Epilepsy in low-grade gliomas:: The impact on cognitive function and quality of life
Epilepsy in low-grade gliomas:: The impact on cognitive function and quality of life
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DOI：
10.1002/ana.10712
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发表时间：
2003-10-01
影响因子：
11.2
通讯作者：
Heimans, JJ
中科院分区：
文献类型：
--
作者：
Klein, M;Engelberts, NHJ;Heimans, JJ
低级别胶质瘤常与癫痫有关。本研究的目的是确定癫痫和抗癫痫药物(AED)治疗对这些患者的认知功能和健康相关生活质量(HRQOL)的影响。156例在组织学诊断后至少一年内无临床或放射学肿瘤复发迹象，且癫痫负担(基于癫痫发作频率和抗癫痫药物使用)从无到严重的患者与健康对照组进行比较。此外，还探讨了癫痫负担与认知/HRQOL的关系。86%的患者患有癫痫，50%的使用AEDs的患者实际上没有癫痫发作。与健康对照组相比，胶质瘤患者在信息处理速度、精神运动功能、注意功能、言语和工作记忆、执行功能和HRQOL方面显著降低。癫痫负担的增加与除注意和记忆功能外的所有认知领域的显著降低有关，这主要可归因于使用抗癫痫药物，而HRQOL的下降可归因于缺乏完全的癫痫控制。总而言之，低级别胶质瘤患者患有许多神经心理和心理问题，癫痫的严重程度和治疗的强度加剧了这些问题。
Low-grade gliomas frequently are associated with epilepsy. The purpose of this study is to determine the impact of epilepsy and antiepileptic drug (AED) treatment on cognitive functioning and health-related quality of life (HRQOL) in these patients. One hundred fifty-six patients without clinical or radiological signs of tumor recurrence for at least I year after histological diagnosis and with an epilepsy burden (based on seizure frequency and AED use) ranging from none to severe were compared with healthy controls. The association between epilepsy burden and cognition/HRQOL was also investigated. Eighty-six percent of the patients had epilepsy and 50% of those using AEDs actually were seizure-free. Compared with healthy controls, glioma patients had significant reductions in information processing speed, psychomotor function, attentional functioning, verbal and working memory, executive functioning, and HRQOL. The increase in epilepsy burden that was associated with significant reductions in all cognitive domains except for attentional and memory functioning could primarily be attributed to the use of AEDs, whereas the decline in HRQOL could be ascribed to the lack of complete seizure control. In conclusion, low-grade glioma patients suffer from a number of neuropsychological and psychological problems that are aggravated by the severity of epilepsy and by the intensity of the treatment.