The Study On The Correlation Between HMGB1-mediated Inflammatory Response And Cognitive Impairment In Epilepsy Comorbidity

Objective: Epilepsy is one of the most common neurological diseases in clinic,and epilepsy and cognitive dysfunction are common,but their mechanism and risk factors are not clear.Inflammatory response may be involved in the development of cognitive impairment in epilepsy.This study discusses the correlation between high mobility group box protein 1(HMGB1)and its related inflammatory factors and epilepsy.Methods: A cross-sectional study was used for analysis.In this study,130 adult patients with epilepsy who attended outpatient clinics at Shengjing Hospital of China Medical University from September 2021 to September 2022 were collected.Fifty healthy subjects who were mutually matched with the case group patients in terms of gender,age,education level and place of residence were also selected.General clinical information was collected and a comprehensive and detailed cognitive,psychological and quality of life assessment was conducted using the Montreal Cognitive Assessment Test(MOCA),the Mini-mental State Examination(MMSE),the Auditory-Verbal Learning Test(AVLT),the Digital Span test(DST),the Digital Elimination test(DET),the Verbal fluency test(VFT),the Boston Naming Test(BNT),the Generalized Anxiety Disorder-7(GAD-7),the Patient Health Questionnaire-9(PHQ-9)and the Quality of Life Questionnaire(SF-12).Patients with epilepsy were grouped according to MOCA scores and analysed for overall comparison,while serum levels of inflammatory factors such as HMGB1 were measured in both groups.Risk factors associated with co-morbid cognitive impairment in epilepsy patients were identified and the correlation between inflammatory factors such as HMGB1 and co-morbid cognitive impairment in epilepsy was further analysed.Results: Cognitive function was significantly reduced in adults with epilepsy compared to healthy controls(P< 0.05).Cognitive impairment including verbal ability,numeracy,attention,transient memory,and short-term memory were severely impaired(P < 0.01).Age,duration of illness,education,type of occupation,and abnormal VEEG discharge were risk factors associated with co-morbid cognitive impairment in patients with epilepsy(P < 0.05).Analysis of laboratory findings in patients with epilepsy revealed that serum levels of HMGB1,NF-κB,IL-1β,IL-6 and TNF-α were significantly higher in the cognitively impaired group compared to the cognitively normal group(P < 0.05),with HMGB1 correlating with co-morbid cognitive impairment in patients with epilepsy(R = 0.327,P < 0.05).Conclusion: Cognitive impairment is one of the common comorbidities of epilepsy.Age,course of disease,education level,occupation type,VEEG epileptic discharge and HMGB1-related inflammatory factors were clearly correlated with cognitive impairment in epileptic patients,and our results suggest that HMGB1-mediated inflammatory pathways may be involved in cognitive dysfunction in patients with epilepsy.