Correlation of serum Orexin-A level with cognitive function and serum inflammatory cytokines in epileptic patients

This study was designed to analyze the associations of serum Orexin-A level with cognitive function and serum inflammatory cytokines in epileptic patients.

Totally 77 epileptic patients treated in Suqian First Hospital between January 2019 and January 2022 were retrospectively analyzed as the observation group, and 65 healthy individuals who had a physical examination in Suqian First Hospital during the same period were enrolled as the control group. The Mini-Mental State Examination (MMSE) was conducted in participants in the two groups, and the enzyme-linked immunosorbent assay (ELISA) was conducted for quantifying serum Orexin-A, interleukin-1β (IL-1β), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α). Additionally, the Pearson correlation test was used for analyzing the associations of Orexin-A with MMSE, IL-1β, IL-6, and TNF-α in the patients, and receiver operating characteristic (ROC) curves were drawn for determining the diagnostic value of Orexin-A in epilepsy and cognitive dysfunction in epileptic patients. The independent risk factors for cognitive impairment in epileptic patients were analyzed by multivariate logistic regression analysis.

Epileptic patients showed a significantly lower serum Orexin-A level than the control group (P < 0.05), and the area under the curve (AUC) of Orexin-A in epilepsy diagnosis was 0.879. Additionally, epileptic patients had notably lower MMSE scores than the control group (P < 0.05). The Pearson correlation test revealed a positive association of Orexin-A with MMSE score and negative correlations of Orexin-A with IL-1β, IL-6, and TNF-α levels (P < 0.05). The AUC of Orexin-A in diagnosing cognitive dysfunction in epileptic patients was 0.908. According to multivariate analysis, lower education level, more severe EEG abnormalities and a lower Orexin-A level were independent risk factors for cognitive impairment in epileptic patients.

Orexin-A can act as a diagnostic marker for epileptic patients, and its level is positively related with cognitive function of patients, but negatively related to the degree of inflammation. It is promising to be an early warning index for epilepsy and cognitive dysfunction in patients.