Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
Epilepsy Res. 2012 Jan;98(1):1-13. doi: 10.1016/j.eplepsyres.2011.10.009. Epub 2011 Nov 17.
Temporal lobe epilepsy (TLE) is typically associated with long-term memory dysfunction. The frontal lobes support high-level cognition comprising executive skills and working memory that is vital for daily life functioning. Deficits in these functions have been increasingly reported in TLE. Evidence from both the neuropsychological and neuroimaging literature suggests both executive function and working memory are compromised in the presence of TLE. In relation to executive impairment, particular focus has been paid to set shifting as measured by the Wisconsin Card Sorting Task. Other discrete executive functions such as decision-making and theory of mind also appear vulnerable but have received little attention. With regard to working memory, the medial temporal lobe structures appear have a more critical role, but with emerging evidence of hippocampal dependent and independent processes. The relative role of underlying pathology and seizure spread is likely to have considerable bearing upon the cognitive phenotype and trajectory in TLE. The identification of the nature of frontal lobe dysfunction in TLE thus has important clinical implications for prognosis and surgical management. Longitudinal neuropsychological and neuroimaging studies assessing frontal lobe function in TLE patients pre- and postoperatively will improve our understanding further.
颞叶癫痫（TLE）通常与长期记忆功能障碍有关。额叶支持高级认知，包括执行技能和工作记忆，这对日常生活功能至关重要。在 TLE 中，这些功能的缺陷越来越多地被报道。神经心理学和神经影像学文献的证据表明，在 TLE 存在的情况下，执行功能和工作记忆都受到了损害。关于执行功能障碍，特别关注的是威斯康星卡片分类任务测量的转换能力。其他离散的执行功能，如决策和心理理论，也似乎很脆弱，但关注很少。关于工作记忆，内侧颞叶结构似乎起着更关键的作用，但也有越来越多的证据表明存在海马依赖性和非依赖性过程。潜在病理和癫痫传播的相对作用可能对 TLE 的认知表型和轨迹有很大影响。因此，确定 TLE 中额叶功能障碍的性质对预后和手术管理具有重要的临床意义。对 TLE 患者术前和术后进行额叶功能的纵向神经心理学和神经影像学研究将进一步提高我们的认识。
