新诊断良性癫痫伴中央颞区棘波儿童的认知特征  

Cognitive profile of children with newly onset benign epilepsy with centro-temporal spikes before treatment： a study of computerized cognitive testing in epilepsy

作　　者：陈倩[1] 程大志[1] 郑彤[1] 高志杰[1] 张桂榛[1] 闫秀贤[1] 周新林[2] 罗桂芳[1] 许克铭[1] 

机构地区：[1]首都儿科研究所附属儿童医院神经内科,北京100020 [2]北京师范大学认知神经科学与学习国家重点实验室

出　　处：《中华儿科杂志》2015年第10期754-759,共6页Chinese Journal of Pediatrics

摘　　要：目的 观察新诊断尚未治疗的良性癫痫伴中央颞区棘波（BECTs）儿童的认知特征.方法 采用癫痫计算机化认知任务测试的方法（CCTE）对2012年10月至2014年5月首都儿科研究所门诊41例新诊断尚未服用抗癫痫药物的BECTs患儿进行测试.其中男20例、女21例;平均年龄（8.2±1.7）岁,起病年龄4.5 ～11.5岁（起病年龄＜8岁者25例,起病年龄≥8岁者16例）;病程0.1～9.1年.对41例患儿进行9项认知心理测试,并选择41名2013年7月至2014年3月北京市普通小学募集的年龄性别相匹配的健康儿童作为对照,其中男20名、女21名,平均年龄（9.0±1.8）岁.分析BECTs组患儿认知特征及其影响因素.采用SPSS 18.0统计软件对两组儿童认知任务测试的答题正确数及反应时间作为原始数据进行处理,两组间测试成绩中的正确题数及反应时间分别采用独立样本t检验.结果 两组儿童测验9项认知任务所得原始数据为连续变量,经检验均符合正态分布,BECTs组患儿选择反应时所用时间、三维心理旋转成绩、视觉追踪成绩3项任务测验的成绩均低于对照组[（618±158）比（524±254）ms、（11±10）比（18±12）分、（10±6）比（15±6）分,t =2.01、3.03、3.47,P＜0.05、＜0.01、＜0.01];其余6项任务测试成绩两组间差异均无统计学意义（P均＞0.05）.BECTs男性患儿简单减法的标准九分值低于女性患儿[（4.7±1.5）分比（5.6±1.2）分,t=-2.24,P＜0.05];其余8项认知测试标准九得分男女两组差异亦均无统计学意义（P均＞0.05）.起病年龄＜8岁组BECTs患儿与≥8岁起病的患儿两组儿童9项测试的标准九分值差异均无统计学意义（P均＞0.05）.BECTs患儿简单减法任务测试在脑电图慢波睡眠期棘慢波放电优势侧别各组间差异有统计学意义（P＜0.05）,双侧放电的BECTs患儿简单减法测验得分分别显著低于左侧或右侧放电占优的患儿[（4.7±1.2）比（6.0±1.2）比（Objective Benign epilepsy with centro-temporal spikes （BECTs） is a common idiopathic partial epileptic syndrome in childhood,which often affect the pre-school and school-age children and a considerable proportion have comorbidity including lower academic achievement and cognitive impairment.Few studies involved the psychocognitive assessment in such a drug-treatable epileptic syndrome especially in the newly diagnosed and medications-naive group.This study aimed to investigate the cognitive characteristics of children with newly onset BECTs before treatment.Method Forty-one outpatients with newly diagnosed BECTs who visited the Clinic during the periods from October 2012 to May 2014 before the medications against epilepsy and 41 healthy controls recruited from regular school in Beijing during the period from July 2013 to March 2014,who matched in age and gender underwent battery testing by computerized cognitive testing in epilepsy （CCTE）.The BECTs group included 41 children,20 boys and 21 girls,mean age （8.2 ± 1.7） years,the age of onset of epilepsy 4.5-11.5 years （the age of onset 〈 8 years in 25 cases,≥ 8 years in 16 cases）.The cognitive characteristics and associated factors were analyzed.The primary data including correct answer numbers and reaction times were analyzed by independent sample t-test between the two groups of children with BECTs and healthy controls based on SPSS 18.0 statistical software.Result Raw data of 9 tasks＇ scores collected from BECTs and healthy control children were continuous variables in accordance with normal distribution.BECTs children performed significantly worse than controls in choice reaction time（（618 ＋ 158）vs.（524 ＋254） ms）,three-dimensional mental rotation （11 ±10vs.18±12） and visual tracing （10±6 vs.15±6）,t=2.01,3.03 and3.47,P〈0.05,〈0.01 and 〈 0.001,respectively.While other 6 tasks showed no significant difference between the two groups （P 〉0.05 for all comparisons）.BECTs boys performed significantly worse th

关 键 词：认知 神经心理学测验 癫痫 运动性 中央颞区棘波 

分 类 号：R742.1[医药卫生—神经病学与精神病学]