Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis
Cognitive decline in temporal lobe epilepsy due to unilateral hippocampal sclerosis
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DOI：
10.1016/j.yebeh.2007.02.002
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发表时间：
2007-05-01
影响因子：
2.6
通讯作者：
Targas Yacubian, Elza Marcia
中科院分区：
文献类型：
--
作者：
Marques, Carolina Mattos;Sales Ferreira Caboclo, Luis Otavio;Targas Yacubian, Elza Marcia
Objective.我们评估了由单侧海马硬化（HS）引起的颞叶癫痫（TLE）患者的认知表现，并与匹配的健康对照组进行比较。我们报告了认知测量和癫痫持续时间之间的关系，与海马体积相关，以及教育水平对认知下降的影响。本研究涉及61例门诊患者（40例接受8年正规教育）与单侧HS和61名对照。对所有患者和10名对照者进行容积MRI。使用Student t检验和Mann-Whitney检验比较健康受试者和患者的神经心理学测试结果（平均值，SD）。在神经心理学评估中，患者的表现比对照组差。当调整后的z分数用于计算损伤指数时，患者与对照组相比，异常测试的百分比更高。通过损伤指数评估的认知能力下降与癫痫持续时间相关。更高的教育水平并不能防止这种下降，因此不支持这一人群的大脑储备假设。仅在左侧HS患者中观察到海马体积测量值与癫痫持续时间之间的显著相关性。由HS引起的TLE患者存在超出记忆缺陷的认知发病率。认知功能下降与癫痫持续时间相关，在左侧HS患者中，持续时间可能与海马体积损失相关。(C)2007年爱思唯尔公司All rights reserved.
Objective. We assessed the cognitive performance of patients with temporal lobe epilepsy (TLE) caused by unilateral hippocampal sclerosis (HS), in comparison with that of matched, healthy controls. We report the relationship between cognitive measures and duration of epilepsy, correlating with hippocampal volumes, and the impact of educational level on cognitive decline.Methods. This study involved 61 outpatients (40 with 8 years of formal education) with unilateral HS and 61 controls. Volumetric MRI was performed on all patients and 10 controls. The results (mean, SD) of the neuropsychological tests of healthy subjects and patients were compared using the Student t and Mann-Whitney tests.Results. Patients performed worse than controls in the neuropsychological evaluation. When adjusted z scores were used to calculate the impairment index, patients had a greater percentage of abnormal tests compared with controls. The cognitive decline, assessed through the impairment index, correlated with duration of epilepsy. Higher level of education did not protect against this decline, thus not supporting the hypothesis of cerebral reserve in this population. A significant correlation between hippocampal volumetric measures and duration of epilepsy was observed only in patients with left HS.Conclusion. Patients with TLE caused by HS present with cognitive morbidity that extends beyond memory deficits. Cognitive decline is associated with duration of epilepsy, and in patients with left-sided HS, duration may correlate with volumetric hippocampal loss. (C) 2007 Elsevier Inc. All rights reserved.