The Impact Of Sleep Disorders And Epileptic Discharges During Sleep On Cognitive Function In Patients With Medial Temporal Lobe Epilepsy

Objective: 1.To clarify the sleep disorders and sleep structural changes in patients with medial temporal lobe epilepsy(MTLE).2.To identify the alterations in cognitive function of patients with MTLE.3.To determine the pattern of epileptic discharges in EEG in each sleep stage of patients with MTLE.4.To investigate the impacts of sleep disorders and EEG epileptic discharges during sleep on cognitive function in patients with MTLE.Methods: 14 patients with MTLE and 11 healthy controls were collected.All the subjects in 2 groups were subjected to polysomnography(PSG),Montreal Cognitive Assessment Scale(MOCA),Pittsburgh Sleep Quality Scale,PSG monitoring indexes including total time(TIB)in bed,sleep efficiency(SE),sleep wake up time(WASO),sleep latency(SL),total sleep time(TST)incubation period,REM sleep phases(REML),non-rem sleep(NREM)sleep phase 1,2,3,and REM sleep phases(REM)and the percentage of total stage in time(to respectively N1%,n2%,n3%,REM%,apnea hypopnea index(AHI),arousal index,hourly periodic limb movement index(PLMs/h),average blood oxygen saturation(Sp O2)and minimum Sp O2 etc and data were compared between 2 groups.The patients with MTLE received 2h-video electroencephalography(2h v EEG)monitoring simultaneously,and quantitative analysis of EEG epileptic discharges during each sleep stage in PSG was performed,in the end correlation analysis were performed between sleep disorders,epileptic discharges during sleep and cognitive function in patients with MTLE.Results: 1.Compared with the control group,the total time in bed(TIB)in MTLE group was prolonged,the REML was prolonged,N1 period was prolonged and REM period was shortened.2.The total score of Montreal Cognitive Assessment Scale(22.9 vs26.5,P<0.05),memory score(1.9 vs 4.5,P<0.01)and language score(1.7 vs 2.9,P<0.01)in MTLE group were significantly lower than those in the control group.3.In MTLE group,the discharge index((0.48%%)in NREM phase had the tendency to be higher than that in REM phase(0.12%),and the discharge index in N1(0.23%)and N2(0.16%)phase had the tendency to be higher than that in N3phase(0.09%),and the discharge index in REM phase(0.12%)also had the tendency to be higher than that in N3 phase(0.09%),but without statistical significance(P all > 0.05).The discharge index in N1 phase was significant higher than that in REM phase(0.23% vs 0.12%,P<0.05).4.In MTLE group,the discharge index in total sleep phase(r=-0.60,P < 0.05),N1(r=-0.63,P < 0.05),N2(r=-0.56,P < 0.05),and N3 phase(r=-0.58,P < 0.05)were negatively correlated with language score respectively.In MTLE group,PSG parameters,N2% was negatively correlated with cognitive function(r=-0.68,P < 0.01)and memory score(r=-0.61,P < 0.05),REM% were positively correlated with cognitive function(r= 0.57,P < 0.05)and memory score(r= 0.73,P < 0.01).5.In MTLE group,the age was negatively correlated with memory score(r=-0.68,P < 0.01),language score(r=-0.68,P < 0.01),and total cognitive function score(r=-0.75,P <0.01).Conclusions: 1.Patients with MTLE have sleep disorders and sleep structural disturbances?2.Patients with MTLE were also associated with cognitive decline.3.The epileptic discharge index are different between different sleep stages,and the discharge index in N1 was significant higher than that in REM phase.4.The discharge index in total sleep phase,N1,N2,N3 phase were negatively correlated with language function respectively.N2% was negatively correlated with cognitive function and memory function,while REM% was positively correlated with cognitive function and memory function.