Anna Sákovics , Gábor Csukly , Csaba Borbély , Anna Kelemen , Zsófia Jordán , Boglárka Hajnal , Johanna Petra Szabó , Loránd Erőss , Dániel Fabó
{"title":"癫痫样放电是局灶性癫痫记忆障碍最重要的混杂因素","authors":"Anna Sákovics , Gábor Csukly , Csaba Borbély , Anna Kelemen , Zsófia Jordán , Boglárka Hajnal , Johanna Petra Szabó , Loránd Erőss , Dániel Fabó","doi":"10.1016/j.eplepsyres.2025.107636","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>Cognitive disturbances are highly prevalent in focal epilepsy and are often attributed to multifactorial causes, though the specific contributions of various predictors remain poorly understood. This study aimed to identify and prioritize factors contributing to memory deficits in temporal lobe epilepsy, with a particular emphasis on interictal epileptiform discharges (IED).</div></div><div><h3>Methods</h3><div>In a cohort of 48 patients with temporal lobe epilepsy undergoing presurgical evaluation with invasive foramen ovale electrodes, we examined offline memory performance alongside language and attention as controls. Cognitive performance was correlated with mesial temporal IED rates recorded over 24 h and additional factors, including seizure characteristics, age at onset, epilepsy duration, temporal lobe lesions, and antiseizure medication use.</div></div><div><h3>Results</h3><div>A robust negative correlation emerged between mesial temporal IED rates and hippocampal-dependent cognitive scores (r = -0.43 - −0.29, p < 0.05), suggesting a direct impact of IEDs on memory consolidation processes. Epilepsy duration, antiseizure medication use and generalized seizures showed limited associations, but other variables including seizure frequency did not significantly correlate with cognitive performance.</div></div><div><h3>Significance</h3><div>Our findings suggest that IEDs may be the most relevant confounding factor contributing to sustained cognitive deficits in focal epilepsy. While IEDs are recognized markers of transient cognitive disruption, they have not yet demonstrated sufficient sensitivity or specificity as biomarkers of long-term cognitive dysfunction. Our study highlights the potential of IED frequency as a practical, clinically accessible biomarker for predicting chronic cognitive decline. These results emphasize the importance of developing targeted therapeutic strategies aimed at reducing interictal activity to improve cognitive outcomes.</div></div>","PeriodicalId":11914,"journal":{"name":"Epilepsy Research","volume":"218 ","pages":"Article 107636"},"PeriodicalIF":2.0000,"publicationDate":"2025-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Interictal epileptiform discharges as the most significant confounding factor underlying memory impairment in focal epilepsy\",\"authors\":\"Anna Sákovics , Gábor Csukly , Csaba Borbély , Anna Kelemen , Zsófia Jordán , Boglárka Hajnal , Johanna Petra Szabó , Loránd Erőss , Dániel Fabó\",\"doi\":\"10.1016/j.eplepsyres.2025.107636\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>Cognitive disturbances are highly prevalent in focal epilepsy and are often attributed to multifactorial causes, though the specific contributions of various predictors remain poorly understood. This study aimed to identify and prioritize factors contributing to memory deficits in temporal lobe epilepsy, with a particular emphasis on interictal epileptiform discharges (IED).</div></div><div><h3>Methods</h3><div>In a cohort of 48 patients with temporal lobe epilepsy undergoing presurgical evaluation with invasive foramen ovale electrodes, we examined offline memory performance alongside language and attention as controls. Cognitive performance was correlated with mesial temporal IED rates recorded over 24 h and additional factors, including seizure characteristics, age at onset, epilepsy duration, temporal lobe lesions, and antiseizure medication use.</div></div><div><h3>Results</h3><div>A robust negative correlation emerged between mesial temporal IED rates and hippocampal-dependent cognitive scores (r = -0.43 - −0.29, p < 0.05), suggesting a direct impact of IEDs on memory consolidation processes. Epilepsy duration, antiseizure medication use and generalized seizures showed limited associations, but other variables including seizure frequency did not significantly correlate with cognitive performance.</div></div><div><h3>Significance</h3><div>Our findings suggest that IEDs may be the most relevant confounding factor contributing to sustained cognitive deficits in focal epilepsy. While IEDs are recognized markers of transient cognitive disruption, they have not yet demonstrated sufficient sensitivity or specificity as biomarkers of long-term cognitive dysfunction. Our study highlights the potential of IED frequency as a practical, clinically accessible biomarker for predicting chronic cognitive decline. 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Interictal epileptiform discharges as the most significant confounding factor underlying memory impairment in focal epilepsy
Background
Cognitive disturbances are highly prevalent in focal epilepsy and are often attributed to multifactorial causes, though the specific contributions of various predictors remain poorly understood. This study aimed to identify and prioritize factors contributing to memory deficits in temporal lobe epilepsy, with a particular emphasis on interictal epileptiform discharges (IED).
Methods
In a cohort of 48 patients with temporal lobe epilepsy undergoing presurgical evaluation with invasive foramen ovale electrodes, we examined offline memory performance alongside language and attention as controls. Cognitive performance was correlated with mesial temporal IED rates recorded over 24 h and additional factors, including seizure characteristics, age at onset, epilepsy duration, temporal lobe lesions, and antiseizure medication use.
Results
A robust negative correlation emerged between mesial temporal IED rates and hippocampal-dependent cognitive scores (r = -0.43 - −0.29, p < 0.05), suggesting a direct impact of IEDs on memory consolidation processes. Epilepsy duration, antiseizure medication use and generalized seizures showed limited associations, but other variables including seizure frequency did not significantly correlate with cognitive performance.
Significance
Our findings suggest that IEDs may be the most relevant confounding factor contributing to sustained cognitive deficits in focal epilepsy. While IEDs are recognized markers of transient cognitive disruption, they have not yet demonstrated sufficient sensitivity or specificity as biomarkers of long-term cognitive dysfunction. Our study highlights the potential of IED frequency as a practical, clinically accessible biomarker for predicting chronic cognitive decline. These results emphasize the importance of developing targeted therapeutic strategies aimed at reducing interictal activity to improve cognitive outcomes.
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.