Adda Carla C, Castro Luiz H M, Além-Mar e Silva Liliane C, de Manreza Maria L G, Kashiara Rosa
Psychology Division and Department of Neurology, São Paulo Medical School, Brazil.
Neuropsychologia. 2008;46(7):1954-64. doi: 10.1016/j.neuropsychologia.2008.01.016. Epub 2008 Feb 2.
Episodic memory impairment is commonly observed in patients with epilepsy associated with mesial temporal sclerosis (MTS). Prospective memory (PM) is a set cognitive abilities that allow future performance of a present intention, in response to time- or event-based evocation cues, that trigger the intended action at the appropriate time. PM has not been evaluated in mesial temporal sclerosis. We evaluated the role of right and left hippocampal lesions on performance in both the retrospective and prospective PM components in patients with epilepsy secondary to mesial temporal sclerosis and correlated with performance in traditional neuropsychological tests, as well as with self-perception of memory impairment. We tested the hypotheses that a hippocampal lesion impacts on the prospective components of PM, and that a left-sided lesion had a greater impact on performance in the prospective component of PM than a right-sided lesion. We evaluated PM in 26 patients with right MTS, 22 left MTS patients, and 26 age-gender and education matched controls. The prospective component of PM was impaired in both patient groups, with both a lesion (patients performed significantly worse in the PM battery) and laterality effect (left MTS patients performed significantly worse than right MTS patients in the PM battery). Performance in the prospective component of the PM battery correlated with long-term delay performance in episodic verbal memory and self-perception of memory impairment in the left MTS group. The retrospective component was impaired in left MTS patients. Impaired performance was not accounted for solely by depression, anxiety or an antiepileptic drug effect. We conclude that mesial temporal lobe structures, including the hippocampus, play an important role in both the prospective and retrospective components of PM processes in tasks involving long delay intervals.
发作性记忆障碍常见于伴有内侧颞叶硬化（MTS）的癫痫患者。前瞻性记忆（PM）是一组认知能力，可根据基于时间或事件的诱发线索，在适当时间触发预期行动，从而使当前意图在未来得以执行。内侧颞叶硬化患者的前瞻性记忆尚未得到评估。我们评估了左右海马体病变对继发于内侧颞叶硬化的癫痫患者回顾性和前瞻性记忆成分表现的作用，并将其与传统神经心理学测试的表现以及记忆障碍的自我认知进行了关联。我们检验了以下假设：海马体病变会影响前瞻性记忆的成分，并且左侧病变对前瞻性记忆成分表现的影响大于右侧病变。我们对26例右侧MTS患者、22例左侧MTS患者以及26例年龄、性别和教育程度相匹配的对照者进行了前瞻性记忆评估。两组患者的前瞻性记忆成分均受损，存在病变效应（患者在前瞻性记忆测试组中的表现明显更差）和偏侧性效应（左侧MTS患者在前瞻性记忆测试组中的表现明显比右侧MTS患者更差）。在前瞻性记忆测试组中，左侧MTS组的表现与情景性言语记忆的长期延迟表现以及记忆障碍的自我认知相关。左侧MTS患者的回顾性记忆成分受损。表现受损并非仅由抑郁、焦虑或抗癫痫药物效应所致。我们得出结论，在内侧颞叶结构，包括海马体，在涉及长延迟间隔的任务中，在前瞻性和回顾性记忆过程成分中均起重要作用。
