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

这个子项目是利用由NIH/NCRR资助的中心拨款提供的资源的许多研究子项目之一。子项目和调查员(PI)可能从另一个NIH来源获得了主要资金，因此可能会出现在其他CRISE条目中。列出的机构是针对中心的，而不一定是针对调查员的机构。这一方案的假设是，颞叶癫痫(TLE)是一种网络性疾病，涉及大脑解剖和功能上远离癫痫灶的区域。癫痫灶可在发作间歇期，即发作之间，引起整个网络的功能障碍。具体目标如下：1)使用基本的心理物理技术，确定3种感觉形式发作间期知觉缺陷的程度和严重程度。2)确定刺激时间特征，特别是持续时间对观察到的心理生理决定的知觉损伤的影响。3)记录移除癫痫焦点对知觉能力的影响。将通过电话采访研究人员，对符合纳入和排除标准的潜在受试者进行预筛选。40名单侧难治性TLE患者和20名神经学正常的对照组将接受一系列神经心理学和知觉心理物理测试。对照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)在服用常用抗癫痫药物(AEDs，初始测试)时进行基线评估，2)在临床指征期间大量或完全停用AED后，住院患者进行视频-脑电监测(非AED测试)，以及3)对于那些最终没有进行手术的患者，在手术后6个月或初始测试后6个月(最终测试)。TLE受试者的AED水平将在所有三个测试过程中进行测量，即测试的第一天。所有的心理物理测试都是无痛和无创的。视觉任务包括在电脑屏幕上看刺激。听觉刺激通过高质量的耳机以舒适的音量呈现。触觉刺激以低或中等的力施加在受试者的指尖上。主要结果衡量标准将包括比较以下组之间在各种测试中的表现：TLE受试者-初始与正常对照，2)配对最终与初始，以及3)非AED与初始配对。次要结果测量将包括在精神物理任务中的初始表现，与癫痫发作侧的手或耳朵对侧相比(视觉任务将以双眼进行)。

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).