癫痫复杂部分性发作患者认知功能与海马质子磁共振波谱改变相关性分析

目的 探讨癫痫复杂部分性发作(CPS)患者认知功能损害的特点以及磁共振波谱(MRS)检查与认知功能的相关性.方法 对45例癫痫CPS患者和16例健康对照组进行临床记忆量表、瑞文标准推理测验的测评,~1H-MRS检测双侧海马,比较2组间2项测验分值及~1H-MRS结果,并对记忆商、智商与海马~1H-MRS结果进行相关性分析.结果 CPS组多项量表分值、记忆商、智商明显低于对照组,差异有统计学意义(P<0.05),CPS组N-乙酰天门冬氨酸(NAA)及NAA/胆碱(Cho)+肌酸(Cr)]明显低于对照组,Cr、Cho明显高于对照组,差异有统计学意义(P<0.05).CPS组记忆商、智商与NAA浓度、NAA/(Cho+Cr)均呈正相关(P<0.05),与Cho浓度呈负相关(P<0.05),与Cr浓度无明显相关性(P>0.05).结论 CPS患者存在短时记忆功能障碍和抽象思维、判断推理能力的下降,其认知功能障碍与海马NAA、Cho浓度及NAA/(Cho+Cr)的相关性表明~1H-MRS检查可成为早期发现CPS患者认知功能情况的一项重要检查,其与神经心理学测验联合应用可早期、准确地发现CPS患者的认知功能障碍.

Correlation analysis of cognitive function and changes in proton magnetic resonance spectroscopy of the hippocampus in patients with complex partial seizures

Objective To investigate the features of cognitive impairment in patients with complex partial seizures (CPS) and the correlation between the cognitive function and proton magnetic resonance spectroscopy (~1H-MRS). Methods Forty-five patients with CPS and 16 healthy controls were examined by the following means: memory function examination by the clinical memory scale, intelligence function examination by Ravin's standard progressive Matrices (R'SPM) and ~1H-MRS scan in the bilateral hippocampus. Memory quotient (MQ), Intelligence quotient (IQ), the levels ofNAA, Cho, Cr and the ratio of NAA/Cr+Cho were compared between the two groups. Meanwhile, the correlation coefficients were calculated. Results The scores of pointing memory, associational learning, image free memory, association memory of portrait and MQ except insignificant figure recognition were significantly lower in patients with CPS than those in the control group (P<0.05); the scores of Ravin's standard progressive matrices and IQ were noticeably lower in patients with CPS than those in the controls. The levels of NAA, Cho, Cr and the ratio of NAA/Cr+Cho in patients with CPS were significantly lower than those in the controls (P<0.05). Patients with CPS showed positive correlation between MQ and the level ofNAA, MQ and the ratio ofNAA/Cr+Cho, IQ and the level of NAA, as well as IQ and the ratio ofNAA/Cr+Cho (P<0.05); while level of Cho and both MQ and IQ were in inverse proportion (P<0.05) and no correlation between the lever of Cr and both MQ and IQ was found in patients with CPS (P>0.05). Conclusions The patients with CPS do have the cognitive impairment including short-term memory deficit and the decreased ability of abstraction, maturity judgment and reasoning. The correlation between cognitive function and the levels ofNAA, Cho, Cr and the ratio of NAA/Cr+Cho indicated that ~1H-MRS can check the cognitive function of patients with CPS in early stage objectively. Together with neuropsychology examination, ~1H-MRS can detect the disturbance of cognitive function in the patients with CPS precisely in early stage.