Cleveland Clinic Epilepsy Center, Neurological Institute, OH 44195, USA.
Arch Clin Neuropsychol. 2011 Dec;26(8):739-45. doi: 10.1093/arclin/acr067. Epub 2011 Aug 11.
This study examined pre-surgical depressed mood as a predictor of post-surgical memory change in adults who underwent temporal lobe resections (TLRs; n = 211). Patients completed the Wechsler Memory Scale-III and Beck Depression Inventory-Second Edition (BDI-II) before and after TLR (left = 110, right = 101) and were divided into two groups (clinically elevated depressive symptoms or not depressed) based on BDI-II score. Left-TLR patients with poorer pre-surgical mood had greater verbal memory declines after surgery compared with nondepressed left- or right-TLR patients and right-TLR patients with poor mood. Further, pre-surgical BDI-II score demonstrated incremental validity in predicting post-surgical memory change in left-TLR patients beyond pre-surgical memory scores. Differences in seizure outcome and post-surgical mood change could not account for memory decline. Results suggest that elevated pre-surgical depressive symptomatology is a risk factor for post-surgical memory decline and indicate that mood should be considered when advising patients about cognitive risks associated with temporal lobectomy. Results are discussed in terms of poor pre-surgical mood as an indicator of reduced cognitive reserve.
本研究考察了术前抑郁情绪是否可以预测行颞叶切除术（TLR；n=211）的成年人术后记忆变化。患者在 TLR 前后（左=110，右=101）完成了韦氏记忆量表第三版（WMS-III）和贝克抑郁量表第二版（BDI-II），并根据 BDI-II 评分分为两组（有临床显著抑郁症状或无抑郁）。与非抑郁的左或右 TLR 患者和情绪不佳的右 TLR 患者相比，术前情绪较差的左 TLR 患者术后言语记忆下降更大。此外，术前 BDI-II 评分在预测左 TLR 患者术后记忆变化方面具有增量有效性，超过了术前记忆评分。手术结果和术后情绪变化的差异不能解释记忆下降。结果表明，术前抑郁症状升高是术后记忆下降的一个风险因素，并表明在告知患者与颞叶切除术相关的认知风险时应考虑情绪因素。结果从认知储备减少的指标角度讨论了术前情绪不佳的情况。
