Department of Neurology and Clinical Neurophysiology, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands.
J Neurol. 2012 Aug;259(8):1632-8. doi: 10.1007/s00415-011-6391-4. Epub 2012 Jan 26.
The purpose of this study was to evaluate the contribution of posterior circulation to memory function by comparing memory scores between patients with and without a foetal-type posterior cerebral artery (FTP) during the intracarotid amobarbital procedure (IAP) in epilepsy patients. Patients undergoing bilateral IAP between January 2004 and January 2010 were retrospectively included. Pre-test angiograms were assessed for the presence of a FTP. Memory function scores (% correct) after right and left injections were obtained. Functional significance of FTP was affirmed by relative occipital versus parietal EEG slow-wave increase during IAP. Memory and EEG scores were compared between patients with and without FTP (Mann-Whitney U test). A total of 106 patients were included, 73 with posterior cerebral arteries (PCA) without FTP ('non-FTP'), 28 patients with unilateral FTP and 5 with a bilateral FTP. Memory scores were lower when amytal was injected to the hemisphere contralateral to the presumed seizure focus (on the right decreasing from 98.3 to 59.1, and on the left decreasing from 89.1 to 72.4; p < 0.001). When IAP was performed on the side of FTP memory scores were significantly lower (70.8) compared to non-FTP (82.0; p = 0.02). Relative occipital EEG changes were 0.44 for FTP cases and 0.36 for non-FTP patients (p = 0.01). A relationship between vasculature and brain function was demonstrated by lower memory scores and more slow-wave activity on occipital EEG during IAP in patients with foetal-type PCA compared to patients with non-FTP. This suggests an important contribution of brain areas supplied by the PCA to memory function.
本研究旨在通过比较癫痫患者在颅内动脉安替比林试验（IAP）中是否存在胎型大脑后动脉（FTP），评估后循环对记忆功能的贡献。回顾性纳入了 2004 年 1 月至 2010 年 1 月期间接受双侧 IAP 的患者。评估术前血管造影是否存在 FTP。获得右侧和左侧注射后的记忆功能评分（%正确）。通过 IAP 期间相对枕叶与顶叶 EEG 慢波增加来证实 FTP 的功能意义。比较了 FTP 患者和非 FTP 患者（Mann-Whitney U 检验）的记忆和 EEG 评分。共纳入 106 例患者，73 例大脑后动脉（PCA）无 FTP（“非-FTP”），28 例单侧 FTP，5 例双侧 FTP。当阿米妥钠注射到假定癫痫灶对侧半球时，记忆评分较低（右侧从 98.3 降至 59.1，左侧从 89.1 降至 72.4；p<0.001）。当在 FTP 侧进行 IAP 时，记忆评分明显较低（70.8）与非-FTP（82.0；p=0.02）。FTP 病例的相对枕叶 EEG 变化为 0.44，非-FTP 患者为 0.36（p=0.01）。与非-FTP 患者相比，具有胎型 PCA 的患者在 IAP 期间枕叶 EEG 上的记忆评分较低且慢波活动更多，这表明 PCA 供应的脑区对记忆功能有重要贡献。
