作为癫痫复发标志的癫痫发病时认知功能障碍

IF 2 4区医学 Q3 CLINICAL NEUROLOGY

Epilepsy Research Pub Date : 2024-02-28 DOI:10.1016/j.eplepsyres.2024.107335

Antonina Omisade , Madison Nugent , Christopher O’Grady , Kristin Ikeda , Stephanie Woodroffe , Karen Legg , Matthias Schmidt , Krista Biggs

{"title":"作为癫痫复发标志的癫痫发病时认知功能障碍","authors":"Antonina Omisade , Madison Nugent , Christopher O’Grady , Kristin Ikeda , Stephanie Woodroffe , Karen Legg , Matthias Schmidt , Krista Biggs","doi":"10.1016/j.eplepsyres.2024.107335","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><p>Cognitive dysfunction has been correlated with seizure control in chronic epilepsy and in newly diagnosed epilepsy, which potentially makes it a good marker for predicting disease course and seizure control. However, there is a lack of prospective studies examining the role of cognitive dysfunction in predicting seizure recurrence at the earliest stages of the disease, such as following the first unprovoked seizure (UFS) or new onset epilepsy (NOE).</p></div><div><h3>Methods</h3><p>Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit.</p></div><div><h3>Results</h3><p>Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed.</p></div><div><h3>Conclusions</h3><p>Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.</p></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"202 ","pages":"Article 107335"},"PeriodicalIF":2.0000,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Cognitive dysfunction at epilepsy onset as a marker for seizure recurrence\",\"authors\":\"Antonina Omisade , Madison Nugent , Christopher O’Grady , Kristin Ikeda , Stephanie Woodroffe , Karen Legg , Matthias Schmidt , Krista Biggs\",\"doi\":\"10.1016/j.eplepsyres.2024.107335\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><p>Cognitive dysfunction has been correlated with seizure control in chronic epilepsy and in newly diagnosed epilepsy, which potentially makes it a good marker for predicting disease course and seizure control. However, there is a lack of prospective studies examining the role of cognitive dysfunction in predicting seizure recurrence at the earliest stages of the disease, such as following the first unprovoked seizure (UFS) or new onset epilepsy (NOE).</p></div><div><h3>Methods</h3><p>Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit.</p></div><div><h3>Results</h3><p>Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed.</p></div><div><h3>Conclusions</h3><p>Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.</p></div>\",\"PeriodicalId\":11914,\"journal\":{\"name\":\"Epilepsy Research\",\"volume\":\"202 \",\"pages\":\"Article 107335\"},\"PeriodicalIF\":2.0000,\"publicationDate\":\"2024-02-28\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Epilepsy Research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0920121124000500\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"CLINICAL NEUROLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epilepsy Research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0920121124000500","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}

引用次数: 0

摘要

认知功能障碍与慢性癫痫和新诊断癫痫的发作控制有关，这可能使其成为预测疾病进程和发作控制的良好标志。然而，目前还缺乏前瞻性研究来探讨认知功能障碍在疾病最早阶段（如首次无诱因癫痫发作（UFS）或新发癫痫（NOE）之后）预测癫痫复发的作用。我们从哈利法克斯首次癫痫发作诊所（HFSC）招募了 33 名成年参与者（FS=18 人，NOE=15 人），并对他们进行了为期 12 个月的随访。所有人都在基线（通常在确诊后 3 个月）完成了认知筛查评估；在首次 HFSC 就诊一年后对癫痫复发情况进行了评估。在随访时，76% 的癫痫复发患者和 55% 的无癫痫复发患者出现了认知障碍，认知障碍的定义是相对于已公布的测试标准，至少有一项 Z 分数处于受损范围（≤-1.5）。速度/执行功能和记忆力是最常受影响的领域，在整个样本中分别有35%和29%的患者表现受损。虽然癫痫复发组与未复发组在任何特定认知领域受损的可能性上没有显著差异，但癫痫复发的回归模型（包括受教育年限、基线情绪和焦虑评分、正常与异常基线磁共振成像以及六个认知领域的功能受损（与未受损））总体上是显著的（Χ2 (10) = 24.04, p =.007*, R2N =.77）。去除认知变量后，回归模型不再显著。癫痫早期患者普遍存在细微的认知功能障碍，尤其是在执行功能和记忆领域。除了基线时异常的磁共振成像和脑电图检查结果（这在 FS 和 NOE 中要少得多）之外，认知因素在帮助预测这些人群的癫痫复发方面也大有可为。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

查看原文本刊更多论文

Cognitive dysfunction at epilepsy onset as a marker for seizure recurrence

Background

Cognitive dysfunction has been correlated with seizure control in chronic epilepsy and in newly diagnosed epilepsy, which potentially makes it a good marker for predicting disease course and seizure control. However, there is a lack of prospective studies examining the role of cognitive dysfunction in predicting seizure recurrence at the earliest stages of the disease, such as following the first unprovoked seizure (UFS) or new onset epilepsy (NOE).

Methods

Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit.

Results

Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed.

Conclusions

Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

Epilepsy Research 医学-临床神经学

CiteScore

0.10

自引率

4.50%

发文量

143

审稿时长

62 days

期刊介绍： Epilepsy Research provides for publication of high quality articles in both basic and clinical epilepsy research, with a special emphasis on translational research that ultimately relates to epilepsy as a human condition. The journal is intended to provide a forum for reporting the best and most rigorous epilepsy research from all disciplines ranging from biophysics and molecular biology to epidemiological and psychosocial research. As such the journal will publish original papers relevant to epilepsy from any scientific discipline and also studies of a multidisciplinary nature. Clinical and experimental research papers adopting fresh conceptual approaches to the study of epilepsy and its treatment are encouraged. The overriding criteria for publication are novelty, significant clinical or experimental relevance, and interest to a multidisciplinary audience in the broad arena of epilepsy. Review articles focused on any topic of epilepsy research will also be considered, but only if they present an exceptionally clear synthesis of current knowledge and future directions of a research area, based on a critical assessment of the available data or on hypotheses that are likely to stimulate more critical thinking and further advances in an area of epilepsy research.