Study Of Relationship And Influence Factors Between Leukocyte Telomere Length And Neurobehavioral Comorbidities Of Epilepsy

BackgroundEpilepsy is a costly and complicated major public health problem.In addition to recurrent seizures,neurobehavioral comorbidities of epilepsies(NCE)is one of the major factors,which increase the burden of disease,especially cognitive impairment,anxiety and depression.Because of ignorance and delay,NCE frequently brings negative effects on prolonging the course,postponing the treatment,reducing the quality of life and increasing the mortality of epilepsy.Leukocyte telomere length(LTL)has been approved as a risky prognostic marker of various diseases,such as dementia(DA),mild cognitive impairment(MCI),Major Depression(MDD)and anxiety.However,no evidences support whether LTL is shortened in patients with NCE.Therefore,we investigated the influent factors of NCE and further sought to determine whether LTL is a potential specific biomarkers of NCE.Methods42 patients diagnosed epilepsy were investigated at the Department of Neurology in the First Affiliated Hospital of Xi'an Medical University from November,2015 to March,2017.44 healthy volunteers matched in age,sex and edueation level are recruited as control group,which are from family numbers of epilepsy patients.All participants were obtained demographic and clinical information,assessed with montreal cognitive assessment(MoCA),hamilton anxiety scale(HAMA)and hamilton depression scale(HAMD),and detected the level of LTL by real-time quantitative PCR(RT-qPCR)together.Statistical analysis included Single sample Kolmogorov-Smirnov test,Mann-Whitney test,t-test,Chi square test,analysis of variance(ANOVA),Person correlation analysis,Spearman correlation analysis,partial correlation and multiple linear regression analysis.Results1)The incidence of NCE in epilepsy group was 57.1%.The incidence of cognitive impairment,anxiety and depression was 52.4%,38.1% and 40.5% respectively,which were significantly higher than control group;2)NCE is affected by social demographic factors(education level),clinical features of epilepsy(course of disease,initiation /recurrence,seizure frequency and duration)and side3)effects of AEDs;4)The existence of NCE is a risk factor for other neurobehavioral comorbidities.Cognitive impairment is negatively correlated with anxiety and depression,anxiety is positively correlated with depression.HAMD score can enter the regression equation with MoCA and HAMA as dependent variable,and the HAMA score can enter the regression equation with HAMD as dependent variable.5)LTL was significantly reduced in patients with epilepsy.LTL is affected by age,education years and the cumulative effect of seizures.The low education level and high seizure frequency are the risk factors of LTL shorten.6)LTL was significantly shortened in patients with cognitive impairment,anxiety and depression.LTL is positively correlated with MoCA score,negatively correlated with HAMA score and HAMD score,LTL can enter the regression equation with MoCA score,HAMA score and HAMD score as dependent variable.ConclusionsNCE is a common complication of epilepsy,which associated with social demographic factors,clinical features,AEDs and other neurobehavioral comorbidities.There is a biphase relationship between cognitive impairment,anxiety and depression,which promote each other.In this work,we confirmed LTL can reflect the severity of epilepsy and NCE,and closely associated with low education level and high seizure frequency.In addition,LTL can predict the risk of cognitive impairment,and anxiety and depression of epilepsy patients and may become a specific biomarker for NCE to support clinical diagnosis,treatment and assessment.