The Study On Cognitive Impairment、serum BDNF And IGF-Ⅰ Levels And Drug Intervention

BACKGROUND:Epilepsy which is a common chronic disease of nervous system showed repeated seizures caused by abnormal discharge of neurons, its influence on cognitive function caused more and more attention by the medical profession Domestic epidemiological investigation shows that the incidence of epilepsy is5‰～7‰, the country has about6.5～9.1million epilepsy patients, of which30%～40%has cognitive dysfunction. Cognitive impairment of epilepsy patients with cognitive impairment includes many aspects, the difficulty in finding the word, short-term memory impairment, inability to concentrate, decreased learning ability, slow thinking activities and more syntax errors,etc. The extent and manifestations of epilepsy-related cognitive dysfunction vary greatly in different populations, it still persists even if the seizure is under control or mitigated and seriously affect the quality of life of patients with epilepsy. With the change of the modern medical pattern, the target of epilepsy treatment and rehabilitation is no longer limited to the control of the attack and remission of symptoms, but committed to the improvement or recovery of patient’s health status.PART ONERelation between serum BDNF and IGF-1levels and cognitive function level in adult epilepsy patientsObjective To discuss the relationship between serum Brain-derived neurotrophic factor(BDNF) and Insulin-like growth factor-1(IGF-1) levels and cognitive function level in adult epilepsy patients, and to analyze the factors that influence cognitive function.Methods We adopted the Montreal Cognitive Assessment (MoCA) scores to assess the cognitive function level of96adult epilepsy patients and90normal people. The concentration of BDNF and IGF-1in the serum were detected by enzyme-linked immunosorbent assay(ELISA).Results1.The scores of MoCA scores, execution of view space, attention, language and delayed memory is lower in adult epilepsy patients than the control group(p<0.05);2.The serum levels of BDNF and IGF-1in the epilepsy group were lower than those in the normal group(p<0.05);3.MoCA scores of patients with epilepsy were negatively correlated with the course, attack frequency(p<0.05), and were positively correlated with years of education and serumIGF-1(p<0.05). And gender, age, serum BDNF seizure type, antiepileptic drugs, the electroencephalogram change, thermal convulsions history and family history were not significantly correlation (P>0.05)Conclusion Adult epilepsy patients were prone to cognitive impairment, cognitive function scores and serum IGF-1levels were positively correlated, serum IGF-1can be used as the molecular biological indicator of cognitive impairment, there was no significant correlation between serum BDNF level and cognitive function in patients with epilepsy. PART TWOEffects of idebenone on cognitive function and quality of life in epilepsy patientsObjective To explore the effects of idebenone on the cognitive function and the quality of life in epilepsy patients.Methods Sixty epilepsy patients with sodium valproate treatment were enrolled who were randomly divided into a research group and a treatment group. In the treatment group only sodium valproate were used, while in the research group idebenone (30mg per day, p.o.)was given besides the routine treatment. The mini-mental state examination (MMSE), Wisconsin card sorting test (WCST) and the quality of life in epilepsy inventory(QOLIE-31)on the60cases of epilepsy patients and30normal controls were assessed before and after the treatment with idebenone.Results1.Before treatment the scores of MMSE. WCST and the QOL1E-31scores in research group and treatment group were significantly lower than that in control group (P<0.05);2.The treatment caused a significant changes of MMSE, the correct number, continuous wrong number, random errors number in WCST in research group (P<0.05), for the quality of life, significant improvements were recorded in the fields of the overall quality of life, the satisfaction of life, energy and cognitive score (P<0.05);3.After treatment the scores of MMSE, WCST and the QOLIE-31scores in the treatment group is no significant differences than that before treatment (P>0.05).Conclusion The treatment of idebenone can effectively improve the cognitive function.