Effects of hippocampus‐sparing resections in the temporal lobe: Hippocampal atrophy is associated with a decline in memory performance
Effects of hippocampus‐sparing resections in the temporal lobe: Hippocampal atrophy is associated with a decline in memory performance
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颞叶海马保留切除的影响：海马萎缩与记忆能力下降相关
DOI：
10.1111/epi.16473
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发表时间：
2020
期刊：
影响因子：
5.6
通讯作者：
Wagner KFoit NA
中科院分区：
文献类型：
--
作者：
Wagner KFoit NA
目的对于具有非病变且非致痫性海马（HC）的颞叶癫痫（TLE）患者，为了保留功能完整的脑组织，不切除HC。然而，一些患者术后记忆力下降，可能是由于海马外记忆网络破坏和继发性海马体积（HV）损失所致。本研究的目的是确定手术侧同侧和对侧海马萎缩的程度及其与记忆结果的关系。方法对 55 名患者（平均年龄±标准差 [SD] 30 ± 15 岁，25 名女性，左侧 31 名）术前和术后 5 个月的颞叶内的海马体积和语言以及视觉记忆表现进行了回顾性检查，而整个 HC 都幸免于难。根据预先指定的模板提取 HV，并确定切除体积。结果手术侧的同侧和对侧均发现 HV 丢失 (P< 0.001)。术后左侧 HV 丢失是左侧手术后言语记忆恶化的重要预测因素 (P<.01)。与术前言语记忆表现一起，术后左侧 HV 解释了几乎 60% 的方差 (P< 0.0001)。然而，右 HV 并不是视觉记忆表现的明确预测指标。无论手术一侧如何，较大的切除体积与较小的术后 HV 相关（左：P< 0.05，右：P< 0.01）。 意义 TL 内（尤其是语言优势半球内）的任何切除对记忆网络的破坏可能导致 HC 萎缩和记忆力下降。这些发现可能会进一步改善患者在 TL 切除术之前对其术后记忆结果的咨询，从而避免整个 HC。
ObjectiveIn patients with temporal lobe epilepsy (TLE) with a nonlesional and nonepileptogenic hippocampus (HC), in order to preserve functionally intact brain tissue, the HC is not resected. However, some patients experience postoperative memory decline, possibly due to disruption of the extrahippocampal memory network and secondary hippocampal volume (HV) loss. The purpose of this study was to determine the extent of hippocampal atrophy ipsilateral and contralateral to the side of the surgery and its relation to memory outcomes.MethodsHippocampal volume and verbal as well as visual memory performance were retrospectively examined in 55 patients (mean age ± standard deviation [SD] 30 ± 15 years, 25 female, 31 left) before and 5 months after surgery within the temporal lobe that spared the entire HC. HV was extracted based on prespecified templates, and resection volumes were also determined.ResultsHV loss was found both ipsilateral and contralateral to the side of surgery (P< .001). Postoperative left HV loss was a significant predictor of postoperative verbal memory deterioration after left‐sided surgery (P< .01). Together with the preoperative verbal memory performance, postoperative left HV explained almost 60% of the variance (P< .0001). However, right HV was not a clear predictor of visual memory performance. Larger resection volumes were associated with smaller postoperative HV, irrespective of side of surgery (left:P< .05, right:P< .01).SignificanceA disruption of the memory network by any resection within the TL, especially within the language‐dominant hemisphere, may lead to HC atrophy and memory decline. These findings may further improve the counseling of patients concerning their postoperative memory outcome before TL resections sparing the entire HC.
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介绍。
影响因子：
1.4
作者：
Sodeke,StephenOlufemi
通讯作者：
Sodeke,StephenOlufemi