Correlational Study Of Attention Function And Attention Networks In Patients With Epilepsy

Obstract:We study the attentional function and attention networks in patients with epilepsy to explore the characters of the attentional function and attention networks, find the Electrophysiological index of the attentional impairment for epilepsy patients, and analyse the relation of attentional function and attention networks so that we can provide a good fundation for the further study of the attentional function and attention networks in patients with epilepsy. Methods:Selected inpatients and outpatients as a case group of 69 cases. Selected 35 healthy volunteers whose age, sex and average schooling years are similar with the case group as normal control group. None of the volunteers in the control group had neuropathy or mental disorder history. All of the patients had CT or MRI head check. The general cognitive function of the subjects were assessed by Montreal Cognitive Assessment(Moca Beijing version). All the patients and the volunteers did Stroop, Continuous Performance Test(CPT) and dual task to assess their selected attention,sustained attention and divided attention. Collected their reaction time and false rate under incongruous, congruous and neutral conditions in Stroop, and calculated their respective interfered effect; Collected the reaction time, missing response rate and false response rate of CPT; Collected the boxes crossed and right rate of digit strings during single task and dual task and calculated their respective dual task decrement;Meanwhile they did Attention Networks Test (ANT). Calculated each patient's reaction time of orienting, alerting, excutive control network, the average response time and accuracy. Results:1. The comparative analysis of groups:(1)The results of Montreal Cognitive Assessment:epilepsy patients had obvious cognitive disorder in executive, attention and delayed memory(P<0.05), but no cognitive disorder in abstract, orientation, naming and verbalization(P>0.05). (2) Stroop test for access selected attention:the reaction time for epilepsy group prolonged significantly than control group under incongruous condition(P<0.01), error rate increased significantly under incongruous, congruous and neutral conditions(P<0.01). Reaction time interfered effects and error interfered effects increased significantly under incongruous and neutral conditions(P<0.01). (3) CPT for access sustained attention:The reaction time for epilepsy group prolonged significantly than control group(P<0.01), and the omission rate increased(P<0.05). (4) Dual task for divided attention:the boxes crossed and right rate of digit strings decreased and decrement increased during dual task than single task(P<0.01). (5) ANT:the rate of executive control network decreased for epilepsy group than control group and their mean reaction time prolonged significantly(P<0.01).The alerting and orienting network showed no significant difference between epilepsy group and control group.2. The variables related to the results of the analysis:(1) The alerting network has direct correlation to the error interfered effects of Stroop and CPT reaction time in epilepsy group; the alerting network has direct correlation to the time interfered effects of Stroop in control group. (2) The orienting network has direct correlation to the time interfered effects of Stroop in epilepsy group and control group. (3) The executive control network has direct correlation to the time interfered effects, error interfered effects of Stroop and CPT reaction time in epilepsy group; the executive control network has direct correlation to the CPT reaction time in control group. Conclusion:1. The results of Montreal Cognitive Assessment demonstrate that the executive, attention and delayed memory functions of the epilepsy patients decrease, but the abstract, orientation, naming and verbalization functions remain.2. The results of Stroop, CPT and dual task demonstrate that the selected attention, sustained attention and divided attention have all been damaged in epilepsy patients.3. The results of ANT demonstrate that the rate of executive control network decreased and mean reaction time prolonged for epilepsy patients. The alerting and orienting network showed no significant difference. It demonstrate that the executive control network of epilepsy patients has been damaged but the functions of alerting and orienting network remain.4. For epilepsy patients, the alerting and executive control network have good correlation to the index of Stroop and CPT, and the orienting network has good correlation to the index of Stroop. It demonstrate that the alerting and executive control network have correlation to selected attention and sustained attention and the orienting network has correlation to sustained attention. Attention network mainly reflex selected attention, and sustained attention comes the next, and divided attention worse relatively. ANT can be regarded as an electrophysiology index which reflexes the epilepsy patients' attentional function especially the selected attention function. In the future, we can combine the test of attentional function and attention network in order to reflex the impairment of epilepsy patients more roundly.