Sawrie S M, Martin R C, Gilliam F, Knowlton R, Faught E, Kuzniecky R
Department of Neurology, Epilepsy Center, University of Alabama at Birmingham, Birmingham, Alabama 35294, USA.
Epilepsia. 2001 May;42(5):651-9. doi: 10.1046/j.1528-1157.2001.30200.x.
To examine the lateralization utility of preoperative verbal retention in patients with and without bilateral hippocampal atrophy.
The sample consisted of 74 patients with EEG-defined unilateral temporal lobe epilepsy (TLE) who had also undergone volumetric magnetic resonance imaging (MRI). Verbal retention was operationalized by the Logical Memory percentage retention subtest (LM%) of the Wechsler Memory Scale. Patients were divided into groups with (a) bilaterally normal hippocampal volumes, (b) unilateral atrophy, or (c) bilateral atrophy. Two different thresholds (empirically derived vs. normative) were used to lateralize on the basis of LM%. LM% lateralization was then examined by group using chi2, sensitivity, positive predictive values, and odds ratios. Analyses were also conducted separately in the subset of patients who were seizure free after surgery.
Mean LM% performance was significantly lower in patients with left versus right TLE in the subset with bilateral hippocampal atrophy (p = 0.018), but not in patients with a normal MRI (p = 0.918) or unilateral atrophy (p = 0.087). The odds of a correct lateralization by LM% increased from 1.67 in patients with normal MRI to 36.11 in patients with bilateral hippocampal atrophy. The power of a right and left lateralization prediction by LM% was 100% and 75%, respectively, in patients with bilateral hippocampal atrophy. Similar results were obtained when analysis was restricted to patients who were seizure free after surgery.
Preoperative verbal retention as measured by LM% may provide meaningful lateralization information in patients who are difficult to lateralize via MRI.
研究术前言语记忆保留情况在有和没有双侧海马萎缩的患者中的定侧效用。
样本包括74例经脑电图定义为单侧颞叶癫痫（TLE）且已接受容积磁共振成像（MRI）检查的患者。言语记忆保留通过韦氏记忆量表的逻辑记忆保留百分比子测试（LM%）来衡量。患者被分为三组：（a）双侧海马体积正常；（b）单侧萎缩；（c）双侧萎缩。基于LM%，使用两种不同的阈值（经验得出的与标准的）进行定侧。然后通过卡方检验、敏感性、阳性预测值和优势比按组检查LM%定侧情况。还对术后无癫痫发作的患者子集进行了单独分析。
在双侧海马萎缩的子集中，左侧TLE患者的平均LM%表现显著低于右侧TLE患者（p = 0.018），但在MRI正常的患者中无显著差异（p = 0.918），在单侧萎缩的患者中也无显著差异（p = 0.087）。通过LM%正确定侧的几率从MRI正常患者的1.67增加到双侧海马萎缩患者的36.11。在双侧海马萎缩的患者中，通过LM%进行右侧和左侧定侧预测的效能分别为100%和75%。当分析仅限于术后无癫痫发作的患者时，获得了类似的结果。
通过LM%测量的术前言语记忆保留情况可能为难以通过MRI进行定侧的患者提供有意义的定侧信息。
