The features of physiological mechanisms of goal-directed activity in epilepsy patients in association with clinical characteristics of the disease

Introduction. Investigation of systemic organization of goal-directed behavior and analysis of the physiological mechanisms ensuring productive activity in epilepsy patients are the variants of the integrative approach to study the mechanisms of epilepsy.

Objective. To refine the mechanisms of simulated goal-directed activity among epilepsy patients in its relationship with clinical characteristics of the disease.

Materials and methods. A total of 72 virtually healthy persons and 163 epilepsy patients were examined. Seizure frequency, the levels of cognitive and emotional impairments, and the number of administered anticonvulsants were assessed. Electroencephalograms, parameters of visual and auditory evoked potentials, the cognitive evoked P300 potential, parameters of the motor systems, and autonomous maintenance of activity were recorded. Division into groups was performed by clustering analysis using the results of the Schulte–Gorbov test.

Results. The high- (99 patients) and low-effectiveness (64 patients) groups of epilepsy patients were revealed. The low-effectiveness group of patients was characterized by predominantly symptomatic forms of the diseases. High cross-correlation values, reduced frequencies of EEG alpha oscillations, reduction in the amplitude of the components of visual evoked potentials and the P300 potential, an increase in N2 and P3 peak latency in the low-effectiveness group of epilepsy patients were determined. Increased amplitude of the wave of conditionally negative deviation, slower latency of sensorimotor responses, reduced variability of heart rate, and increased respiratory rate group of patients were observed in this group of patients.

Conclusions. The inadequate performance in epilepsy patients is associated with the reduced activity of specific afferent associative subsystems and mechanisms of motor-based maintenance of performance, as well as with excessive activity of stress-inducing mechanisms, which increases the physiological costs and reduces the effectiveness of simulated activity.