EFFECT OF TEMPORAL LOBECTOMY ON SENSORY DEFICITS IN TEMPORAL LOBE EPILEPSY (TLE)

这个子项目是许多研究子项目中的一个 由NIH/NCRR资助的中心赠款提供的资源。子项目和 研究者（PI）可能从另一个NIH来源获得主要资金， 因此可以在其他CRISP条目中表示。所列机构为 中心，不一定是研究者的机构。 本方案的假设是颞叶癫痫（TLE）是一种网络性疾病，涉及解剖学和功能上远离癫痫灶的脑区域。 癫痫病灶可在发作间期状态下引起整个网络的功能障碍，即，癫痫发作之间 具体目的如下：（1）应用基本的心理物理学技术，确定发作间期3种感觉通道知觉缺陷的范围和严重程度。 2)确定刺激时间特征（特别是持续时间）对观察到的精神病理学确定的感知障碍的影响。 3)记录消除癫痫病灶对感知能力的影响。 将通过与研究人员的电话访谈对潜在受试者进行预筛选，以确定其是否符合入选和排除标准。 40例单侧难治性颞叶癫痫患者和20例神经系统正常对照者将接受一系列神经心理学和知觉心理物理学测试。 对照组受试者将在所有任务中接受一次测试; TLE受试者将接受三次测试：1）基线评估，同时服用他们常用的抗癫痫药物（AED，初始测试），2）在有临床指征的住院视频EEG监测期间大量或完全停用AED后（非AED测试），和3）手术后6个月或对于最终不进行手术的那些患者的初始测试后6个月（最终测试）。 在测试的第一天，将在所有三个测试期间测量TLE受试者的AED水平。 所有的心理物理测试都是无痛和非侵入性的。 视觉任务涉及在计算机屏幕上观看刺激。 听觉刺激通过高品质耳机以舒适的音量呈现。 触觉刺激以低或中等的力施加到受试者的指尖。 主要结果测量将包括比较以下组之间的各种测试的性能：TLE受试者-初始与正常对照，2）配对的最终与初始，和3）配对的非AED与初始。 次要结局指标将包括与癫痫发作同侧的手或耳朵相比，癫痫发作对侧的手或耳朵在心理物理任务上的初始表现（视觉任务将双眼进行）。

This subproject is one of many research subprojects utilizing the resources provided by a Center grant funded by NIH/NCRR. The subproject and investigator (PI) may have received primary funding from another NIH source, and thus could be represented in other CRISP entries. The institution listed is for the Center, which is not necessarily the institution for the investigator. The hypothesis of this protocol is that temporal lobe epilepsy (TLE) is a network disease, involving brain regions anatomically and functionally distant from the seizure focus. The seizure focus can cause dysfunction throughout the network in the interictal state, i.e., between seizures. The specific aims are as follows: 1) To define the extent and severity of interictal perceptual deficits in 3 sensory modalities using basic psychophysical techniques. 2) To determine the effect of stimulus temporal features, specifically duration, on observed psychophysically-determined perceptual impairments. 3) To document the effect of removing the seizure focus on perceptual abilities. Potential subjects will be prescreened for meeting the inclusion and exclusion criteria by telephone interview with research personnel. Forty patients with unilateral, medically intractable TLE and 20 neurologically normal controls will undergo a battery of neuropsychological and perceptual psychophysical tests. Control subjects will be tested once on all tasks; TLE subjects will be tested three times: 1) baseline assessment while taking their usual anti-epileptic drugs (AEDs, initial test), 2) after substantial or complete AED withdrawal during clinically indicated, inpatient video-EEG monitoring (non-AED test), and 3) 6 months after surgery or 6 months after initial testing for those patients who ultimately do not have surgery (final test). AED levels in TLE subjects will be measured during all three testing sessions, on the first day of testing. All of the psychophysical tests are painless and non-invasive. Visual tasks involve looking at stimuli on a computer screen. Auditory stimuli are presented through high-quality headphones at a comfortable volume. Tactile stimuli are applied to the subject's fingertip with low or moderate force. Primary outcome measures will include comparing performance on the various tests between the following groups: TLE subjects - initial to normal controls, 2) paired final to initial, and 3) paired non-AED to initial. Secondary outcome measures will include initial performance on psychophysical tasks with the hand or ear contra lateral to side of seizure onset compared to hand or ear ipsilateral to side of seizure onset (visual tasks will be performed binocularly).