颞叶癫痫患者认知损害和定量脑电功率的相关性研究  

Correlation between cognitive impairment and power of quantitative electroencephalogram in patients with temporal lobe epilepsy

作　　者：宋春杰 徐海清[2] 李俊 仲银节 Song Chunjie;Xu Haiqing;Li Jun;Zhong Yinjie(Department of Neurology,Suqian First Hospital,Suqian,Jiangsu 223899,China;Department of Neurology,Xuzhou Central Hospital,Xuzhou,Jiangsu 221009,China)

机构地区：[1]江苏省宿迁市第一人民医院神经内科,223899 [2]江苏省徐州市中心医院神经内科,221009

出　　处：《中华神经科杂志》2019年第7期531-536,共6页Chinese Journal of Neurology

摘　　要：目的评价颞叶癫痫患者认知损害和定量脑电图脑电功率之间的相关性。方法选取2017年1月至2018年6月连续在宿迁市第一人民医院门诊就诊或住院治疗的颞叶癫痫患者55例及40名健康对照人群,对所有患者进行简易精神状态检查(MMSE)和简易认知量表(BCB)检查,并进行定量脑电图监测,计算半球间各脑区功率谱比值差值(Dv-PSR)、半球内各脑区相对颞区Dv-PSR,并进行统计学分析。结果颞叶癫痫患者和健康对照组MMSE评分分别为(26.9±2.4)分和(27.3±2.6)分,差异无统计学意义(t=0.502,P=0.549)。BCB9项测试结果显示,颞叶癫痫患者即刻记忆、随意记忆、延迟记忆、词语流畅性、学习测试、再识别测试6项检测结果(分)低于健康对照组(分别为7.34±1.33与8.92±1.37、6.05±1.12与7.93±1.20、6.77±1.08与8.19±1.14、11.87±4.47与16.8±4.56、8.52±1.74与9.75±1.36、8.74±1.19与9.87±1.18,t=2.916、Z=3.204、t=2.549、Z=3.937、t=1.341、t=2.791,均P<0.05);颞叶癫痫患者半球间额区、中央区、顶区、颞区的Dv-PSR均高于健康对照组(分别为0.478±0.043与0.252±0.028、0.441±0.051与0.306±0.039、0.394±0.027与0.247±0.018、0.511±0.036与0.224±0.021,t=3.711、2.403、3.144、4.327,均P<0.05);颞叶癫痫患者半球内额区、中央区、顶区、枕区相对颞区的Dv-PSR亦均高于健康对照组(分别为0.521±0.024与0.221±0.017、0.249±0.012与0.167±0.008、0.187±0.013与0.104±0.007、0.313±0.021与0.127±0.009,t=4.208、3.192、2.611、3.737,均P<0.05)。Spearman相关性分析显示,BCB多项认知域测试值下降和半球间Dv-PSR具有正相关性(均P<0.05),BCB多项认知域测试值下降和半球内Dv-PSR同样具有正相关性(均P<0.05)。结论颞叶癫痫患者存在以记忆下降为特点的轻度认知损害,且和定量脑电图检查Dv-PSR存在相关性,提示定量脑电图Dv-PSR检查可用于颞叶癫痫患者认知损害的筛查。Objective To assess cognitive impairment and its correlation with power of quantitative electroencephalogram (qEEG) in patients with temporal lobe epilepsy (TLE). Methods Fifty-five patients with TLE seen consecutively in Suqian First Hospital and 40 healthy controls (HC) were assessed by Mini-Mental State Examination (MMSE), Brief Cognitive Battery (BCB) and qEEG. The global interhemispheric and intrahemispheric difference values for power spectral ratios (Dv-PSR) were calculated. Cognitive functions and Dv-PSR of the TLE patients and the HC were compared, and correlation between cognitive impairment and power of qEEG was assessed using Spearman correlation analysis. The significance level was set at P≤0.05. Results Statistical analysis showed that MMSE scores did not have statistically significant difference between the TLE patients and the HC (26.9±2.4 vs 27.3±2.6,t=0.502,P=0.549). However, BCB examination showed that immediate memory, incidental memory, delayed recall, learning test,verbal fluency and recognition differed significantly between the TLE and the HC groups (7.34±1.33 vs 8.92±1.37,6.05±1.12 vs 7.93±1.20,6.77±1.08 vs 8.19±1.14,11.87±4.47 vs 16.8±4.56,8.52±1.74 vs 9.75±1.36, 8.74±1.19 vs 9.87±1.18, respectively;t=2.916, Z=3.204, t=2.549, Z=3.937, t=1.341, t=2.791, P<0.05). Interhemispheric Dv-PSR in frontal, central, temporal and parietal area was higher in the TLE group than in the HC group (0.478±0.043 vs 0.252±0.028,0.441±0.051 vs 0.306±0.039,0.394±0.027 vs 0.247±0.018,0.511±0.036 vs 0.224±0.021,respectively;t=3.711,2.403,3.144,4.327,P<0.05),and intrahemispheric Dv-PSR in frontal, central, parietal and occipital area (minus temporal area respectively) was also higher in the TLE group than in the HC group (0.521±0.024 vs 0.221±0.017, 0.249±0.012 vs 0.167±0.008, 0.187±0.013 vs 0.104±0.007, 0.313±0.021 vs 0.127±0.009, respectively;t=4.208, 3.192, 2.611, 3.737, P<0.05). Spearman analysis showed positive correlations between intrahemispheric, interhemispheric Dv-PSR and

关 键 词：癫痫 颞叶 脑电描记术 认知障碍 

分 类 号：R742.1[医药卫生—神经病学与精神病学]