Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, United Kingdom.
Epilepsia. 2012 Oct;53(10):1756-64. doi: 10.1111/j.1528-1167.2012.03570.x. Epub 2012 Jul 5.
Focal epilepsies are often associated with structural and functional changes that may extend beyond the area of seizure onset. In this study we investigated the functional anatomy of memory in patients with frontal lobe epilepsy (FLE), focusing on the local and remote effects of FLE on the networks supporting memory encoding.
We studied 32 patients with drug-resistant FLE and 18 controls using a functional magnetic resonance imaging (fMRI) memory encoding paradigm.
During encoding of stimuli, patients with FLE recruited more widely distributed areas than healthy controls, in particular within the frontal lobe contralateral to the seizure onset. Normal memory performance was associated with increased recruitment of frontal areas, and conversely a poor performance was associated with an absence of this increased recruitment and decreased activation in mesial temporal lobe areas.
In patients with FLE, recruitment of wider areas, particularly in the contralateral frontal lobe, appears to be an effective compensatory mechanism to maintain memory function. Impaired hippocampal activation is relatively rare and, in turn, associated with poor recognition memory.
局灶性癫痫常与结构和功能改变相关，这些改变可能超出发作起始区域。在这项研究中，我们调查了额叶癫痫（FLE）患者的记忆功能解剖，重点研究了 FLE 对支持记忆编码的网络的局部和远程影响。
我们使用功能磁共振成像（fMRI）记忆编码范式研究了 32 例耐药性 FLE 患者和 18 名对照者。
在刺激编码期间，FLE 患者比健康对照组募集了更广泛分布的区域，特别是在与发作起始相对应的对侧额叶。正常的记忆表现与额叶区域的募集增加有关，相反，较差的表现与这种募集增加的缺乏以及内侧颞叶区域的激活减少有关。
在 FLE 患者中，更广泛区域的募集，特别是对侧额叶的募集，似乎是维持记忆功能的有效代偿机制。海马激活受损相对较少，并且与较差的识别记忆有关。
