Different effects of anterior temporal lobectomy and selective amygdalohippocampectomy on verbal memory performance of patients with epilepsy
Different effects of anterior temporal lobectomy and selective amygdalohippocampectomy on verbal memory performance of patients with epilepsy
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DOI：
10.1016/j.yebeh.2015.09.012
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发表时间：
2015-11-01
影响因子：
2.6
通讯作者：
Rouleau, Isabelle
中科院分区：
文献类型：
--
作者：
Boucher, Olivier;Dagenais, Emmanuelle;Rouleau, Isabelle
选择性杏仁核海马区切除术(SAH)治疗颞叶癫痫(TLE)的优势仍存在争议。由于ATL的范围更广，累及颞叶的外侧和内侧部分，可以预见，它对记忆的影响比SAH更重要，后者只涉及内侧颞叶结构的切除。然而，几项研究并不支持这一假设。可能的解释包括特定于任务的因素，如需要记忆的语义和句法信息的程度，以及对主要混杂因素的控制失败。我们比较了13名SAH患者和26名接受ATL治疗的SAH患者的术前和术后记忆表现，这些患者的智商、癫痫发作开始年龄和手术年龄匹配。采用韦氏记忆量表第三版(Lm-WMS)中的逻辑记忆测验、雷伊听觉语言学习测验(RAVLT)、韦氏成人智力量表中的数字广度测验和Rey-Osterrieth复杂图形测验评定记忆功能。重复测量的方差分析表明，SAH和ATL在两个单词学习记忆测试中的作用相反。在LM-WMS的即刻回忆试验中，与SAH后相比，ATL后的成绩有所下降。相比之下，在RAVLT的延迟再认实验中，SAH后的成绩比ATL后的成绩差。然而，进一步的分析表明，只有在右脑进行手术时，才能观察到后一种发现。没有发现交互作用对其他记忆结果的影响。这一结果与以下观点一致：与内侧颞叶切除相比，具有丰富语义内容和句法结构的任务对外侧颞叶切除的影响更为敏感。这一发现突显了任务选择在TLE手术患者记忆评估中的重要性。(C)2015 Elsevier Inc.保留所有权利。
The advantage of selective amygdalohippocampectomy (SAH) over anterior temporal lobectomy (ATL) for the treatment of temporal lobe epilepsy (TLE) remains controversial. Because ATL is more extensive and involves the lateral and medial parts of the temporal lobe, it may be predicted that its impact onmemory is more important than SAH, which involves resection of medial temporal structures only. However, several studies do not support this assumption. Possible explanations include task-specific factors such as the extent of semantic and syntactic information to be memorized and failure to control for main confounders. We compared preoperative vs. postoperative memory performance in 13 patients with SAH with 26 patients who underwent ATL matched on side of surgery, IQ, age at seizure onset, and age at surgery. Memory function was assessed using the Logical Memory subtest from the Wechsler Memory Scales - 3rd edition (LM-WMS), the Rey Auditory Verbal Learning Test (RAVLT), the Digit Span subtest from the Wechsler Adult Intelligence Scale, and the Rey-Osterrieth Complex Figure Test. Repeated measures analyses of variance revealed opposite effects of SAH and ATL on the two verbal learning memory tests. On the immediate recall trial of the LM-WMS, performance deteriorated after ATL in comparison with that after SAH. By contrast, on the delayed recognition trial of the RAVLT, performance deteriorated after SAH compared with that after ATL. However, additional analyses revealed that the latter finding was only observed when surgery was conducted in the right hemisphere. No interaction effects were found on other memory outcomes. The results are congruent with the view that tasks involving rich semantic content and syntactical structure are more sensitive to the effects of lateral temporal cortex resection as compared with mesiotemporal resection. The findings highlight the importance of task selection in the assessment of memory in patients undergoing TLE surgery. (C) 2015 Elsevier Inc. All rights reserved.