Study On Cognitive Function And Quality Of Life Related Factors In Adult Patients With Temporal Lobe Epilepsy

Objectives:The Wechsler Intelligence Scale For Adult-Chinese Revised(W AIS-RC),Clinical Memory Scale(CMS)and Quality Of Life In Epilepsy Inv entory-89(QOLIE-89)were used to assess the cognitive function and quality o f life of adult temporal lobe epilepsy(TLE)patients,respectively.To analyze a nd discuss the related factors affecting the cognitive function and quality of lif e of adult patients with TLE,so as to provide evidence for the early detection of cognitive dysfunction in patients with TLE and the adoption of effective m easures to improve their cognitive function and quality of life.Methods:Using case-control study,on the basis of the set and exclusion criteria,this study continuously collected 60 adult patients with TLE from Febr uary 2018 to February 2019 in the First Affiliated Hospital Of Kunming Medic al University neurology department as an epilepsy group,and randomly selected 60 cases of healthy adults as a normal control group,whose age,gender,educ ation level were matched with epilepsy group.The basic information and clinic al data of the subjects were recorded in detail.All the subjects were tested by WAIS-RC and CMS.In the epilepsy group,MRI,long-term video or dynamic electroencephalogram(VEEG)examination and QOLIE-89 evaluation were com pleted at the same time.Using statistical methods to analyze the difference of WAIS RC,CMS total score and each test item score between the epilepsy gro up and normal control group,analyzing the characteristics of the cognitive func tion in adult patients with TLE,Correlation analysis was conducted between ea ch clinical factor and the score of cognitive function assessment scale and QO LIE-89,further explore related influence factors of cognitive function and qualit y of life in adult patients with TLE.Results:1.Comparison of WAIS-RC scores between the adult TLE group and the normal control group:VIQ,PIQ and FIQ in the adult TLE group we re all lower than those in the normal control group,and the difference was sta tistically significant(P<0.05).The incidence of cognitive dysfunction in the adu It TLE group was higher than that in the normal control group.2.Comparison of the CMS between the adult TLE group and the normal control group:pointing memory,associative learning,image free recall,recognit ion of meaningless graphics,portrait feature recall and MQ in the adult TLE g roup were all lower than those in the normal control group,and the difference s were statistically significant(P<0.01).3.Correlation analysis of possible factors affecting cognitive function in a dults with TLE shows that:?VIQ was positively correlated with education level(p<0.05),and negati vely correlated with course of disease(p<0.05).?There was a significant correlation between PIQ and abnormal EEG(p<0.01).?There was a positive correlation between FIQ and education level(p<0.05),and a significant negative correlation between FIQ and disease course(p<0.01).There was a correlation between FIQ and abnormal EEG in interepisode(p<0.05),in which disease course had a greater influence on FIQ.? MQ was negatively correlated with the course of disease(p<0.05),an d was correlated with the type of attack and whether the EEG in the interepis ode was abnormal(p<0.05 or p<0.01).Association learning was correlated with frequency of seizure and head MRI abnormality(p<0.01 or p<0.05),Free imag e recall was negatively correlated with the duration and interepisode EEG abno rmalities(p<0.05),Recognition of meaningless figures was negatively correlated with the frequency of seizure and the abnormality of head MRI(p<0.01 or p<0.05),There was a significant positive correlation between portrait characteristi cs and educational level(p<0.01).4.Correlation analysis of possible influencing factors on quality of life of adult TLE patients showed that:quality of life of adult TLE patients was sig nificantly negatively correlated with attack frequency and quantity of Antiepilep tic Drugs(AEDs)(p<0.01),and the quantity of AEDs had a more significant i mpact on quality of life of adult TLE patients(Beta=-0.580).5.Adult cognitive function in patients with TLE test scores and QOLIE-89 test score correlation analysis showed that:QOLIE-89 total score and th e score of self health feeling and physiological social limitation,emotional soci al limitation,work/driving/social ability,energy/fatigue,attention,concern about health,attack fear,memory,language,social support,social isolation,drug sid e effects,all of them were correlated with VIQ,PIQ,FIQ and MQ to varying degrees(p<0.01 or p<0.05).Conclusions:1.The average level of cognitive function of adult patients with TLE is lower than that of normal adults,in which memory disorder is th e characteristic manifestation,and the incidence of cognitive dysfunction of adu It patients with TLE is higher than that of normal people.2.The course,frequency,type,education level,MRI and EEG during the seizures are important factors affecting the cognitive function of adult patients with TLE.The longer the course of the disease,the higher the frequency of the seizures,the more comprehensive the seizures were,the lower the level of ed ucation,and with abnormal head MRI and interepisode EEG examination the more severe the cognitive impairment was in adult TLE patients,while there was no significant correlation between the age,age of onset,gender,and numb er of AEDs with cognitive function in adult TLE patients.3.The frequency of seizures and the number of AEDs used are important factors affecting the quality of life of adult TLE patients.The higher the freq uency of seizures and the more AEDs used,the worse the quality of life of a dultTLE patients.4.There was a positive correlation between cognitive function and quality of life in adults with TLE.