Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy_Journal of Epilepsy

Authors：

HU Xu , DONG Jirong , XU Feng , SUN Shibai , XU Xiaomei ,  WANG Yuhai

Department of Neurosurgery, 904th Hospital of PLA, Wuxi 214044, China;

Corresponding?author：

WANG Yuhai, Email: wangyuhai67@126.com

Keywords：

Post-traumatic epilepsy; Cognitive impairment; Risk factors

DOI：

10.7507/2096-0247.202209008

Video：

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Objective To analyze the related factors of cognitive impairment in patients with post-traumatic epilepsy. Methods From January 2016 to January 2019, 45 patients with post-traumatic epilepsy (epilepsy group) and 48 patients with physical examination (control group) at the Department of Neurosurgery, the 904th Hospital of PLA were analyzed retrospectively. Cognitive assessment were evaluated by the following scales: Montreal cognitive assessment (MoCA), Mini-mental state examination (MMSE), Audio verbal memory test (AVMT), Rey-osterrieth complex figure test (CFT) and Trail making test (TMT). Then we analyzed the influences of gender, age, course of disease, cause, type, degree and location of injury, seizure frequency and Anti-seizure medications (ASMs) on cognitive impairment. Results The results showed that there were significant differences between the epilepsy group and the control group in all scales (P<0.01). Analysis of influencing factors in epilepsy group showed: MoCA and MMSE scores: there were statistical significance in the comparison of seizure frequency and injury degree (P<0.05); AVMT, CFT and TMT scores: there were statistical significance in the comparison of seizure frequency, injury degree and location, ASMs within the group (P<0.05). Conclusion Post-traumatic epilepsy can cause cognitive impairment. The more frequent epileptic seizures and the more severe the degree of trauma, the more serious the cognitive impairment. Different injury sites affect the scope of cognitive impairment, temporal lobe injury is easy to cause memory function decline, frontal lobe injury is easy to cause spatial structure and executive ability decline, at the same time, the combined use of ASMs has an impact on cognitive function.

Citation： HU Xu, DONG Jirong, XU Feng, SUN Shibai, XU Xiaomei, WANG Yuhai. Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy. Journal of Epilepsy, 2023, 9(1): 26-32. doi: 10.7507/2096-0247.202209008 Copy

1.	Semple BD, Zamani A, Rayner G, et al. Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy. Neurobiology of Disease, 2019, 123: 27-41.
2.	Liu SY, Han XM, Yan YY, et al. Quality of life and its influencing factors in patients with post-traumatic epilepsy. Chinese Journal of Traumatology, 2011, 14(2): 100-103.
3.	郭起浩, 呂傳真, 洪震. 聽覺詞語記憶測驗在中國老人中的試用分析. 中國心理衛生雜志, 2001, 15(1): 13-15.
4.	郭起浩, 呂傳真, 洪震. Rey-Osterrith復雜圖形測驗在中國正常老人中的應用. 中國臨床心理學雜志, 2000, 8(4): 205-207.
5.	陸駿超, 郭起浩, 洪震. 連線測驗(中文修訂版)在早期識別阿爾茲海默病中的作用. 中國臨床心理學雜志, 2006, 14(2): 118-120.
6.	Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia, 1999, 40(5): 584-589.
7.	Englander J, Bushnik T, Duong TT, et al. Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Archives of Physical Medicine and Rehabilitation, 2003, 84(3): 365-373.
8.	Bushnik T, Englander J, Wright J, et al. Traumatic brain injury with and without late posttraumatic seizures. Journal of Head Trauma Rehabilitation, 2012, 27(6): E36-E44.
9.	Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia, 2003, 44(4): 569-574.
10.	虞培敏, 郭起浩, 丁玎, 等. 癲癇患者認知功能影響因素的研究. 中國臨床神經科學, 2007, 15(1): 41-45.
11.	劉陽, 孫濤, 徐文中, 等. 75例癲癇患者認知功能與影響因素分析. 臨床神經外科雜志, 2014, 11(6): 409-411.
12.	郭韜, 張波, 武江, 等. 藥物難治性額葉、顳葉癲癇患者認知功能評估及影響因素對照分析. 中華神經醫學雜志, 2016, 15(10): 1004-1010.
13.	Elger CE, Helmstaedter C, Kurthen M. Chronic epilepsy and cognition. The Lancet Neurology, 2004, 3(11): 663-672.
14.	Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8): S21-26.
15.	Piccenna L, Shears G, O’Brien TJ. Management of post-traumatic epilepsy: an evidence review over the last 5 years and future directions. Epilepsia Open, 2017, 2(2): 123-144.
16.	Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 18(7): 89.
17.	Rosenbaum RS, Moscovitch M, Foster JK, et al. Patterns of autobiographic memory loss in medial-temporal lobe amnesic patients. Journal of Cognitive Neuroscience, 2008, 20(8): 1490-1506.
18.	郭翠萍, 席春華, 朱幼玲, 等. 輕度認知功能損害患者的執行能力和工作記憶研究. 中華神經科雜志, 2009, 42(4): 237-240.
19.	Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
20.	Ventre-Dominey J, Bailly A, Lavenne F, et al. Double dissociation in neural correlates of visual working memory: a PET study. Cognitive Brain Research, 2005, 25(3): 747-759.
21.	Helmstaedter C, Witt JA, Ortinski P, et al. Comments on cognitive side effects of antiepileptic drugs. Epilepsy & Behavior, 2004, 5(Suppl. 1): 60-65. Epilepsy & Behavior, 2014, 40: 29-31.

1. Semple BD, Zamani A, Rayner G, et al. Affective, neurocognitive and psychosocial disorders associated with traumatic brain injury and post-traumatic epilepsy. Neurobiology of Disease, 2019, 123: 27-41.
2. Liu SY, Han XM, Yan YY, et al. Quality of life and its influencing factors in patients with post-traumatic epilepsy. Chinese Journal of Traumatology, 2011, 14(2): 100-103.
3. 郭起浩, 呂傳真, 洪震. 聽覺詞語記憶測驗在中國老人中的試用分析. 中國心理衛生雜志, 2001, 15(1): 13-15.
4. 郭起浩, 呂傳真, 洪震. Rey-Osterrith復雜圖形測驗在中國正常老人中的應用. 中國臨床心理學雜志, 2000, 8(4): 205-207.
5. 陸駿超, 郭起浩, 洪震. 連線測驗(中文修訂版)在早期識別阿爾茲海默病中的作用. 中國臨床心理學雜志, 2006, 14(2): 118-120.
6. Asikainen I, Kaste M, Sarna S. Early and late posttraumatic seizures in traumatic brain injury rehabilitation patients: brain injury factors causing late seizures and influence of seizures on long-term outcome. Epilepsia, 1999, 40(5): 584-589.
7. Englander J, Bushnik T, Duong TT, et al. Analyzing risk factors for late posttraumatic seizures: a prospective, multicenter investigation. Archives of Physical Medicine and Rehabilitation, 2003, 84(3): 365-373.
8. Bushnik T, Englander J, Wright J, et al. Traumatic brain injury with and without late posttraumatic seizures. Journal of Head Trauma Rehabilitation, 2012, 27(6): E36-E44.
9. Mazzini L, Cossa FM, Angelino E, et al. Posttraumatic epilepsy: neuroradiologic and neuropsychological assessment of long-term outcome. Epilepsia, 2003, 44(4): 569-574.
10. 虞培敏, 郭起浩, 丁玎, 等. 癲癇患者認知功能影響因素的研究. 中國臨床神經科學, 2007, 15(1): 41-45.
11. 劉陽, 孫濤, 徐文中, 等. 75例癲癇患者認知功能與影響因素分析. 臨床神經外科雜志, 2014, 11(6): 409-411.
12. 郭韜, 張波, 武江, 等. 藥物難治性額葉、顳葉癲癇患者認知功能評估及影響因素對照分析. 中華神經醫學雜志, 2016, 15(10): 1004-1010.
13. Elger CE, Helmstaedter C, Kurthen M. Chronic epilepsy and cognition. The Lancet Neurology, 2004, 3(11): 663-672.
14. Meador KJ. Cognitive outcomes and predictive factors in epilepsy. Neurology, 2002, 58(8): S21-26.
15. Piccenna L, Shears G, O’Brien TJ. Management of post-traumatic epilepsy: an evidence review over the last 5 years and future directions. Epilepsia Open, 2017, 2(2): 123-144.
16. Hunt RF, Boychuk JA, Smith BN. Neural circuit mechanisms of post–traumatic epilepsy. Frontiers in Cellular Neuroscience, 2013, 18(7): 89.
17. Rosenbaum RS, Moscovitch M, Foster JK, et al. Patterns of autobiographic memory loss in medial-temporal lobe amnesic patients. Journal of Cognitive Neuroscience, 2008, 20(8): 1490-1506.
18. 郭翠萍, 席春華, 朱幼玲, 等. 輕度認知功能損害患者的執行能力和工作記憶研究. 中華神經科雜志, 2009, 42(4): 237-240.
19. Lucke-Wold BP, Nguyen L, Turner RC, et al. Traumatic brain injury and epilepsy: Underlying mechanisms leading to seizure. Seizure, 2015, 33: 13-23.
20. Ventre-Dominey J, Bailly A, Lavenne F, et al. Double dissociation in neural correlates of visual working memory: a PET study. Cognitive Brain Research, 2005, 25(3): 747-759.
21. Helmstaedter C, Witt JA, Ortinski P, et al. Comments on cognitive side effects of antiepileptic drugs. Epilepsy & Behavior, 2004, 5(Suppl. 1): 60-65. Epilepsy & Behavior, 2014, 40: 29-31.

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Analysis of influencing factors of cognitive impairment after post-traumatic epilepsy

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