儿童期自限性局灶性癫痫睡眠期持续棘慢波激活损伤注意网络功能  

Persistent spike-and-slow wave activations during sleep in childhood self-limiting focal epilepsy impair the attention network function

作　　者：汪晓翠 李梦宁 吴璐璐 杨阳 叶小飞 杨斌 Wang Xiaocui;Li Mengning;Wu Lulu;Yang Yang;Ye Xiaofei;Yang Bin(Department of Child Neurology,Anhui Provincial Children′s Hospital/Children's Hospital of Fudan University,Hefei,Anhui 230051,China)

机构地区：[1]复旦大学附属儿科医院安徽医院,安徽省儿童医院儿童神经科,安徽合肥230051

出　　处：《中国微侵袭神经外科杂志》2024年第5期261-266,共6页Chinese Journal of Minimally Invasive Neurosurgery

基　　金：安徽省卫生计生科研资助项目(编号:2017ek003)。

摘　　要：目的研究儿童期自限性局灶性癫痫(self-limited focal epilepsies,SeLFE)脑电图合并睡眠期持续棘慢波激活患儿的注意网络功能特征。方法运用注意网络测试(attention networks test,ANT),对SeLFE组(n=54)和健康对照组(n=55)进行ANT,收集ANT参数与非快速眼动睡眠期(non-rapid eye movement,NREM)的脑电图棘慢波指数(spike and wave index,SWI)等数据并进行统计学分析。结果ANT正确率:SeLFE组为(92.96±6.93)%,健康对照组为(98.05±2.19)%;SeLFE组低于健康对照组,差异有统计学意义(t=-5.150,P<0.05)。ANT总平均反应时间:SeLFE组为(987.46±189.45)ms,对照组为(788.73±181.42)ms,SeLFE组长于对照组,差异有统计学意义(t=5.594,P<0.05)。执行功能网络效率:SeLFE组为76.00(21.50,110.75)ms,对照组为54.00(-4.00,89.00)ms,SeLFE组长于对照组,差异有统计学意义(t=-2.151,P=0.031)。警觉网络效率、定向网络效率,两组比较差异无统计学意义(P>0.05)。ANT正确率:高SWI组(NREM期SWI>60%组)为(90.89±7.52)%,低SWI组(SWI≤60%组)为(95.04±5.71)%,高SWI组低于低SWI组,差异有统计学意义(t=-2.284,P<0.05)。多重线性回归分析及Kendall tau-b相关分析均提示SWI影响ANT总平均正确率(F=2.664,P=0.021;Kendall tau-b=-0.331,P=0.001),而不影响总平均反应时间。结论SeLFE组患儿有注意网络功能损害,以执行控制网络损害为主,且SWI影响ANT总平均正确率。Objective To investigate the characteristics of attention network function in children with self-limited focal epilepsies(SeLFE)with EEG combined with persistent spike-and-slow wave activation during sleep.Methods The attention networks test(ANT)was performed to assess the attention network function in the SeLFE group(n=54)and the healthy control group(n=55),and the ANT parameters and the electroencephalogram(EEG)spike and wave index(SWI)during non-rapid eye movement(NREM)sleep period were collected and statistically analyzed.Results The accuracy rate of the ANT was 92.96%±6.93%in the SeLFE group and(98.05%±2.19%)in the healthy control group,showing a statistically significant difference(t=-5.150,P<0.05).The total average response time of the ANT was(987.46±189.45)ms in the SeLFE group and(788.73±181.42)ms in the control group,with the SeLFE group having a longer response time and a statistically significant difference(t=5.594,P<0.05).The execution function network efficiency was 76.00(21.50,110.75)ms in the SeLFE group and 54.00(-4.00,89.00)ms in the control group,with the SeLFE group showing a longer time and a statistically significant difference(t=-2.151,P=0.031).There were no significant differences in alerting network efficiency or orienting network efficiency between the two groups(P>0.05).The accuracy rate of the ANT was 90.89%±7.52%in the high SWI group(NREM period SWI>60%)and 95.04%±5.71%in the low SWI group(SWI≤60%),with the high SWI group showing a lower accuracy rate and a statistically significant difference(t=-2.284,P<0.05).Both multiple linear regression analysis and Kendall tau-b correlation analysis indicated that the SWI affected the total average accuracy rate of the ANT(F=2.664,P=0.021;Kendall tau-b=-0.331,P=0.001),but did not affect the total average response time.Conclusions The children in the SeLFE group have attention network function impairment,and the execution control network damage is the main problem,and SWI affects the total average accuracy of ANT.

关 键 词：癫痫 睡眠期棘慢波激活 注意网络测试 

分 类 号：R742.1[医药卫生—神经病学与精神病学]