The relationship between serum Netrin-1,NGF levels,EEG abnormalities and cognitive function in epilepsy patients

Tang Wenyu; Liu Zhe; Ma Xuan; Pan Jianping

doi:10.3969/j.issn.1671-6450.2025.04.012

Abstract：Objective To investigate the relationship between serum Netrin-1,nerve growth factor(NGF),electro-encephalogram(EEG)abnormalities and cognitive function in epilepsy patients.Methods A total of 316 epilepsy patients diagnosed and treated in the Department of Neurology Ⅷ of Xi'an International Medical Centre Hospital from March 2022 to May 2024 were selected as a case group,and the cognitive function of epilepsy patients was assessed by Montreal Cog-nitive Assessment Scale(MoCA),of which 141 were classified into the subgroup of non-cognitively impaired NCDs,and 175 were classified into the subgroup of cognitively impaired CDs,and 280 cases of those who had a health check-up were se-lected during the same period as a control group.The enzyme-linked immunosorbent assay(ELISA)method was used to detect serum Netrin-1 and NGF levels,and an electroencephalograph was used to examine the degree of EEG abnormalities in patients with epilepsy.Spearman method was applied to analyze the correlation between serum Netrin-1,NGF levels,elec-troencephalogram detection,and MoCA score.The value of plotting subjects'work characteristic curve(ROC)curves to as-sess serum Netrin-1,NGF levels and EEG abnormalities in predicting cognitive dysfunction in patients with epilepsy.Results Compared with the control group,the serum Netrin-1 level in the case group was increased,and the serum NGF level was decreased(t=34.511,11.727,P＜0.001).There were no EEG abnormalities in the control group,and 285(90.19％)patients in the case group had EEG abnormalities.Serum Netrin-1 level increased with the severity of EEG abnormality,and serum NGF level decreased with the severity(F=113.23,31.29,P＜0.001).The serum Netrin-1 level in CDs subgroup was higher than that in NCDs subgroup,and the serum NGF level was lower than that in NCDs subgroup(t=12.594,5.584,P＜0.001).The total MoCA score of NCDs subgroup was higher than that of CDs subgroup(t=26.572,P＜0.001).MoCA score was nega-tively correlated with serum Netrin-1 level in epileptic patients,positively correlated with serum NGF level,and negatively correlated with EEG abnormalities in epileptic patients(r=-0.452,0.497,-0.507,P＜0.001).The AUC of serum Netrin-1,NGF level,EEG abnormality and their combination in predicting cognitive dysfunction in epilepsy patients were 0.846,0.728,0.552 and 0.908,respectively,and the combined efficacy of the three was superior to that of each alone(Z=3.988,6.929,16.109,P＜0.001).Conclusion Serum Netrin-1 expression is abnormally elevated and NGF expression is abnormally de-creased in patients with CDs epilepsy.The MoCA score of epilepsy patients is closely related to serum Netrin-1,NGF ex-pression,and the degree of EEG abnormalities.The combined efficacy of serum Netrin-1,NGF levels and EEG abnormalities in predicting cognitive dysfunction in patients with epilepsy is high.