Study Of Cognitive Function Features And Related Factors In Temporal Lobe And Frontal Lobe Epilepsy

Objective:To investigate the features of cognitive function and related factors in Temporal lobe and Frontal lobe epilepsy.Methods:35subjects with TLE,30with FLE, and30control subjects underwent neuropsypsychological assessment of attension, executive functions, and memory components. A battery of neutopsychologic tests comprise Working memory test, Auditory Verbal Memoty Test(AVMT), Digital symbol test(WAIS-C), Trail making test (TMT), Rey-Osterrieth Complax figure test (CFT-R-O), Stroop color words test(SCW), Verbal Fluency Test (VF), Block pattern(WAIS-C). All subjects are right-handed,and have no serious cognitive disorder (MMSE>24). The relation between the scores of neuropsychologic tests and the factors was analysed by linear correlation or rank correlation.Results:Compared to the control group, both TLE and FLE were impaired in attention,executive functions,memory, seveal cognitive function deficit greater in FLE than TLE(Working memory test, Stroop color words test, the forgetting of CFT-R-O,Block pattern). Education(r=-0.600-0.537, P<0.05), the unnormal of back-ground activity(r=-0.504-0.705, P<0.05), the account of antiepileptic drugs(r=-0.523-0.375, P<0.05), the changes of interictal EEG(r=-0.404-0.338, P<0.05), HAMA (r=0.361-0.407, p<0.05)、BDI(r=0.335-0.346, P<0.05)were related to the cognitive function of TLE, especially education and the unnormal of background activity. Education was more likely to affect the attention test(β数字符号转换=2.235),the unnormal of background activity was more likely to affect Shifting/Switching tests(β连线A时间=16.635,β连线B时间=38.797,β转移注意时间=20.770). Education(r=-0.501-0.761, P<0.05), the unnormal of background activity(r=-0.868-0.554, P<0.05), the course of epilepsy (r=-0.630-0.744, P<0.05), the account of antiepileptic drugs(r=-0.764-0.403, P<0.05),the duration of seizure(r=-0.543-0.482, P<0.05),the type of seizure(r=-0.488-0.535, P<0.05), HAMA(r=-0.568-0.571, P<0.05) were related to the cognitive function of TLE. Education was more likely to affect Shifting/Switching tests(β连线A时间=-4.554, β连线B时间=-5.423), the unnormal of background activity was more likely to affect verbal memory tests(βAVMT短延迟回忆=-5.421,βAVMT长延迟回忆=-6.271),HAMA was more likely to affect the attention test(β�'清测试=-3.230),the account of antiepileptic drugs was more likely to affect the Shifting/Switching tests(β转移注意时间=-20.480).Conclusion:Both TLE and FLE have widely cognition deficts. seveal cognitive function deficit greater in FLE than TLE.Education,the unnormal of background activity,the course of epilepsy,the account of antiepileptic drugs,anxious or depression were well correlated with the cognitive impairment. Studying the mechanism of the cognition deficts of epilepsy,choicing a reasonable treatment perscription to control the seazures and subclinical seazures,avoiding polypharmacy are the importent premise of avoiding or reducing the cognition deficts of epilepsy.Improve the education of child epilepsy is also an effective method to reduce the influence of epilepsy clinical factors that could impair the cognitive function of epilepsy.