| Objective To explore the relationship between epilepsy and cognitive function by monitoring the changes of power spectral density in patients with epilepsy by high-density electroencephalography(hd EEG),and to analyze the correlation between serum Aβ42,P-Tau levels and cognitive function in patients with epilepsy,and to further explore the potential pathogenic mechanism of cognitive impairment in patients with epilepsy.Meanwhile,comprehensively analyze the factors of cognitive impairment in patients with epilepsy,so as to provide clinical ideas for delaying cognitive function decline in patients with epilepsy.MethodsForty-six patients with epilepsy admitted to Anhui Medical University of Suzhou Hospital from August 2020 to November 2022 and 41 healthy subjects from the physical examination center were collected.According to the score of Montreal Cognitive Assessment Scale,patients with epilepsy were divided into cognitive impairment group and non-cognitive impairment group.Nine patients in the cognitive impairment group,the non-cognitive impairment group and the normal control group each completed the high-density EEG examination.The relative power of the whole brain and each brain region in different frequency bands [δ(1-3.9HZ),θ(4-7.9HZ),α(8-12.9HZ),β(13-30 Hz)] and the DTABR between the three groups were compared.Spearman correlation analysis was used to explore the correlation between the relative power and DTABR of the whole brain and each brain region and the cognitive function in 18 patients with epilepsy.The receiver operating characteristic(ROC) curve was drawn and the area under the curve(AUC)was calculated to evaluate the value of relative power and DTABR predicting cognitive dysfunction in patients with epilepsy.The serum levels of Aβ42 and p-Tau were detected in 46 patients with epilepsy by ELISA.Meanwhile,the serum levels of Aβ42 in 41 healthy subjects and the serum levels of p-Tau in 23 healthy subjects were detected.The serum levels of Aβ42 and p-Tau in the cognitive impairment group,the non-cognitive impairment group and the normal control group were compared.Spearman correlation analysis was used to explore the correlation between serum Aβ42,p-Tau levels and cognitive function in 46 patients with epilepsy.The ROC curve was drawn and the area under the curve(AUC)was calculated to evaluate the value of serum Aβ42 and p-Tau levels in predicting cognitive dysfunction in patients with epilepsy.Logistic regression was used to analyze the influencing factors of cognitive impairment in patients with epilepsy.Results1.The relative power of δ and DTABR of left frontoparietal region,left frontotemporal region and left temporal region in the cognitive impairment group were higher than the non-cognitive impairment group and the normal control group,and the differences were statistically significant(P<0.05).The relative power of α at the left frontoparietal,left frontotemporal and left temporal regions in the cognitive impairment group was lower than the non-cognitive impairment group and the normal control group,and the difference was statistically significant(P<0.05).The relative power of α at the left frontoparietal region in the non-cognitive impairment group was lower than that the normal control group,and the difference was statistically significant(P<0.05).2.The relative power of δ and DTABR at left frontoparietal,left frontotemporal and left temporal regions were negatively correlated with cognitive function;The relative power of α at left frontoparietal,left frontotemporal and left temporal regions was positively correlated with cognitive function.3.The serum levels of Aβ42 in the cognitive impairment group and the non-cognitive impairment group were significantly lower than the normal control group(P<0.05).The serum level of Aβ42 in the cognitive impairment group was lower than that in the non-cognitive impairment group,but the difference was not statistically significant(P>0.05);The serum level of p-Tau in the cognitive impairment group was higher than the non-cognitive impairment group and the normal control group,and the difference was statistically significant(P<0.05).The serum level of p-Tau in the noncognitive impairment group was higher than the normal control group,but the difference was not statistically significant(P>0.05).4.The occurrence of cognitive dysfunction in patients with epilepsy is related to the levels of serum Aβ42 and p-Tau.The level of serum Aβ42 is positively correlated with the cognitive function in patients with epilepsy,and the level of serum p-Tau is negatively correlated with the cognitive function in patients with epilepsy.5.The further analysis of ROC curve showed that the relative power of δ and α band and DTABR at the left frontoparietal region,left frontotemporal region,left temporal region,and the serum levels of Aβ42 and p-Tau had high predictive value for cognitive impairment in patients with epilepsy.6.The results of logistic regression analysis showed that the state of consciousness at the time of seizure and the number of antiepileptic drugs taken in combination were the influencing factors of cognitive impairment in patients with epilepsy.Conclusion1.The patients with cognitive impairment in epilepsy have changes in power spectrum in some brain regions,mainly manifested as changes of the relative power of δ and α band,and DTABR between frequency bands in the left frontoparietal region,left frontotemporal region and left temporal region.2.The relative power of δ and α bands and DTABR at the left frontoparietal region,left frontotemporal region,and left temporal region have high predictive value for cognitive impairment in epilepsy,which provides an objective basis for the evaluation of cognitive impairment in epilepsy.3.Serum p-Tau and Aβ42 levels provide a theoretical basis for further exploring the potential pathogenic mechanism of cognitive impairment in patients with epilepsy.4.The risk of cognitive impairment is higher in patients with the loss of consciousness at the time of seizure and the number of antiepileptic drugs taken in combination,which provides ideas for delaying the decline of cognitive function in patients with epilepsy. |
PDF Full Text Request