Case Control Study
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World J Psychiatry. Oct 19, 2023; 13(10): 714-723
Published online Oct 19, 2023. doi: 10.5498/wjp.v13.i10.714
Serum neuronal pentraxin 2 is related to cognitive dysfunction and electroencephalogram slow wave/fast wave frequency ratio in epilepsy
Xiao-Fen Huang, Ming-Xia Xu, Yue-Fan Chen, Yun-Qing Lin, Yuan-Xiang Lin, Feng Wang
Xiao-Fen Huang, Ming-Xia Xu, Yue-Fan Chen, Yun-Qing Lin, Yuan-Xiang Lin, Department of Neurosurgery, The First Affiliated Hospital of Fujian Medical University, Fuzhou 350005, Fujian Province, China
Feng Wang, Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, Fuzhou 350212, Fujian Province, China
Author contributions: Huang X, Lin Y, and Wang F were responsible for the study’s conception and design; Xu M and Chen Y provided administrative support; Huang X and Lin Y provided the study materials and patients; Xu M and Lin Y conducted data collection; Chen Y and Wang F conducted data analysis and interpretation; all authors contributed to the manuscript writing process and granted final approval for the manuscript.
Supported by 2022 Educational Research Program for Young and Middle-aged Teachers in Fujian Province (Science and Technology), No. JAT220107.
Institutional review board statement: The study was approved by the ethics board of First Affiliated Hospital of Fujian Medical University (No. [2019]274).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Feng Wang, MD, Doctor, Postdoc, Professor, Department of Neurosurgery, National Regional Medical Center, Binhai Campus of the First Affiliated Hospital, Fujian Medical University, No. 999 Huashan Road, Changle District, Fuzhou 350212, Fujian Province, China. fengwedu@163.com
Received: August 16, 2023
Peer-review started: August 16, 2023
First decision: August 31, 2023
Revised: September 8, 2023
Accepted: September 22, 2023
Article in press: September 22, 2023
Published online: October 19, 2023
Processing time: 56 Days and 19.3 Hours
ARTICLE HIGHLIGHTS
Research background

Cognitive dysfunction is a common complication in epileptic patients, but there is a lack of effective diagnostic biomarkers. This study investigated the relationship between serum levels of neuronal pentraxin 2 (NPTX2), an important molecule involved in neurotransmission and synaptic plasticity, and cognitive dysfunction in epilepsy patients. The study also explored the association between electroencephalogram (EEG) slow wave/fast wave frequency ratio and cognitive impairment. The aim was to determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in epilepsy patients, addressing the need for reliable diagnostic tools in this population.

Research motivation

The high incidence of cognitive dysfunction in epileptic patients highlights the need for effective diagnostic biomarkers. Currently, there is a lack of reliable tools to identify cognitive impairment in this population. This study aimed to investigate the correlation between serum NPTX2 levels and EEG slow wave/fast wave frequency ratios with cognitive dysfunction in epilepsy patients. By exploring these potential biomarkers, the study aimed to contribute to the development of a diagnostic tool for identifying cognitive impairment in epilepsy patients, facilitating early intervention and improved patient care.

Research objectives

The main objectives of this study were to investigate the relationship between serum levels of NPTX2 and EEG with cognitive dysfunction in epilepsy patients. The study aimed to determine if serum NPTX2 could serve as a potential biomarker for diagnosing cognitive impairment in patients with epilepsy. Additionally, the study aimed to assess the correlation between serum NPTX2 levels, EEG patterns, and cognitive function using the mini-mental state examination (MMSE) scale. The ultimate goal was to contribute to the development of effective diagnostic tools for identifying cognitive impairment in epilepsy patients.

Research methods

The study enrolled three groups of participants: Normal group, 74 epilepsy patients without cognitive dysfunction; epilepsy patients with cognitive dysfunction group, 37 epilepsy patients with cognitive dysfunction; Control group, 30 healthy individuals. Cognitive function was evaluated using the MMSE scale. Serum levels of NPTX2 were measured using an enzyme-linked immunosorbent kit, and EEG recordings were used to calculate the slow wave/fast wave frequency ratio in different EEG regions. Statistical analyses were performed to compare variables among the groups and assess correlations between biomarkers and cognitive function. Receiver operating characteristic (ROC) curve analysis was conducted to evaluate the diagnostic performance of serum NPTX2 and EEG patterns for cognitive dysfunction in epilepsy patients.

Research results

The study found no significant differences in age, gender, or education level among the three groups. There were also no significant differences in epilepsy-related factors between the normal group and the cognitive dysfunction group. Serum levels of NPTX2 were significantly higher in the normal group compared to the cognitive dysfunction group, while the control group showed no significant difference from the normal group. The cognitive dysfunction group had the lowest MMSE scores. The EEG slow wave/fast wave frequency ratio values were significantly higher in the cognitive dysfunction group compared to the normal group in various EEG regions. In epilepsy patients with cognitive dysfunction, NPTX2 levels correlated positively with the MMSE score and negatively with epilepsy duration and the EEG slow wave/fast wave frequency ratio value in the temporal region. ROC curve analysis demonstrated that serum NPTX2 level and EEG patterns had diagnostic potential for evaluating cognitive dysfunction in epilepsy patients.

Research conclusions

The study concluded that serum NPTX2 levels are associated with cognitive dysfunction and the EEG slow wave/fast wave frequency ratio in epilepsy patients. Serum NPTX2 shows potential as a diagnostic biomarker for cognitive impairment in epilepsy. The study found no significant differences in demographic and epilepsy-related factors between the normal and cognitive dysfunction groups. However, serum NPTX2 levels were significantly higher in the normal group compared to the cognitive dysfunction group. The EEG slow wave/fast wave frequency ratios were also higher in the cognitive dysfunction group. These findings suggest that serum NPTX2 and EEG patterns may serve as valuable indicators for diagnosing cognitive impairment in epilepsy patients.

Research perspectives

The findings of this study highlight the potential of serum NPTX2 as a diagnostic biomarker for cognitive impairment in epilepsy patients. Further research is needed to validate and expand upon these results. Future studies could explore the underlying mechanisms linking NPTX2 levels and cognitive dysfunction, investigating the role of NPTX2 in neurotransmission and synaptic plasticity. Additionally, larger sample sizes and longitudinal studies could provide more robust evidence regarding the relationship between serum NPTX2, EEG patterns, and cognitive dysfunction. Ultimately, establishing reliable biomarkers could aid in early detection and intervention for cognitive impairments in epilepsy, improving patient outcomes and quality of life.