Neuropsychological Studies In Patients With Idiopathic Epilepsy

Introduction: Epilepsy is a common brain disease that is characterized by recurrent and spontaneous seizures that result from abnormal and excessive synchronization of neuronal activity.Epilepsy can occurs in any age,region,and ethnic group,but with a high incidence of children and adolescents.In China about 6 million of the patients with epilepsy still have an seizure each year,and 400 thousand of patients are newly diagnosised with epilepsy every year.Epilepsy has a serious negative impact on individuals,families,and society.About 60 percents of the patients with epilepsy arise from unknown causes,most of these patients were idiopathic epilepsy clinically.The cognitive function of idiopathic epilepsy is relatively less studied.At present,it is generally believed that cognitive function of idiopathic generalized epilepsy is lower than that of normal people,but it is still in the range of normal values.In this paper,we intends to reveal the social cognitive function of the patients with idiopathic epilepsy and explore its influencing factors by neuropsychological tests.Methods: The patients with idiopathic epilepsy in the Department of Neurology,the First Affiliated Hospital of Anhui Medical University,as well as the healthy control participant were selected.Social cognition were measured by eye emotion recognition task(eye basic emotion recognition,eye complex emotion recognition),empathy(Chinese version of the interpersonal relationship scale)and decision-making tests(Iowa gambling task,moral judgment).Frontal lobe function were measured by verbal fluency,Stroop,digit span,Wisconsin Card Sorting Test.Results: Study one found that the ability of eye emotion recognition and empathywerer impaired in patients with idiopathic generalized epilepsy and those impairments were corelated with their frontal lobe functions;Study two found that idiopathic epilepsy patients with frontal lobe interictal epileptiform discharges performenced worse than extra-frontal lobe interictal epileptiform discharges;Study three found that the idiopathic generalized epilepsy patients with interictal epileptiform discharges performed worse on executive function tests compared with patients without interictal epileptiform discharges,furthermore,the idiopathic generalized epilepsy patients without interictal epileptiform discharges performed worse compared with healthy controls;Study four found that patients with idiopathic epilepsy showed impaired function of risk decision;and study five found that idiopathic generalized epilepsy patients with impaired frontal lobe function choosed more utilitarian options than healthy controls in impersonal dilemmas but not in personal dilemmas.The performance of impersonal judgments were correlated with their frontal lobe function.Conclusion:In this paper,we using the method of neuropsychological tests to investigate the social cognition of patients with idiopathic epilepsy and found that idiopathic epilepsy patients have impaired empathy,emotion recognition,risk decision and moral judgment ability,indicating that the social cognition were widely impaired in patients with idiopathic epilepsy.The impairment of social cognition ability in patients with idiopathic epilepsy were closely related to their frontal lobe dysfunction,which suggests that the frontal lobe plays an important role in social cognitive processing.Epileptiform discharge and frontal lobe dysfunction in patients with idiopathic epilepsy is closely related,indicating that of epileptiform discharges in patients with idiopathic epilepsy may impair their social cognition through the frontal lobe dysfunction.