Unidade de Pesquisa e Tratamento das Epilepsias (UNIPETE), Universidade Federal de São Paulo (UNIFESP-EPM), São Paulo, SP, Brazil; Centro de Cirurgia de Epilepsia de Santa Catarina (CEPESC), Hospital Governador Celso Ramos (HGCR), Florianópolis, SC, Brazil.
Epilepsy Behav. 2013 Oct;29(1):247-51. doi: 10.1016/j.yebeh.2013.06.034. Epub 2013 Aug 22.
Juvenile myoclonic epilepsy (JME) is a well-defined idiopathic generalized epilepsy (IGE) syndrome, being the most common IGE in adults and accounting for 5-11% of patients with epilepsy. While neuropsychological and neuroimaging studies have discussed the thalamofrontal dysfunction as the major pathophysiologic mechanism of JME, investigation on memory is scarce in patients with JME, with lack of objective assessments addressing common complaints and daily difficulties such as recalling telephone numbers, messages to pass on, and taking antiepileptic drugs regularly. The aim of this study was to objectively assess memory deficits in a group of patients with JME using neuropsychological examination combined with structural MRI of the hippocampi. After informed consent, a cohort of 56 consecutive patients with JME (29 males; mean age ± SD = 26.5 ± 9.01 years; range = 14.0-55.0 years) was included. The control group consisted of 42 healthy volunteers (18 males; mean age ± SD = 31.0 ± 8.54 years; range=20.0-56.0 years) without a family history of neuropsychiatric disorders. Patients and controls were submitted to a MRI and to a neuropsychological assessment, and comparisons between groups were performed, as well as a correlation study between hippocampal atrophy and neuropsychological performance in a group of patients with JME. The level of statistical significance was set at p<0.05. Significant hippocampal atrophy among patients with JME was observed, which was correlated with memory dysfunctions. The present findings reinforce the existence of functional-anatomic ictogenic networks that are not limited to frontal lobes, providing further support towards the concept of 'system epilepsies' in JME.
青少年肌阵挛癫痫（JME）是一种明确的特发性全面性癫痫（IGE）综合征，是成人中最常见的 IGE，占癫痫患者的 5-11%。虽然神经心理学和神经影像学研究已经讨论了丘脑-额叶功能障碍作为 JME 的主要病理生理机制，但 JME 患者的记忆研究很少，缺乏客观评估来解决常见的抱怨和日常困难，如回忆电话号码、要传达的信息以及定期服用抗癫痫药物。本研究的目的是使用神经心理学检查结合海马结构 MRI 客观评估一组 JME 患者的记忆缺陷。在获得知情同意后，纳入了 56 例连续 JME 患者（29 名男性；平均年龄±标准差=26.5±9.01 岁；范围=14.0-55.0 岁）。对照组由 42 名健康志愿者（18 名男性；平均年龄±标准差=31.0±8.54 岁；范围=20.0-56.0 岁）组成，无神经精神障碍家族史。患者和对照组均接受 MRI 和神经心理学评估，并对两组进行比较，还对一组 JME 患者的海马萎缩与神经心理学表现进行了相关性研究。统计显著性水平设定为 p<0.05。观察到 JME 患者存在明显的海马萎缩，与记忆功能障碍相关。这些发现进一步证实了存在不限于额叶的功能解剖致痫网络，为 JME 中“系统癫痫”的概念提供了更多支持。
