P300 Waveform Analysis Of Temporal Lobe Epilepsy And Frontal Lobe Epilepsy

BackgroundThe study found that 50% of untreated patients with new onset epilepsy have cognitive impairment,which is not conducive to the improvement of epileptic symptoms and increase the disease burden.Therefore,early cognitive function evaluation is very important.Among the components of event-related potentials（ERPs）,the maximum late positive wave P300,with an latency of about 300 ms,is the most important component to evaluate cognitive processes such as attention and working memory.At present,the research on mild cognitive impairment believes that P300 is an objective and sensitive index to evaluate the decline of cognitive function.The purpose of this paper is to compare the cognitive function of patients with focal epilepsy originated from frontal and temporal lobes,and to explore the reasons for the differences of cognitive impairment.ObjectiveThe P300 waveform of patients with temporal lobe epilepsy and frontal lobe epilepsy was analyzed to explore whether they have cognitive impairment and the correlation of influencing factors.MethodsThe outpatient treatment or inpatient treatment of the Department of Neurology of the First Affiliated Hospital of Xinxiang Medical University from January 1,2019 to January 1,2021 were collected,and epilepsy was diagnosed by clinical and EEG examination according to the diagnostic criteria of the new classification of seizures and epilepsy of the International League Against Epilepsy（ILAE）in 2017,according to the evaluation of Montreal Cognitive Assessment（Mo CA）（Beijing version）,Hamilton Anxiety Scale（HAMA）,Hamilton Depression Scale（HAMD）,a total of 49 people who met the inclusion criteria were used as the case group.The informed consent of clinical trial shall be signed by the subject himself or his family.Subjects were divided into two subgroups based on seizure origin: temporal lobe epilepsy（TLE）group（n=26）and frontal lobe epilepsy（FLE）group（n=23）.At the same time,29 demographically matched healthy volunteers were selected as the control group.Baseline data of subjects were collected and evaluated by Mo CA（Beijing version）,HAMA and HAMD scales.Auditory stimulation was given according to Oddball paradigm,and the latent period and amplitude of P300 were examined and compared.SPSS 26.0 software was used to perform t test for the latency and amplitude of P300 among the three groups.Spearman correlation analysis and Pearson correlation analysis were used to analyze the correlation between P300 latency,wave amplitude and influencing factors.P<0.05 was considered statistically significant.Results1.General data: There were no significant differences in gender,age,handedness,years of education,Mo CA（Beijing version）,HAMA,HAMD,among the three groups.There were no significant differences in onset age,disease course,attack type and medication type between TLE group and FLE group（P>0.05）.2.Comparison of P300 latency and amplitude between the experimental group and the control group:Compared with the control group,the P300 latency in TLE group and FLE group was prolonged（F=42.85,P < 0.01）and the P300 amplitude was decreased（F=558.53,P<0.01）,with statistically significant differences.Compared with TLE group,the P300 latency in the FLE group was longer（t=-2.05,P=0.04）and the P300 amplitude was lower（t=0.20,P=0.03）,with statistically significant differences.3.Comparison of P300 latency and amplitude among different drug groups:Carbamazepine treatment group（latency t=-3.75,P=0.002;amplitude t=3.68,P=0.002）and levetiracetam treatment group（latency t=-4.53,P=0.005;amplitude t=6.70,P<0.01）compared with other drug treatment groups,P300 latency prolonged and P300 amplitude decreased,the differences were statistically significant.Compared with carbamazepine,the levetiracetam treatment group had shorter P300 latency（t=3.33,P=0.002）and higher P300amplitude（t=-3.42,P=0.002）,with statistically significant differences.4.Correlation analysis: P300 latency was positively correlated with the course of disease（r=0.747,P < 0.01）,P300 latency was positively correlated with bilateral tonic-clonic seizure（r=0.381,P=0.007）,P300 amplitude was negatively correlated with the course of disease（r=-0.747,P<0.01）,P300 amplitude was negatively correlated with focal to bilateral tonic-clonic seizures（r=-0.341,P=0.016）were negatively correlated.ConclusionsP300 showed that there was cognitive decline in patients with frontal and temporal focal epilepsy after neuropsychiatric scale screening,and the cognitive decline was more significant in patients with frontal lobe epilepsy.It was confirmed that THE P300 test can be used for the early evaluation of cognitive function in patients with epilepsy.