| 高怡珂,高岭,申改青,等.儿童癫痫病人的长程视频脑电图特征与认知功能障碍的关联性研究[J].安徽医药,2025,29(10):2017-2021. |
| 儿童癫痫病人的长程视频脑电图特征与认知功能障碍的关联性研究 |
| Correlation between long-term video electroencephalography and cognitive dysfunction in children with epilepsy |
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| DOI：10.3969/j.issn.1009-6469.2025.10.021 |
| 中文关键词: 癫痫 长程视频脑电图 认知功能障碍 多因素 logistic回归分析 神经心理测验 儿童 |
| 英文关键词: Epilepsy Long-term video electroencephalography Cognitive dysfunction Multivariate Logistic regression analy-sis Neuropsychological test Child |
| 基金项目:河南省医学科技攻关计划联合共建项目( LHGJ20221043) |
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| 中文摘要: |
| 目的深入探讨儿童癫痫病人的长程视频脑电图( vEEG)特征与其认知功能障碍之间的关联性。方法纳入 2022年 1月至 2023年 1月于南阳市第一人民医院就诊的 60例癫痫诊断明确的儿童病人，年龄范围为 6~16岁。根据癫痫发作类型将病人分为部分性发作组与全面性发作组，根据年龄将病人分为 6~11岁组与 >11~16岁组。所有受试者均接受了为期 48 h的 vEEG监测，并进行了标准化的认知功能评估，包括韦氏儿童智力量表(WISC)、持续注意力测试(CPT)和儿童记忆量表( CMS)。使用 Pearson相关性分析评估 vEEG特征(异常放电频率、持续时间及其在额叶、颞叶等脑区的分布)与认知功能测试结果( WISC、 CPT、CMS)之间的相关性。采用多因素 logistic回归分析进一步评估影响认知功能障碍的独立危险因素。结果部分性发作病人的异常放电频率( 5.3±0.3)次 /小时和持续时间［12.0(11.5，12.5)s］较全面性发作病人低［(5.9±0.5)次/时， 13.1(12.8，13.4)s］(P<0.05)；同时， 6~11岁部分性发作病人的 WISC全量智商评分为( 91.0±5.1)分，高于全面性发作组( 81.6±4.8)分， CPT错误率分别为( 15.7±1.0)%与( 18.2±1.2)%，CMS视觉记忆得分为 86.5(85.0，88.0)分与 82.7(81.0，84.0)分，均差异有统计学意义( P< 0.05)。 Pearson相关性分析结果表明，儿童癫痫病人异常放电频率、持续时间、额叶与颞叶异常放电频率与 WISC、CPT、CMS各项评分均呈显著的负相关( P<0.05)。多因素 logistic回归分析结果显示，异常放电频率［OR=1.48，95%CI:(1.15，1.91)，P<0.05］、持续时间［OR=1.35，95%CI:(1.09，1.68)P<0.05］以及额叶［OR=1.55，95%CI:(1.23，1.96)，P<0.05］和颞叶［OR=1.42，95%CI:(1.14，1.76)，P<0.05］区域的异常放电都是，认知功能障碍的独立危险因素。结论儿童癫痫病人的长程视频脑电图特征与其认知功能障碍密切相关。高频且持续地异常放电，尤其在额叶和颞叶区域的放电，可能是认知功能受损的重要因素。 |
| 英文摘要: |
| Objective To explore the correlation between long-term video electroencephalogram (vEEG) characteristics and cognitive dysfunction in children with epilepsy. Methods This study included 60 children with confirmed epilepsy diagnoses, aged 6 to 16 years, who were treated at Nanyang First People's Hospital from January 2022 to January 2023. Patients were divided into partial sei-zure and generalized seizure groups based on the type of seizure and into 6-11 years and 12-16 years groups based on age. All subjects underwent 48-hour vEEG monitoring and standardized cognitive function assessments, including the Wechsler Intelligence Scale forChildren (WISC), Continuous Performance Test (CPT), and Children's Memory Scale (CMS). Pearson correlation analysis was used toassess the relationship between vEEG characteristics (seizure frequency, duration, and distribution in brain regions such as the frontaland temporal lobes) and cognitive function test results (WISC, CPT, CMS). Multivariate Logistic regression analysis was used to furtherevaluate independent risk factors for cognitive dysfunction.Results The frequency of abnormal discharges in the partial seizure group(5.3±0.3) times/hour and their duration [12.0 (11.5, 12.5) seconds] were significantly lower than those in the generalized seizure group[5.9±0.5) times/hour; 13.1 (12.8, 13.4) seconds] (P<0.05). Among children aged 6-11 years, the partial seizure group showed signifi-cantly higher scores in WISC full-scale IQ [(91.0±5.1) point vs. (81.6±4.8) point], lower CPT error rate [(15.7±1.0)% vs. (18.2±1.2%)], and better CMS visual memory scores [86.5 (85.0, 88.0) point vs. 82.7 (81.0, 84.0) point] compared with the generalized seizure group (all P<0.05). Pearson correlation analysis revealed significant negative correlations between vEEG features (including discharge fre-quency, duration, and distribution in the frontal and temporal lobes) and cognitive test performance (WISC, CPT, CMS) (P<0.05). Multi-variate Logistic regression analysis indicated that seizure frequency [OR = 1.48, 95%CI: (1.15, 1.91), P < 0.05], duration [OR = 1.35, 95%CI: (1.09, 1.68), P < 0.05], and abnormal discharges in the frontal [OR = 1.55, 95%CI: (1.23, 1.96), P < 0.05] and temporal lobes [OR = 1.42, 95%CI: (1.14, 1.76), P < 0.05] were independent risk factors for cognitive dysfunction.Conclusions The long-term vEEG characteristics of children with epilepsy are closely related to their cognitive dysfunction. High-frequency and continuous abnormal dis-charges, especially in the frontal and temporal lobe areas, may be an important factor in impaired cognitive function. |
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