Verbal Dominant Memory Impairment and Low Risk for Post-operative Memory Worsening in Both Left and Right Temporal Lobe Epilepsy Associated with Hippocampal Sclerosis.
Verbal Dominant Memory Impairment and Low Risk for Post-operative Memory Worsening in Both Left and Right Temporal Lobe Epilepsy Associated with Hippocampal Sclerosis.
复制标题
口头占主导地位记忆障碍和与海马硬化有关的左右颞叶癫痫病后术后记忆恶化恶化的风险较低。
DOI：
10.2176/nmc.oa.2016-0004
复制
发表时间：
2016-11-15
影响因子：
1.9
通讯作者：
Tominaga T
中科院分区：
文献类型：
--
作者：
Khalil AF;Iwasaki M;Nishio Y;Jin K;Nakasato N;Tominaga T
颞叶手术后的记忆变化主要通过认知结果的组分析来确定。本研究调查了手术治疗的内侧颞叶癫痫（TLE）患者的个体患者记忆结果。本研究纳入84例连续接受癫痫手术的单侧海马硬化（HS）致顽固性TLE患者（女性47例，左[Lt] TLE 41例）。术前和术后1年分别用韦氏记忆量表评估记忆功能。术前记忆功能分为三种模式：言语显性记忆障碍（Verb-D）、视觉显性记忆障碍（Vis-D）和非物质特异性记忆障碍。术后语言和视觉记忆指标的变化分为有意义的改善、恶化和无显著变化。比较左（Rt） TLE组和右（Rt） TLE组的语言和视觉记忆功能的术前模式和术后变化。术前，动词d型损伤在Lt组和Rt TLE组中最为常见（分别为65.9和48.8%），言语记忆指标低于视觉记忆指标，其中Lt组较Rt TLE组更明显。仅在11.6%的Rt和7.3%的Lt TLE患者中观察到Vis-D。术后23.3 ~ 36.6%患者的记忆指标有明显改善，Lt组与Rt组、言语材料组与视觉材料组的记忆改善相当。综上所述，Verb-D最常见于与HS相关的Lt和Rt TLE患者。海马切除术可以改善这类患者的记忆指标，而不考虑手术的侧面和功能受损。
Post-operative memory changes after temporal lobe surgery have been established mainly by group analysis of cognitive outcome. This study investigated individual patient-based memory outcome in surgically-treated patients with mesial temporal lobe epilepsy (TLE). This study included 84 consecutive patients with intractable TLE caused by unilateral hippocampal sclerosis (HS) who underwent epilepsy surgery (47 females, 41 left [Lt] TLE). Memory functions were evaluated with the Wechsler Memory Scale-Revised before and at 1 year after surgery. Pre-operative memory function was classified into three patterns: verbal dominant memory impairment (Verb-D), visual dominant impairment (Vis-D), and no material-specific impairment. Post-operative changes in verbal and visual memory indices were classified into meaningful improvement, worsening, or no significant changes. Pre-operative patterns and post-operative changes in verbal and visual memory function were compared between the Lt and right (Rt) TLE groups. Pre-operatively, Verb-D was the most common type of impairment in both the Lt and Rt TLE groups (65.9 and 48.8%), and verbal memory indices were lower than visual memory indices, especially in the Lt compared with Rt TLE group. Vis-D was observed only in 11.6% of Rt and 7.3% of Lt TLE patients. Post-operatively, meaningful improvement of memory indices was observed in 23.3–36.6% of the patients, and the memory improvement was equivalent between Lt and Rt TLE groups and between verbal and visual materials. In conclusion, Verb-D is most commonly observed in patients with both the Lt and Rt TLE associated with HS. Hippocampectomy can improve memory indices in such patients regardless of the side of surgery and the function impaired.