NEUROBEHAVIORAL FEATURES OF MESIAL TEMPORAL LOBE EPILEPSY

本研究的目的是建立一个概念模型，以促进颞叶起源性复杂部分性癫痫患者手术的最佳神经发育时机，颞叶起源性癫痫是局灶性切除（颞叶前部切除术）最常见的候选者。本研究调查了癫痫持续时间和严重程度的增加与以下因素的关联程度：(1)原发性（同侧）致痫海马外神经区域解剖异常（萎缩）的存在和程度；(2)对侧记忆功能和广义神经心理能力的存在和程度受损，两者都表明原发性（同侧）致痫海马外神经区域受损；(3)与健康相关的生活质量受损程度。受试者组包括：(1)150例早期（< 14岁）复杂部分性癫痫复发的患者，年龄在14-40岁之间，因此癫痫的持续时间和严重程度有相当大的差异；(2)75例年龄和性别匹配的对照组。患者和对照组将接受选定感兴趣区域的定量MRI体积测量、综合神经心理学评估、健康相关生活质量评估和标准化访谈。据推测，持续时间的增加，尤其是癫痫的严重程度（例如，无持续缓解期的癫痫年数、癫痫持续状态的发作次数、继发性全身性强直-阵挛发作的终生次数）将与解剖学、神经心理学和与健康相关的生活质量损害的证据显著相关。

The purpose of this investigation is to develop a conceptual model to facilitate the optimal neurodevelopmental timing of epilepsy surgery for patients with complex partial seizures of temporal lobe origin, the most common candidates for focal resection (anterior temporal lobectomy). This study investigates the degree to which increasing duration and severity of epilepsy are associated with: (1) the presence and degree of anatomic abnormality (atrophy) in neural regions outside the primary (ipsilateral) epileptogenic hippocampus, (2) the presence and degree of impairments in contralateral memory function and generalized neuropsychological ability, both suggesting damage to neural regions outside the primary (ipsilateral) epileptogenic hippocampus, and (3) the degree of impairment to health-related quality of life. Subject groups include: (1) 150 patients with early (< 14 years) age of recurrent onset of complex partial seizures between the chronological ages of 14-40 years, thus with considerable variability as to the duration and severity of epilepsy, and (2) 75 age and sex matched controls. Patients and controls will undergo quantitative MRI volumetrics of selected regions of interest, comprehensive neuropsychological assessment, evaluation of health-related quality of life, and standardized interview. It is hypothesized that increasing duration but especially severity of epilepsy (e.g., years of epilepsy without sustained periods of remission, episodes of status epilepticus, lifetime number of secondarily generalized tonic-clonic seizures) will be significantly associated with evidence of anatomic, neuropsychological, and health-related quality of life impairments.