耐药型癫痫患者EEG功率谱变化与认知损伤分级的相关性  

Correlation between EEG power spectrum changes and cognitive impairment grade in drug-resistant epilepsy patients

作　　者：陈悦 王轶男 吴阳 王恒 樊红彬 Chen Yue;Wang Yinan;Wu Yang;Wang Heng;Fan Hongbin(Department of Neurology,Xuzhou Medical University,Jiangsu 221002,China)

机构地区：[1]徐州医科大学第一临床学院,江苏221002 [2]徐州医科大学附属医院神经内科

出　　处：《脑与神经疾病杂志》2025年第1期7-14,共8页Journal of Brain and Nervous Diseases

基　　金：江苏省自然科学基金项目(BK20221221)。

摘　　要：目的探究耐药性癫痫(DRE)患者脑电图(EEG)功率谱变化与认知损伤分级的相关性。方法选择2021年1月-2024年1月于徐州医科大学附属医院神经内科就诊的DRE患者79例(DRE组,n=79)和同时期体检的健康人群82例(健康组,n=82)为研究对象,比较两组临床资料和EEG功率谱的差异进行认知测试。根据认知损伤程度将DRE患者分为轻度认知损伤组(n=21)、中度认知损伤组(n=27)、重度认知损伤组(n=34)。采用相关性分析对EEG指标与患者认知水平的相关性进行分析;采用有序Logistic回归分析EEG功率谱对认知损害程度的影响。结果DRE组患者前额区(θ)、前额区(β2)、额区(α1)、颞区(δ)、枕区(β2)及枕区(δ)均显著高于健康组(^(均)P<0.05),中央-顶区(α2)和颞区(β1)显著低于健康组(^(均)P<0.05),记忆商、图像自由回忆、无意义图像再认、言语流畅性测试、顺背及倒背均低于健康组(^(均)P<0.05),重度认知损伤组患者前额区RP(β2)、中央-顶区AP(α2)及枕区RP(δ)显著低于轻度认知损伤组和中度认知损伤组(^(均)P<0.05)。相关性分析显示,MoCA与额区AP(α1)和枕区RP(δ)呈正相关,记忆商与颞区AP(δ)呈正相关,图像自由回忆与额区AP(α1)、颞区RP(β1)及枕区RP(δ)呈负相关,无意义图像再认与前额区RP(β2)、枕区AP(β2)呈正相关,言语流畅性测试与颞区AP(δ)和颞区AP(δ)呈负相关。有序Logistic回归分析显示,前额区RP(β2)、中央-顶区AP(α2)、枕区RP(δ)是认知损害程度的保护因素。结论DRE患者EEG功率谱变化与认知损伤分级之间存在显著的相关性,随着认知损伤程度的加重,EEG的异常程度也会增加。Objective To explore the correlation of electroencephalogram(EEG)power spectrum change and cognitive impairment grade in drug-resistant epilepsy(DRE).Methods A total of 79 DRE patients(drugresistant epilepsy group,n=79)and 82 healthy people(healthy group,n=82)who underwent physical examination during the same period from January 2021 to January 2024 in the Department of Neurology,Affiliated Hospital of Xuzhou Medical University were selected as the study objects.Clinical data and EEG power spertrum changes were compared and cognitive tests were performed.The patients with drug-resistant epilepsy were divided into mild cognitive impairment group(n=21),moderate cognitive impairment group(n=27)and severe cognitive impairment group(n=34)according to the degree of cognitive impairment.The correlation between EEG and cognitive level of patients was analyzed by Pearson carrelation analysis.The degree of cognitive impairment induced by EEG was analyzed by ordered Logistic regression.Results The frontal(θ)of drug resistant epilepsy,frontal(β2)frontal(α1),temporal(δ)and occipital(β2)(δ)were significantly higher than the healthy group(^(all)P<0.05),Centraltop(α2)and temporal(β1)were significantly lower than in the healthy group(^(all)P<0.05),Memory quotient,image free remeaningless image rerecognition,verbal fluency test,smooth back and backward back were all lower than the healthy group(^(all)P<0.05),The RP(β2),central-apical AP(α2)and RP(δ)were significantly lower than the MCI and moderate cognitive impairment groups(~(al)lP<0.05).Correlation analysis showed that MoCA was positively correlated with frontal AP(α1)and occipital RP(δ),memory quotient with temporal AP(δ),image free recall with frontal AP(α1),temporal RP(β1),and occipital RP(δ),nonsense image recognition positively correlated with frontal RP(β2)and occipital AP(β2),and verbal fluency test negatively correlated with temporal AP(δ)and temporal AP(δ).Orderly regression analysis showed that frontal RP(β2),central-apical AP(α2),and occipital

关 键 词：耐药性癫痫 脑电图变化 认知损伤分级 相关性 

分 类 号：R742.1[医药卫生—神经病学与精神病学]