Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy.
Better object recognition and naming outcome with MRI-guided stereotactic laser amygdalohippocampotomy for temporal lobe epilepsy.
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作者：
Drane DL;Loring DW;Voets NL;Price M;Ojemann JG;Willie JT;Saindane AM;Phatak V;Ivanisevic M;Millis S;Helmers SL;Miller JW;Meador KJ;Gross RE
颞叶癫痫(TLE)患者在遵循标准手术方法的类别相关物体识别和命名方面存在显著缺陷。这些缺陷可能源于核心处理模块(例如，语言、视觉处理、语义记忆)的分离，这是由于开放手术入路后对海马体外的颞区造成的“附带损伤”。我们预测，立体定向激光杏仁海马区切开术(SLAH)将最大限度地减少这种缺陷，因为它保留了对这些认知过程至关重要的白质通路和新皮质区域。采用前瞻性、非随机、非盲法、平行分组设计，对19例内科难治性近侧TLE患者(10例显性，9例非显性)和39例接受标准手术治疗的TLE患者进行非参数分析，比较常用名词(波士顿命名测验)和名人的命名和再认测试。对于接受开放切除的主要TLE患者，与命名著名面孔和常见名词的SLAH患者相比，性能下降明显更大(F=24.3p<；.0001，η2=.57，&F=11.2，p<；.001，η2=.39)；对于接受开放切除的非显性TLE患者，与识别著名面孔的SLAH患者相比，性能下降更大(F=3.9p<；.02，η2=0.19)。当在单个受试者的基础上进行检查时，没有SLAH患者在这些指标上经历任何表现下降。相比之下，39例接受标准手术治疗的患者中，有32例在两种对象类型的一项或多项指标上均有所下降(P<；.001，Fisher‘s精确测试)。22例左侧(显性)TLE患者中，21例在开放切除后完成一项或两项命名任务，而17名右侧(非显性)TLE患者中有11例面部识别能力下降。初步结果表明，1)接受SLAH的TLE患者可以免除命名和识别功能，2)海马体似乎不是支持名称提取或识别常见物体或著名面孔的神经网络的重要组成部分。
Temporal lobe epilepsy (TLE) patients experience significant deficits in category-related object recognition and naming following standard surgical approaches. These deficits may result from a decoupling of core processing modules (e.g., language, visual processing, semantic memory), due to “collateral damage” to temporal regions outside the hippocampus following open surgical approaches. We predicted stereotactic laser amygdalohippocampotomy (SLAH) would minimize such deficits because it preserves white matter pathways and neocortical regions critical for these cognitive processes. Tests of naming and recognition of common nouns (Boston Naming Test) and famous persons were compared with nonparametric analyses using exact tests between a group of nineteen patients with medically-intractable mesial TLE undergoing SLAH (10 dominant, 9 nondominant), and a comparable series of TLE patients undergoing standard surgical approaches (n=39) using a prospective, non-randomized, non-blinded, parallel group design. Performance declines were significantly greater for the dominant TLE patients undergoing open resection versus SLAH for naming famous faces and common nouns (F=24.3, p<.0001, η2=.57, & F=11.2, p<.001, η2=.39, respectively), and for the nondominant TLE patients undergoing open resection versus SLAH for recognizing famous faces (F=3.9, p<.02, η2=.19). When examined on an individual subject basis, no SLAH patients experienced any performance declines on these measures. In contrast, 32 of the 39 undergoing standard surgical approaches declined on one or more measures for both object types (p<.001, Fisher’s exact test). Twenty-one of 22 left (dominant) TLE patients declined on one or both naming tasks after open resection, while 11 of 17 right (non-dominant) TLE patients declined on face recognition. Preliminary results suggest 1) naming and recognition functions can be spared in TLE patients undergoing SLAH, and 2) the hippocampus does not appear to be an essential component of neural networks underlying name retrieval or recognition of common objects or famous faces.
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影响因子：
2.2
作者：
Bonelli, Silvia B.;Powell, Rob;Thompson, Pamela J.;Yogarajah, Mahinda;Focke, Niels K.;Stretton, Jason;Vollmar, Christian;Symms, Mark R.;Price, Cathy J.;Duncan, John S.;Koepp, Matthias J.
通讯作者：
Koepp, Matthias J.
影响因子：
5.6
作者：
Martin, R;Sawrie, S;Kuzniekcy, R
通讯作者：
Kuzniekcy, R
DOI：
10.1017/s135561770505054x
发表时间：
2005-07-01
影响因子：
2.6
作者：
Seidenberg, M;Geary, E;Hermann, B
通讯作者：
Hermann, B
影响因子：
9.9
作者：
Glosser, G;Salvucci, AE;Chiaravalloti, ND
通讯作者：
Chiaravalloti, ND
影响因子：
2.6
作者：
Curry, Daniel J.;Gowda, Ashok;Wilfong, Angus A.
通讯作者：
Wilfong, Angus A.