Pre- and postoperative cognitive function scores in resective and destructive surgeries for pharmacoresistant epilepsy (as assessed by MoCA)
Notice bibliographique
Résumé
Epilepsy is associated with comorbid diseases and cognitive impairment, which, even with successful compensation of seizures by medication and/or surgery, continue to have a negative impact on the quality of life of patients. The cognitive outcomes of surgery are variable: they may include positive changes or no changes, but there is also a risk of increasing cognitive dysfunction. Purpose of the study. To ascertain the impact of resective and destructive surgeries in pharmacoresistant epilepsy on cognitive functions, as assessed using the Montreal Cognitive Assessment (MoCA) screening scale. Materials and Methods. The article presents the results of an investigation into the impact of resective and destructive surgeries in pharmacoresistant epilepsy on cognitive functions, as assessed by the MoCA. The study comprised 50 patients with a verified diagnosis of focal pharmacoresistant epilepsy, divided into two groups: group 1 (25 patients) underwent resective surgery, while group 2 (25 patients) had destructive surgery. Cognitive function was evaluated using the Montreal Cognitive Assessment Scale (MoCA) prior to surgery and at intervals between six months and five years post-operatively. Results. The mean age of the subjects at the time of surgery was 33.2 ± 10.05 years, and the mean duration of epilepsy was 20.7 ± 10.98 years. In 50 % of patients, the epileptic focus was localized to the left side of the brain, while in 44 % of cases, it was localized to the right side. In 6 % of patients, the epileptic focus was bilateral. The majority of patients (70 %) exhibited temporal epilepsy, while 18 % demonstrated extratemporal epilepsy and 4 % showed both temporal and extratemporal epilepsy. At the preoperative stage, cognitive deficit was observed in the majority of patients (76 %), with an average score of 23.1 points. In the postoperative period, cognitive impairment was also observed in 76 % of patients, with no change in the mean MoCA score of 23.1. In group 1, 80 % of patients exhibited cognitive deficits prior to the operation, with an average score of 22.2. In the postoperative period, the score showed an increase, reaching 23.4. In group 2, cognitive deficit was also observed in the majority of patients (72 %) at the preoperative stage. The average score in group 2 was 21.7 points, which increased to 22.2 points after the operation. Conclusion. The practice of delaying surgical treatment for pharmacoresistant epilepsy persists, with cognitive functions preserved at the time of hospitalization in only a quarter of patients. The mean score on the Cognitive Function Assessment Screening Scale did not decline as a result of surgical intervention. However, a negative effect was observed in patients who did not show cognitive deficits prior to surgery. The findings will assist physicians in making informed decisions regarding the timing and approach to pharmacoresistant epilepsy treatment.
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Comment cette classification a été obtenuedéplier
Prédiction distillée sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Apprise à partir de 10 348 étiquettes directes de Codex et de 10 348 étiquettes directes de Gemma. Le mode candidate est l'union des têtes enseignantes seuillées; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont ni des étiquettes humaines ni des étiquettes directes de modèles de pointe.
Scores Codex et Gemma par catégorie
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,001 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,000 |
| Bibliométrie | 0,001 | 0,000 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,000 | 0,000 |
| Science ouverte | 0,000 | 0,000 |
| Intégrité de la recherche | 0,000 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,000 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule tête enseignante, pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».