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难治性颞叶癫痫患者的认知障碍

Cognitive impairments in patients with intractable temporal lobe epilepsy.

作者信息

Tavakoli Mahgol, Barekatain Majid, Doust Hamid Taher Neshat, Molavi Hossein, Nouri Reza Kormi, Moradi Alireza, Mehvari Jafar, Zare Mohammad

机构信息

Assistant Professor, Department of Psychology, School of Educational Sciences and Psychology, University of Isfahan, Isfahan, Iran.

出版信息

J Res Med Sci. 2011 Nov;16(11):1466-72.

Abstract

BACKGROUND

Cognitive impairment associated with temporal lobe epilepsy (TLE) has been recognized in multiple studies. We designed this study to find a specific cognitive profile in patients with TLE who were candidates for epilepsy surgery. We also sought to find if neuropsychological assessment could differentiate left TLE, right TLE and normal subjects.

METHODS

The sample of this study consisted of 29 patients with right TLE, 31 with left TLE, and 32 subjects without history of seizure as the control group. For all recruited patients and controls, demographic questionnaire, Wechsler Memory Scale-III (WMS-III) and Wechsler Adult Intelligence Scale-R (WAIS-R) were administered. Multivariate analysis of variance was carried out to reveal differences in memory and intelligence performance between the three groups.

RESULTS

All of the mean scores of the WMS-III indexes were significantly higher in the control group in comparison with the right or the left TLE groups (p < 0.001). There were not any significant differences between mean scores of WMS-III indexes of the right and the left. The WAIS-R also showed significantly better mean scores of full scale intelligence quotient (FSIQ) and performance intelligence quotient (PIQ) in the control groups than both of the right and left TLE patients (p < 0.001). Although the verbal intelligence quotient (VIQ) mean scores were significantly different between the left TLE and the control group (p = 0.037), there were not any significant differences between the right TLE patients and the control group.

CONCLUSIONS

These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

摘要

背景

多项研究已认识到与颞叶癫痫(TLE)相关的认知障碍。我们设计了本研究,以找出适合癫痫手术的TLE患者的特定认知特征。我们还试图确定神经心理学评估是否能够区分左侧TLE、右侧TLE患者和正常受试者。

方法

本研究样本包括29例右侧TLE患者、31例左侧TLE患者以及32例无癫痫发作史的受试者作为对照组。对所有招募的患者和对照者进行人口统计学问卷调查、韦氏记忆量表第三版(WMS-III)和韦氏成人智力量表修订版(WAIS-R)测试。进行多变量方差分析以揭示三组之间在记忆和智力表现方面的差异。

结果

与右侧或左侧TLE组相比,对照组WMS-III各项指标的所有平均得分均显著更高(p < 0.001)。右侧和左侧WMS-III指标的平均得分之间没有显著差异。WAIS-R也显示,对照组的全量表智商(FSIQ)和操作智商(PIQ)平均得分显著高于右侧和左侧TLE患者(p < 0.001)。尽管左侧TLE患者与对照组之间的言语智商(VIQ)平均得分存在显著差异(p = 0.037),但右侧TLE患者与对照组之间没有显著差异。

结论

这些发现表明,WMS-III和WAIS-R能够区分难治性颞叶癫痫患者与正常受试者。然而,所获得的认知特征无法区分右侧和左侧TLE。

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