Nz、Fpz、Fp1和Fp2）的皮质区域。
前额叶皮质前部的θ频段EEG功率为癫痫患者的记忆和执行功能提供了简单、可及且客观的电生理测量方法。我们的结果提示了一种可行的临床生物标志物，可用于采用新兴的靶向神经调节方法诊断、监测和治疗认知缺陷。
