ObjectiveAnalyzing the seizure and cognitive outcome after different treatment by observation of a large group of intractable child epilepsy patients under 15 years old. MethodsCollecting data of children with Intractable epilepsy from Apirl 2008 to December 2013 in Sanbo Brain Hospital, Capital Medical University. Three historical cohorts of intractable child epilepsy defined by the final treatment including medication, curative operation and palliative operation depending on the surgical assessment and the families intension was retrospectively observed. 1 year and 3 years follow-up postoperatively were conducted including seizure outcome and cognitive outcome. ResultsThe curative operation group had significant better seizure free rate, and cognitive statement than medication group. And, the seizure free and cognitive outcome were better in palliative operation group than the medication group. ConclusionsEarly surgical intervention is highly recommended for intractable epilepsy chilelren in order to improve both the seizure and cognitive prognosis.
Objective This study aimed to observe the protective effects of 17β-estradiol (17β-E2) to the damage of phenobarbital (PB) upon the cognition of the newly-born rats. Methods Thirty healthy 3-day-old Sprague Dawley (SD) rats were randomly divided into 3 groups: control group (10 rats), PB group (10 rats) and PB+17β-E2 group (10 rats). The control group were injected saline water with a dose of 10 mL/(kg·d); the PB group were injected with PB of 10 mg/(kg·d); the PB+17β-E2 group were injected with PB 10 mg/(kg·d) and 17β-E2 300 ug/(kg·d). All the rats were intraperitoneal injected once a day after weighing, for three continuous days. They were normally raised to one month old and then 8 rats were selected out of each group respectively for water maze test. Results The PB group was reported to have increasing latent periods in finding the underwater stage compared with control group (P<0.05). In comparison with the PB group, the PB+17β-E2 group has a shorter latent period in finding the underwater stage, and furthermore statistically significantly fewer times in finding validation areas (P<0.05). During the 120s test, the stage quadrant journey to total journey ratio of PB+17β-E2 group was lower than the ratio of PB groups, but no statistics significance had been detected. The PB+17β-E2 group exhibits no significance difference from the control group in the above-mentioned indexes. Conclusions Even a short-term injection of PB with an usual clinical dose will bring a long-term damage to an immature brain in terms of the learning ability and memory, whereas the 17β-E2 may play a protective role in this course.
ObjectiveTo investigate the effects of hippocampal long-term potentiation (LTP) on cognitive dysfunction in immature epileptic rats. MethodsImmature epileptic rats were established by intraperitoneal injection of lithium chloride-pilocarpine (li-pilo). Racine classification standard modified by Becker was used to evaluate behavior of epileptic seizure, and the survival rats within RacineⅣmagnitude were selected in the experiment. The function of learning and memory of epileptic rats when they were adult was assessed using Morris water maze experiment, and their independent exploratory behavior was evaluated by the open-field test. Field potential was recorded by electrophysiological technology to detecte whether hippocampal LTP was essential of cognitive dysfunction. ResultsThe function of learning and memory was significantly impaired when compared with controls(n=8, t=10.86, P < 0.05;n=8, t=9.98, P < 0.05). In addition, independent exploratory behavior was significantly reduced when compared with controls(n=8, t=12.89, P < 0.05). Besides, CA1 hippocampal LTP induced by high-frequency stimulation presented the significant inhibition in epileptic rats with cognitive dysfunction when compared with controls(Slope:n=8, t=13.32, P < 0.05;Amplitude:n=8, t=20.02, P < 0.05). ConclusionInhibition of CA1 hippocampal LTP may be implicated in cognitive dysfunction of epileptic rats.
ObjectiveTo investigate the correlation and clinical significance of 8-hydroxydeoxyguanosine (8-OHdG) and endothelin-1 (ET-1) levels with cognitive dysfunction in patients with chronic obstructive pulmonary disease (COPD), and provide new idea for the prevention and treatment for cognitive dysfunction in COPD patients.MethodsA total of 103 COPD patients, according to the Montreal cognitive assessment scale standard for evaluation, were divided into a cognitive dysfunction group and a cognitive normal group. Serum 8-OHdG and ET-1 levels were compared between the two groups and their correlations with cognitive function were analyzed with the receiver operating characteristic (ROC) curve.ResultsThe levels of serum 8-OHdG and ET-1 in the COPD patients with cognitive impairment were significantly higher than those in the cognitive normal group ［8-OHdG: (13.91±9.04) ng/ml vs. (7.28±3.00) ng/ml; ET-1: (95.64±57.66)pg/ml vs. (69.20±7.89)pg/ml］ (both P<0.05). The levels of 8-OHdG (OR=22.94, 95%CI 7.06-74.53) and ET-1 (OR=19.76, 95%CI 6.59-59.31) were associated with cognitive impairment in the COPD patients. The areas under ROC curve of serum 8-OHdG and ET-1 levels to predict cognitive dysfunction in the COPD patients were 0.786 (95%CI 0.691-0.881) and 0.790(95%CI 0.695-0.885).ConclusionsThe serum levels of 8-OHdG and ET-1 are associated with cognitive impairment in COPD patients. The levels of 8-OHdG and ET-1 in serum can predict cognitive impairment with high specificity.
ObjectiveTo investigate the status of newly diagnosed adult epilepsy in the General Hospital of Jilin Province, in order to improve the prevention and treatment of epilepsy. MethodsTo collect the clinical data of newly diagnosed adult epilepsy from October 2016 to February 2017, and to follow up 6 months. ResultsA total of 81 patients were included. At the last clinic visit, 73 cases origined from focal, 74 cases were positive in EEG examination, 56 cases were unknown etiology, 12 cases had hippocampal sclerosis, 48 cases were mildly declined cognitive function, and 30 cases were poor compliance. ConclusionThe newly diagnosed epilepsy were focal origin, delayed treatment, mildly declined cognitive function and poor compliance.
ObjectiveTo explore the correlation between cognitive function and diffusion tensor imaging (DTI) in children with self-limited epilepsy with centrotemporal spikes (SelECTS). Methods A total of 28 children with SelECTS who visited our hospital from June 2020 to December 2022 were selected as the SelECTS group. An additional 28 healthy children of similar age and gender were selected as the control group. Cognitive function was assessed using the Wechsler Intelligence Scale for Children (WISC). The SelECTS group also underwent cranial DTI. The results of the WISC were then combined with DTI values for correlation analysis. Results Children in the SelECTS group exhibited varying degrees of cognitive deficits. Their full-scale IQ and verbal IQ were significantly lower than those of the control group (P<0.05). Specific cognitive domains, including classification, verbal comprehension, block design, knowledge, and comprehension, also showed significantly lower scores compared to the control group (P<0.05). DTI revealed significant microstructural changes in multiple regions of interest in the SelECTS group (P<0.05), and these changes were correlated with the results of several cognitive function tests. Conclusion Children with SelECTS have certain cognitive deficits. There is evidence of occult damage in brain white matter, and cognitive function is correlated with damage in specific brain regions.
Objective To investigate the characteristics of cognitive function and its correlation to neuroendocrine status in patients with refractory depression. Methods A total of 41 patients diagnosed by ICD-10 as depression onset who have been treated with more than two antidepressants drugs, fulfilled the criteria of refractory depression. Another 40 patients diagnosed by ICD-10 as depression onset but who have not been treated, or have been treated with only one antidepressant drug were selected as controls. Patients in both groups were evaluated by WAIS-RC, STROOP, VF, TRAILS A, B, TOH and M-WCST, and the concentrations of CORT, ACTH, T3, FT3, T4, FT4, TSH were also determined. Results A significant difference was found in VF between the refractory depression group and the control group. This showed that the damage to short-term memory, attention and interference rejection capability was much more serious in the refractory depression group. The ACTH concentration in the refractory depression group was significantly different from that of the control group, which indicated that the damage to the Hypothalamic-pituitary-adrenal axis was more serious in the refractory depression group. In particular in relation to memory and attention defect. Conclusion Changes in the levels of CORT, ACTH, TSH, FT3 and T4 may be correlated to cognitive function damage in patients with refractory depression.
Nowadays, an increasing number of researches have shown that epilepsy, as a kind of neural network disease, not only affects the brain region of seizure onset, but also remote regions at which the brain network structures are damaged or dysfunctional. These changes are associated with abnormal network of epilepsy. Resting-state network is closely related to human cognitive function and plays an important role in cognitive process. Cognitive dysfunction, a common comorbidity of epilepsy, has adverse impacts on life quality of patients with epilepsy. The mechanism of cognitive dysfunction in epileptic patients is still incomprehensible, but the change of resting-state brain network may be associated with their cognitive impairment. In order to further understand the changes of resting-state network associated with the cognitive function and explore the brain network mechanism of the occurrence of cognitive dysfunction in patients with epilepsy, we review the related researches in recent years.
Epilepsy is defined as a disorder of brain neural function, characterized by the persistent possibility of seizures, which are usually sudden, brief, and recurrent. Cognition is a process of receiving information from the external world and analyzing and processing it, such as memory, language, visual-spatial, executive, calculation, comprehension, and judgement. With the increasing awareness of health, more and more scholars have begun to pay attention to the relationship between cognitive dysfunction and epilepsy. Data shows that over 80% of epilepsy patients have lower cognitive abilities than healthy people, and over 50% of patients have significant cognitive problems, which have a negative impact on their quality of life even greater than the seizures themselves. Cognitive impairment in epilepsy patients not only hinders their own treatment progress, but also has a negative impact on their daily life, academic and job performance, which brings huge care and economic pressure to their families and a heavy economic burden to the whole society. This review aimed to assess cognitive modules and provide key information for early diagnosis and treatment of patients.
With the increasing prominence of population aging, the cognitive decline of the elderly has gradually become a hotspot of clinical research. As a traditional rehabilitation exercise, Tai Chi has been proved to have a positive effect on improving cognitive function and delaying cognitive decline in the elderly. However, the related brain function mechanism is still unclear. In this paper, we collected studies which observed the changes of Tai Chi on brain regions related to cognitive function in the elderly using magnetic resonance imaging (MRI), electroencephalogram (EEG) and functional near-infrared spectroscopy (fNIRS). We summarized relevant studies from perspective of structural and functional changes in the brain. The results showed that Tai Chi may delay and improve cognitive decline in the elderly by reshaping the structure and function of brain regions related to cognitive function such as memory, attention and execution. The effect of Tai Chi for cognitive function may be associated with positive regulation of cardiovascular function, emotion and meditation level of the elderly. In addition, the improvement of cognitive function further enhances the balance of the elderly. We also found that practice time, frequency and intensity of Tai Chi could be factors influencing the improvement of cognitive function and brain function in the elderly.