Is self-report sleepiness associated with cognitive performance in temporal lobe epilepsy?

ABSTRACT Sleepiness and cognitive impairment are common symptoms observed in patients with epilepsy. We investigate whether self-reported sleepiness is associated with cognitive performance in patients with refractory mesial temporal lobe epilepsy with hippocampal sclerosis (MTLE-HS). Seventy-one consecutive patients with MTLE-HS were evaluated with the Stanford Sleepiness Scale (SSS) before neuropsychological evaluation. Their mean SSS scores were compared with controls. Each cognitive test was compared between patients with (SSS ≥ 3) or without sleepiness (SSS < 3). Imbalances were controlled by regression analysis. Patients reported a significantly higher degree of sleepiness than controls (p < 0.0001). After multiple linear regression analysis, only one test (RAVLT total) remained associated with self-reported sleepiness. Conclusion: Self-reported sleepiness was significantly higher in MTLE-HS patients than controls, but did not affect their cognitive performance. If confirmed in other populations, our results may have implications for decision making about sleepiness screening in neuropsychological settings.

摘要：嗜睡与认知功能障碍是癫痫患者常见的临床表现。本研究旨在探讨伴海马硬化的难治性内侧颞叶癫痫（refractory mesial temporal lobe epilepsy with hippocampal sclerosis，MTLE-HS）患者的自我报告嗜睡症状与其认知表现是否存在关联。研究纳入71例连续入组的MTLE-HS患者，在接受神经心理学评估前，采用斯坦福嗜睡量表（Stanford Sleepiness Scale，SSS）对其进行嗜睡症状评估，并将患者的平均SSS得分与对照组进行对比。分别对比存在嗜睡症状（SSS≥3）与无嗜睡症状（SSS<3）患者的各项认知测验结果，通过回归分析控制组间失衡因素的影响。结果显示，患者报告的嗜睡程度显著高于对照组（p < 0.0001）。经多元线性回归分析后，仅雷伊听觉语言学习测验（Rey Auditory Verbal Learning Test，RAVLT）总分与自我报告的嗜睡症状存在关联。结论：伴海马硬化的难治性内侧颞叶癫痫患者的自我报告嗜睡程度显著高于对照组，但嗜睡症状并未对其认知表现产生影响。若该结果在其他人群中得到验证，可为神经心理学评估场景下的嗜睡症状筛查决策提供参考依据。