Temporal lobe epilepsy (TLE) is the most common form of adult epilepsy, frequently accompanied with cognitive deficits. The present study aims to investigate functional network alterations affected by cognitive impairments in drug-resistant TLE. Patients with drug-resistant TLE were divided into normal cognition (NC) and abnormal cognition (AC) groups based on their primary medical history and completed the Wechsler intelligence scale. Thirty-one patients in the NC group and 30 in the AC group had mean intelligence quotients (IQ) of 107 (96-137) and 71 (60-85), respectively. Eighteen controls were enrolled in the study. Graph theory analysis showed decreased alpha small world index (SWI) in the AC group compared to that in the NC group and controls. Increased SWI in the fast rhythm was observed in both TLE groups compared with controls. But the gamma SWI in the AC group declined and was significantly lower than in the NC group at 50–70 Hz. A lower IQ is associated with a decreased SWI in alpha and 50-70Hz. Spectral analysis revealed reduced alpha power and increased delta power in the TLE groups compared to the controls. Immunofluorescence analysis revealed more severe amyloid-β (Aβ) and phosphorylated Tau (p-Tau) loads in the resected hippocampus of the AC group than that of NC group. Cognitive deficits in drug-resistant TLE are associated with general EEG activity slowing, loss of efficiency in gamma connectivity, and increased Aβ and p-Tau expression. These alterations are potential markers and intervention targets for concomitant cognitive decline in drug-resistant epilepsy.

Aims: The interaction between the heart and brain is highly complex. Left ventricular (LV) longitudinal contraction is the most sensitive to the presence of myocardial disease. Whether subclinical change in LV longitudinal contraction assessed by echocardiography is associated with cognitive impairment in the general population has not been investigated. Methods and Results: All residents aged ≥ 35 years, living in five villages of Shunyi, a suburb district of Beijing, were invited to participate in the study from June 2013 to April 2016. This was an exploratory cross-sectional analysis of the baseline data of 894 participants enrolled in the Shunyi Study. Cognitive status was evaluated using the Montreal Cognitive Assessment (MoCA). LV longitudinal contraction was assessed by the peak systolic velocity measured at the mitral annulus (Sm) obtained by Tissue Doppler imaging echocardiography. Cognitive impairment (MoCA score <26) was found in 771 (86.2%) participants. LV longitudinal myocardial contraction (Sm) and diastolic function (Em, E/A ratio, and E/e) were associated with cognitive impairment (all P<0.01). The association between Sm and cognitive impairment remained significant after adjusting for age, sex, education level, physical activity, vascular risk factors, and cerebral small-vessel disease (OR, 0.84; 95% CI, 0.73–0.97, P=0.02). Receiver operating characteristic curve analysis for Sm in identifying normal cognitive status showed the area under the curve of 0.59 (95% CI, 0.54–0.65; P<0.01). Conclusions: Our findings suggest that LV longitudinal myocardial contraction in the general population is associated with cognitive status in Chinese community-dwelling populations.