儿童颞叶癫癎及特发性癫癎对认知功能及情绪的影响

Effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children

摘要:

目的 评估儿童颞叶癫癎及特发性癫癎对认知及情绪的影响，并探索影响认知的危险因素。方法 回顾性分析38例颞叶癫癎、40例特发性癫癎患儿资料，招募42例健康儿童为对照组，每位受试者均行以下神经心理测试：蒙特利尔认知测评量表 （MoCA）、言语流畅性、数字广度、木块图、儿童社交焦虑量表 （SASC）、儿童抑郁障碍自评量表 （DSRSC）。结果 与对照组比较，颞叶癫癎组及特发性癫癎组MoCA、言语流畅性、数字广度、木块图得分均较低 （P <0.05）；SASC、DSRSC 得分均较高 （P <0.05）。颞叶癫癎组的MoCA、言语流畅性、数字广度、木块图得分均低于特发性癫癎组 （P <0.05），SASC、DSRSC 得分高于特发性癫癎组 （P <0.05）。颞叶癫癎组的MoCA 得分与SASC、DSRSC 及发作频率呈负相关 （r=-0.571，-0.529，-0.545，P <0.01）；特发性癫癎组的MoCA 得分与SASC、DSRSC 及发作频率呈负相关 （r=-0.542，-0.487，-0.555，P <0.01）。结论 颞叶癫癎、特发性癫癎患儿的整体认知及言语、记忆、执行功能均受损，并合并焦虑抑郁，尤其以颞叶癫癎更明显。较高水平的焦虑、抑郁及发作频率是影响认知的危险因素。

Abstract:

Objective To investigate the effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children and the risk factors for cognitive impairment. Methods A retrospective analysis was performed for the clinical data of 38 children with temporal lobe epilepsy and 40 children with idiopathic epilepsy. The controls were 42 healthy children. All subjects received the following neuropsychological tests: Montreal Cognitive Assessment (MoCA) scale, verbal fluency test, digit span test, block design test, Social Anxiety Scale for Children (SASC), and Depression Self-rating Scale for Children (DSRSC). Results Compared with the control group, the temporal lobe epilepsy and idiopathic epilepsy groups showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). Compared with the idiopathic epilepsy group, the temporal lobe epilepsy group showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (P<0.05) and significantly higher scores on SASC and DSRSC (P<0.05). In the temporal lobe epilepsy group, MoCA score was negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.571, -0.529, and -0.545 respectively; P<0.01). In the idiopathic epilepsy group, MoCA score was also negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.542, -0.487, and -0.555 respectively; P<0.01). Conclusions Children with temporal lobe epilepsy and idiopathic epilepsy show impaired whole cognition, verbal fluency, memory, and executive function and have anxiety and depression, which are more significant in children with temporal lobe epilepsy. High levels of anxiety, depression, and seizure frequency are risk factors for impaired cognitive function.