The Study Of Dynamic Cerebral Autoregulation In Patients With Frontal Lobe Epilepsy

Objective:Frontal lobe epilepsy is the second common focal epilepsy,most of Which occur in complex parts,mostly in night sleep.Frontal lobe epilepsy is often accompanied by autonomic nervous symptoms.When the autonomic nerve changes in frontal lobe epilepsy are serious,it may lead to sudden death of epilepsy due to conduction to the guide lobe.On the other hand,the study of epileptic autonomic nerve is the forefront of international research at present,and some studies have pointed out that the dynamic cerebral blood flow regulation function of epileptic patients is damaged.The purpose of this study is to explore the autonomic nerve dysfunction and the automatic regulation of dynamic cerebral blood flow in patients with frontal lobe epilepsy,so as to provide evidence for the comprehensive treatment of frontal lobe epilepsy.Methods:In this study,40 patients with FLE were selected from December 2020 to December 2022,and 40 healthy people matched with the personality and age of the case group were selected from the control group,and their d CA function was monitored.The TCD combined with continuous fingertip blood pressure monitoring method was used to continuously and synchronously record the cerebral blood flow velocity and arterial blood pressure of bilateral middle cerebral arteries.The transfer function analysis（TFA）method was used to obtain the relevant parameters of automatic regulation of dynamic cerebral blood flow:gain and phase difference.The obtained data were statistically analyzed.Results:1.Compared with the control group,the left and right phase differences in frontal lobe epilepsy group decreased significantly(P_left=0.002,P_right=0.005),suggesting that the d CA function of frontal lobe epilepsy patients is damaged.2.In patients with frontal lobe epilepsy with dysautonomia,the autonomic scale score（SCOPA-AUT）were negatively correlated with both left and right phase differences（left:β=-1.621,P=0.001;right:β=-2.428,P=0.002）.SCOPA-AUT（Cardiovascular section）were negatively correlated with both left and right phase differences（left:β=-0.432,P=0.012;right:β=-0.543,P=0.006）.The relationship between clinical factors and d CA parameters was analyzed by univariate regression models,and it was found that the number of spike slow waves influenced d CA function(β_left=-0.344,P=0.029;β_right=-0.413,P=0.008).3.After antiepileptic drugs treatment,the left and right phase differences of patients were increased compared with no treatment,and the difference was statistically significant（P=0.001）.Conclusion:1.The phase differences of dynamic cerebral blood flow parameters in patients with frontal lobe epilepsy is decreased,it suggested that d CA function is impaired.2.SCOPA-AUT scale and the number of spike-slow waves were negatively correlated with DCA function in patients with frontal lobe epilepsy;3.DCA function、SCOPA-AUT and SCOPA-AUT（Cardiovascular section）were improved in patients with frontal lobe epilepsy after treatment with lamotrigine.