Yao Xiaojuan, Yu Qing, Yang Erjuan, Ouyang Hui, Chen Ying, Yang Weidong, Chen Zhijuan, Wang Zengguang
Department of Neurosurgery, General Hospital, Tianjin Medical University, Tianjin 300052, China.
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Zhonghua Yi Xue Za Zhi. 2014 Feb 25;94(7):521-4.
To explore the changes of executive function in patients with temporal lobe epilepsy and analyze its correlation with P300 event-related potentials.
Fifty patients with temporal lobe epilepsy and 30 age, gender and education-matched healthy control subjects were assessed by neuropsychological tests, including Montreal cognitive assessment (MoCA), working memory, verbal fluency, trail making, digit span, digit symbol and Stroop color-word interference to detect P300 event-related potentials.
In temporal lobe epilepsy group, the scores in MoCA, verbal and non-verbal working memory, verbal fluency, digit span, digit symbol and Stroop test were lower than those of the normal control group. And trail making tests A and B became prolonged (P < 0.05). Comparing with normal control group, temporal lobe epilepsy patients had prolonged latency [(332 ± 33)ms] and decreased P300 amplitude [(10 ± 8)µV] (P < 0.05). Comparing epileptogenic focus group on the left and right sides, there was statistically significant difference in verbal working memory (P < 0.05). There was a negative correlation of P300 latency and MoCA, non-verbal working memory, digit span and digit symbol test scores (r = -0.29--0.45, P < 0.05). And a positive correlation of P300 amplitude and MoCA, non-verbal working memory, digit symbol conversion and Stroop scores was also found (r = 0.37-0.47, P < 0.05). P300 amplitude was more relevant to overall cognitive level and executive functions.
Temporal lobe is involved in the regulation of executive functions. Besides a wide range of cognitive impairment, temporal lobe epilepsy patients have a number of executive dysfunctions, including working memory, cognitive flexibility, attention and inhibitory control ability. And an impairment of verbal working memory is evident in left-sided lesion. Their manifestations include decreased latency and amplitude of P300 on executive function tests. Therefore these two objective parameters may be employed to evaluate the cognitive impairment in patients with temporal lobe epilepsy.
探讨颞叶癫痫患者执行功能的变化，并分析其与P300事件相关电位的相关性。
对50例颞叶癫痫患者及30例年龄、性别、教育程度相匹配的健康对照者进行神经心理学测试，包括蒙特利尔认知评估（MoCA）、工作记忆、言语流畅性、连线测验、数字广度、数字符号及Stroop色词干扰试验，并检测P300事件相关电位。
颞叶癫痫组在MoCA、言语和非言语工作记忆、言语流畅性、数字广度、数字符号及Stroop测验中的得分低于正常对照组。且连线测验A和B的时间延长（P<0.05）。与正常对照组相比，颞叶癫痫患者的潜伏期延长[（332±33）ms]，P300波幅降低[（10±8）μV]（P<0.05）。比较左右致痫灶组，言语工作记忆存在统计学差异（P<0.05）。P300潜伏期与MoCA、非言语工作记忆、数字广度及数字符号测验得分呈负相关（r=-0.29～-0.45，P<0.05）。P300波幅与MoCA、非言语工作记忆、数字符号转换及Stroop得分呈正相关（r=0.37～0.47，P<0.05）。P300波幅与整体认知水平及执行功能更相关。
颞叶参与执行功能的调节。颞叶癫痫患者除存在广泛的认知损害外，还存在多种执行功能障碍，包括工作记忆、认知灵活性、注意力及抑制控制能力。左侧病变时言语工作记忆损害明显。其表现为执行功能测试中P300潜伏期缩短、波幅降低。因此，这两个客观参数可用于评估颞叶癫痫患者的认知损害。
