Research Of Cognitive Function In Idiopathic Generalized Epilepsy

PART ONE:COGNITIVE FUNCTION IN THE NEWIY DIAGNOSED JUVENILE MYOCLONIC EPILEPSYObjective:To study cognitive function in the newly diagnosed juvenile myoclonic epilepsy and estimate the related factors to cognitive function in patients with juvenile myoclonic epilepsy.Methods:Neuropsychological tests were performed in JME patients, such as Trail making test (TMT),the Stroop test, Verbal fluency,Auditory verbal memory test and Digit span. Self-Rating Anxiety Scale, Self-Rating Depression Scale, as well as Mini Mental State were used in JME patients for mood and intelligent test and the comparative study of cognitive function has been carried out in 63 cases of newly diagnosed JME patients and 63 healthy volunteers. At the same time, the factors that may affect cognitive functions such as the patient’s age, gender, educational level, with or without a family history of epilepsy, EEG conditions, duration, age of onset and frequency of attacks were also analyzed.Results:Compared with the control group, patients in the test group exhibit worse performances in type A connection time (P<0.01) and B-type connection time (P<0.01), the time of card A、card B, and the correct number of card B、card C in Stroop-test (p<0.01), total vocabulary word of verbal fluency (P<0.01), the immediately and delayed recall of auditory verbal memory test(P<0.01), forward and backward digit spans (p<0.01);The difference was statistically significant. However,there was no statistically significant difference in intelligence and mood test(P> 0.05). Correlation analysis showed that there were significant correlations between verbal memory and onset age(r=0.443, p<0.05). There were no significant differences in the attention and executive function.Conclusions:The newly diagnosed patients with juvenile myoclonic epilepsy may exhibit impaired cognitive function in terms of memory and attention and execution, while having normal intelligence and mood.PART TWO:NEUROPSYCHOLOGICAL ASSESSMENT IN CHILDREN WITH ABSENCE EPILEPSYObjective:To study cognitive function in children with absence epilepsy.Methods:Neuropsychological tests were performed in CAE patients, include Trail making test (TMT),the Stroop test, Verbal fluency,Auditory verbal memory test and Digit span. Self-Rating Anxiety Scale, Self-Rating Depression Scale, as well as Mini Mental State were used in CAE patients for mood and intelligent test. A comparative study of cognitive function has been carried out in 25 cases of newly diagnosed CAE patients and 25 healthy volunteers.Results:Compared with the control group, patients in the test group exhibit worse performances in type A connection time (P<0.01) and B-type connection time (P<0.01), the time of card A、card B, and the correct number of card B、card C in Stroop-test(p<0.01), total vocabulary word of verbal fluency (P<0.01), the immediately and delayed recall of auditory verbal memory test(P<0.01), forward and backward digit spans (p<0.01), intelligence test; The difference was statistically significant. However,there was no statistically significant difference in mood test(P>0.05).Conclusions:Children with absence epilepsy may exhibit impaired cognitive function in global terms rather than specific lateralizing defcits.PART THREE:fMRI STUDY OF THE NEWIY DIAGNOSED JUVENILE MYOCLONIC EPILEPSYObjective:To study of resting-state networks in the newly diagnosed juvenile myoclonic epilepsy by using fMRI and to explorer the pathophysiological mechanism of cognitive impairment.Methods:23 cases of JME patients and 23 cases of healthy controls were included in the study, and the whole brain data were collected by using rs -fMRI, then fALFF method was used to analysis the brain activity in JME patients and healthy controls under the resting-state. And build brain function network to analysis abnormal brain networks in JME patients. The whole brain 3D T1WI images of JME patients and healthy controls were also collected, and then observe the cortex thickness difference of JME patients and healthy controls through cortex morphology method.Results:Compared with the control group, JME patients had lower fALFF value in following regions:left medial superior frontal gyrus、right inferior parietal lobule. The higher fALFF value in following regions:right fusiform、left precentral gyrus、left postcentral gyrus. The higher ReHo value in following regions:left inferior temporal gyrus、right precentral gyrus. The lower ReHo value in following regions:left anterior cingulate cortex and the left frontal central. The left orbital frontal Hub region disappeared. The decreased cortical thickness regions is located in right angular gyrus, right middle temporal gyrus and right inferior temporal gyrus. The difference was statistically significant (P<0.01)Conclusions:The resting-state networks in the newly diagnosed juvenile myoclonic epilepsy were abnormal, which led to cognitive impairment in memory, attention and execution.