Lah Suncica, Lee Teresa, Grayson Sandra, Miller Laurie
Macquarie University, Sydney, Australia.
Epilepsia. 2006 Mar;47(3):615-25. doi: 10.1111/j.1528-1167.2006.00476.x.
In a previous investigation (Lah et al., 2004), we found deficits in retrograde memory in patients who had undergone temporal lobectomy (TL). In this study, we set out to determine whether such deficits are present before surgery in patients with temporal lobe epilepsy (TLE).
Memory for public and autobiographic facts and events was assessed in patients with focal left-sided (n=15) or right-sided (n=14) TLE and healthy control subjects (n=15). The impact of epilepsy and underlying cognitive deficits on retrograde memory also was examined.
Patients with left TLE demonstrated retrograde memory deficits across domains. Patients with right TLE showed defective recall only in the autobiographic domain. Young age at onset (younger than 14 years) was associated with greater difficulties in recall of famous events, and patients receiving polytherapy had significantly reduced recall of autobiographic events compared with those receiving monotherapy. In most cases, deficient memory for the past was associated with impairments in other cognitive skills, especially language abilities.
In unoperated-on patients with TLE, we found deficits in retrograde memory that were similar to those seen after TL, with the pattern of deficits being influenced by side of lesion, anticonvulsant medication, and word-finding deficits. Unlike patients tested after right TL, patients with right TLE did not have difficulty recalling details of famous events, which raises the possibility that right TL results in a decline in this aspect of retrograde memory.
在之前的一项研究(拉赫等人,2004年)中,我们发现接受颞叶切除术(TL)的患者存在逆行性记忆缺陷。在本研究中,我们着手确定颞叶癫痫(TLE)患者在手术前是否存在此类缺陷。
对左侧局灶性(n = 15)或右侧局灶性(n = 14)TLE患者及健康对照者(n = 15)进行公共及自传性事实和事件的记忆评估。还研究了癫痫及潜在认知缺陷对逆行性记忆的影响。
左侧TLE患者在各个领域均表现出逆行性记忆缺陷。右侧TLE患者仅在自传性领域存在回忆缺陷。发病年龄较小(14岁以下)与著名事件回忆困难程度增加有关,与接受单一疗法的患者相比,接受联合疗法的患者自传性事件回忆显著减少。在大多数情况下,对过去记忆不足与其他认知技能受损有关联,尤其是语言能力。
在未经手术的TLE患者中,我们发现逆行性记忆缺陷与TL术后所见相似,缺陷模式受病变侧、抗惊厥药物及找词缺陷的影响。与右侧TL术后测试的患者不同,右侧TLE患者回忆著名事件细节没有困难,这增加了右侧TL导致逆行性记忆这方面下降的可能性。