Abstract：
BACKGROUND: Cognitive dysfunction has been correlated with seizure control in chronic epilepsy and in newly diagnosed epilepsy, which potentially makes it a good marker for predicting disease course and seizure control. However, there is a lack of prospective studies examining the role of cognitive dysfunction in predicting seizure recurrence at the earliest stages of the disease, such as following the first unprovoked seizure (UFS) or new onset epilepsy (NOE).
METHODS: Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit.
RESULTS: Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed.
CONCLUSIONS: Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.
METHODS: Thirty three adult participants (FS=18, NOE=15) from the Halifax First Seizure Clinic (HFSC) completed a cognitive screening assessment at baseline (typically 3 months following diagnosis); seizure-recurrence was evaluated one year after the initial HFSC visit.
RESULTS: Cognitive impairment, defined as at least one z-score in the impaired range (≤-1.5) relative to published test norms, was documented in 76% of the patients with seizure recurrence at follow-up and in 55% without seizure recurrence. Speed/executive functions and Memory were the most frequently affected domains, with impaired performance noted in 35% and 29% of the entire sample, respectively. Although the seizure recurrence vs. non-recurrence groups did not differ significantly on likelihood of impairment in any specific cognitive domains, a regression model of seizure recurrence that included years of education, baseline mood and anxiety scores, normal vs. abnormal baseline MRI, and impaired (vs. unimpaired) function in six cognitive domains was significant overall (Χ2 (10) = 24.04, p =.007*, R2N =.77). The regression model was no longer significant with the cognitive variables removed.
CONCLUSIONS: Subtle cognitive dysfunction, especially in the domains of executive functions and memory are prevalent in individuals at the earliest stages of epilepsy. In addition to abnormal MRI and EEG findings at baseline, which are far less prevalent in FS and NOE, cognitive factors show promise in helping predict seizure recurrence in these populations.
摘要：
背景：认知功能障碍与慢性癫痫和新诊断的癫痫发作控制有关，这可能使其成为预测疾病进程和癫痫发作控制的良好指标。然而,缺乏前瞻性研究来研究认知功能障碍在预测疾病早期癫痫发作复发中的作用，例如在第一次无缘无故的癫痫发作（UFS）或新发作的癫痫（NOE）之后。
方法：来自哈利法克斯第一癫痫诊所（HFSC）的33名成年参与者（FS=18，NOE=15）在基线时（通常在诊断后3个月）完成了认知筛查评估；在初次HFSC就诊一年后评估癫痫复发。
结果：认知障碍，定义为相对于已发布的测试规范，在受损范围（≤-1.5）中至少有一个z分数，有记录显示76%的患者在随访时癫痫发作复发,55%的患者没有癫痫发作复发.速度/执行功能和记忆是最常受影响的领域，在整个样本的35%和29%中，性能受损，分别。虽然癫痫发作复发与非复发组在任何特定认知领域受损的可能性上没有显着差异，癫痫发作复发的回归模型，包括教育年限，基线情绪和焦虑评分，正常vs.基线MRI异常，和受损(vs.未受损)六个认知域的功能总体上是显著的(X2(10)=24.04，p=.007*，R2N=.77）。去除认知变量后，回归模型不再显著。
结论：微妙的认知功能障碍，特别是在执行功能和记忆领域普遍存在于癫痫早期阶段的个体中。除了基线时的异常MRI和EEG发现，在FS和NOE中不那么普遍，认知因素有望帮助预测这些人群的癫痫发作复发.
方法：来自哈利法克斯第一癫痫诊所（HFSC）的33名成年参与者（FS=18，NOE=15）在基线时（通常在诊断后3个月）完成了认知筛查评估；在初次HFSC就诊一年后评估癫痫复发。
结果：认知障碍，定义为相对于已发布的测试规范，在受损范围（≤-1.5）中至少有一个z分数，有记录显示76%的患者在随访时癫痫发作复发,55%的患者没有癫痫发作复发.速度/执行功能和记忆是最常受影响的领域，在整个样本的35%和29%中，性能受损，分别。虽然癫痫发作复发与非复发组在任何特定认知领域受损的可能性上没有显着差异，癫痫发作复发的回归模型，包括教育年限，基线情绪和焦虑评分，正常vs.基线MRI异常，和受损(vs.未受损)六个认知域的功能总体上是显著的(X2(10)=24.04，p=.007*，R2N=.77）。去除认知变量后，回归模型不再显著。
结论：微妙的认知功能障碍，特别是在执行功能和记忆领域普遍存在于癫痫早期阶段的个体中。除了基线时的异常MRI和EEG发现，在FS和NOE中不那么普遍，认知因素有望帮助预测这些人群的癫痫发作复发.
