颞叶癫痫患者的冲动特征及影响因素分析

Impulsive characteristics of temporal lobe epilepsy and influencing factors

目的分析颞叶癫痫患者的冲动特征及可能的影响因素。方法收集2017年8月-2018年10月就诊于我科癫痫专病门诊的癫痫患者159例,分为颞叶癫痫组及非颞叶癫痫组,颞叶癫痫组95例,男性52例,女性43例,年龄15~50(30.6±9.6)岁;非颞叶癫痫组64例,男性36例,女性28例,年龄16~54(30.3±10.5)岁。同期选择与患者性别、年龄及受教育年限相匹配的健康对照52例。应用蒙特利尔认知评估量表(MoCA)、BIS-11冲动量表和Dickman冲动量表对所有入组人员进行认知评估及冲动性评估,分析颞叶癫痫患者冲动性的影响因素。结果颞叶癫痫组BIS-11总分高于正常对照组(66.3±10.2 vs 62.1±10.3,P<0.05)。颞叶癫痫组及非颞叶癫痫组的Dickman功能性冲动评分均低于正常对照组(4.9±2.8和4.5±2.6 vs 6.2±2.5,P<0.05),Dickman非功能性冲动评分均高于正常对照组(4.3±3.0和5.3±3.3 vs 3.0±2.9,P<0.05)。多重线性回归分析显示年龄、性别、教育年限、起病年龄、发作频率、发作类型、服用药物种类、认知是颞叶癫痫患者冲动性的影响因素(P<0.05)。结论颞叶癫痫BIS-11总分增高,颞叶癫痫及颞叶外癫痫均表现为Dickman非功能性冲动增高、功能性冲动降低,颞叶癫痫患者冲动性受到年龄、性别、教育年限、起病年龄、发作频率、发作类型、服用药物种类、认知等因素的影响。

Objective To assess the impulsivity of patients with temporal lobe epilepsy by using the self-report scale and analyze its possible influencing factors.Methods A total of 159 epilepsy patients admitted to our hospital from August 2017 to October 2018 were included and divided into temporal lobe epilepsy group(95 cases)and non-temporal epilepsy group(64 cases).Another 52 healthy people matched in gender,age and years of education were selected as controls during the same period.Cognitive assessment was performed using the Montreal Cognitive Assessment(MoCA)and impulsivity assessment was performed using the Barratt Impulsiveness Scale(BIS-11)and the Dickman Impulsivity Inventory(DII).Factors that might influence the impulsivity of patients with temporal lobe epilepsy were analyzed.Results The total score of BIS-11 in temporal lobe epilepsy group was significantly higher than that in the control group(66.3±10.2 vs 62.1±10.3,P<0.05).In terms of DII,the two epilepsy groups had lower functional impulsivity scores(4.9±2.8,4.5±2.6 vs 6.2±2.5,P<0.05)and higher dysfunctional impulsivity scores(4.3±3.0,5.3±3.3 vs 3.0±2.9,P<0.05)than the control group.Multiple linear regression analysis showed that age,gender,education years,onset age,seizure frequency,seizure types,drugs,and cognition were all influential factors of impulsivity in patients with temporal lobe epilepsy(all P<0.05).Conclusion BIS-11 total score increases in the temporal lobe epilepsy group.Both the temporal lobe epilepsy group and the non-temporal lobe epilepsy group show an increase in dysfunctional impulsivity and decrease in functional impulsivity.Age,gender,education years,onset age,seizure frequency,seizure types,number of drugs used,and cognition are all influential factors of impulsivity in patients with temporal lobe epilepsy.