癫痫合并焦虑、抑郁障碍的临床特征及其与神经递质、脑电图改变的相关性研究

Clinical features of epilepsy comorbid with anxiety and depression disorders and their correlations with neurotransmitters and electroencephalogram changes

摘要:

目的 探究癫痫合并焦虑、抑郁障碍的临床特征，并分析其与神经递质、脑电图变化的关联。方法 选取2022年6月至2025年6月延安大学附属医院神经内科收治的150例癫痫患者。依据汉密尔顿焦虑量表及汉密尔顿抑郁量表评分，将患者分为合并焦虑、抑郁障碍组（85例）与无焦虑、抑郁障碍组（65例）。评估患者的焦虑、抑郁状况，检测患者的神经递质水平，监测脑电图并计算频段相对功率值、统计异常率，收集近3个月癫痫发作频率。结果 脑电图频段相对功率值方面，合并焦虑、抑郁障碍组δ、θ频段相对功率值高于无焦虑、抑郁障碍组。在脑电图改变程度上，合并焦虑、抑郁障碍组脑电图正常患者比例低于无焦虑、抑郁障碍组，轻度、中度、重度异常患者比例高于无焦虑、抑郁障碍组。神经递质水平方面，合并焦虑、抑郁障碍组5-羟色胺、多巴胺、γ-氨基丁酸、去甲肾上腺素水平低于无焦虑、抑郁障碍组。合并焦虑、抑郁障碍组近3个月内癫痫发作频率高于无焦虑、抑郁障碍组。相关性分析显示，汉密尔顿焦虑量表及汉密尔顿抑郁量表评分与神经递质水平呈负相关，与δ、θ频段相对功率值、癫痫发作频率呈正相关，与α、β频段相对功率值呈负相关。结论 癫痫合并焦虑、抑郁障碍与神经递质水平降低、脑电图改变及癫痫发作频率增加紧密相关，临床治疗癫痫时需重视患者心理状态评估。

Abstract:

Objective To explore the clinical features of epilepsy comorbid with anxiety and depression disorders， and analyze their correlations with neurotransmitters and electroencephalogram （EEG） changes.Methods A total of 150 epilepsy patients admitted to the Department of Neurology， Affiliated Hospital of Yan'an University between June 2022 and June 2025 were selected. According to the Hamilton Anxiety Scale and Hamilton Depression Scale scores， they were divided into a group with anxiety and depression disorders （85 cases） and a group without anxiety and depression disorders （65 cases）. The anxiety and depression status of patients was evaluated， neurotransmitter levels were measured， EEG was monitored to calculate the relative power values of frequency bands and the abnormality rates， and the frequency of epileptic seizures in the past three months was recorded.Results Regarding the relative power values of EEG frequency bands， the relative power values of δ and θ bands in the group with anxiety and depression disorders were higher than those in the group without anxiety and depression disorders. For the degree of EEG changes， the proportion of patients with normal EEG was lower in the group with anxiety and depression disorders than that in the group without anxiety and depression disorders， while the proportions of patients with mild， moderate， and severe abnormalities were higher than those in the group without anxiety and depression disorders. In terms of neurotransmitter levels， the levels of 5-hydroxytryptamine， dopamine， γ-aminobutyric acid， and norepinephrine were lower in the group with anxiety and depression disorders than those in the group without anxiety and depression disorders. The seizure frequency in the past three months was higher in the group with anxiety and depression disorders than in the group without anxiety and depression disorders. Correlation analysis showed that the Hamilton Anxiety Rating Scale and Hamilton Depression Rating Scale scores were negatively correlated with neurotransmitter levels， positively correlated with the relative power values of δ and θ frequency bands and the seizure frequency， and negatively correlated with the relative power values of α and β frequency bands.Conclusions Epilepsy comorbid with anxiety and depression disorders is closely related to decreased neurotransmitter levels， EEG changes， and increased seizure frequency. In the clinical treatment of epilepsy， attention should be paid to the assessment of patient psychological status.