Knopman Alex A, Wong Chong H, Stevenson Richard J, Homewood Judi, Mohamed Armin, Somerville Ernest, Eberl Stefan, Wen Lingfeng, Fulham Michael, Bleasel Andrew F
Department of Psychology, Macquarie University, NSW, Australia; Department of Medical Psychology, Westmead Hospital, NSW, Australia.
Sydney Medical School, University of Sydney, NSW, Australia; Departments of Neurology, Westmead Hospital and The Children's Hospital at Westmead, NSW, Australia.
Epilepsy Behav. 2015 Mar;44:136-42. doi: 10.1016/j.yebeh.2015.01.023. Epub 2015 Feb 20.
We examined the relationship between baseline neuropsychological functioning and 18-fluorodeoxyglucose positron emission tomography (FDG-PET) in intractable mesial temporal lobe epilepsy (MTLE). We hypothesized relationships between dominant temporal lobe hypometabolism and verbal memory and between nondominant temporal lobe hypometabolism and nonverbal memory in line with the lateralized material-specific model of memory deficits in MTLE. We also hypothesized an association between performance on frontal lobe neuropsychological tests and prefrontal hypometabolism. Thirty-two patients who had undergone temporal lobectomy for treatment of MTLE and who completed both presurgical FDG-PET and comprehensive neuropsychological investigations with widely used standardized measures were included. Age-adjusted composite measures were calculated for verbal memory, nonverbal memory, relative material-specific memory, IQ, executive function, attention/working memory, and psychomotor speed. Fluorodeoxyglucose positron emission tomography was analyzed with statistical parametric mapping (SPM) to identify hypometabolism relative to healthy controls. Pearson's correlation was used to determine the relationship between regions of hypometabolism and neuropsychological functioning. Dominant temporal lobe hypometabolism was associated with relatively inferior verbal memory, while nondominant temporal lobe hypometabolism was associated with inferior nonverbal memory. No relationship was found between performance on any frontal lobe measures and prefrontal hypometabolism. Statistical parametric mapping-quantified lateralized temporal lobe hypometabolism correlates with material-specific episodic memory impairment in MTLE. In contrast, prefrontal hypometabolism is not associated with performance on frontal lobe measures. We suggest that this is because frontal lobe neuropsychology tests may not be good measures of isolated frontal lobe functioning.
我们研究了难治性内侧颞叶癫痫（MTLE）患者的基线神经心理功能与18-氟脱氧葡萄糖正电子发射断层扫描（FDG-PET）之间的关系。我们假设，根据MTLE记忆缺陷的侧化材料特异性模型，优势颞叶低代谢与言语记忆之间以及非优势颞叶低代谢与非言语记忆之间存在关联。我们还假设额叶神经心理测试表现与前额叶低代谢之间存在关联。研究纳入了32例因MTLE接受颞叶切除术且术前完成FDG-PET检查以及使用广泛应用的标准化测量方法进行全面神经心理调查的患者。计算了言语记忆、非言语记忆、相对材料特异性记忆、智商、执行功能、注意力/工作记忆和精神运动速度的年龄校正综合测量值。采用统计参数映射（SPM）分析氟脱氧葡萄糖正电子发射断层扫描数据，以确定相对于健康对照的低代谢区域。采用Pearson相关性分析来确定低代谢区域与神经心理功能之间的关系。优势颞叶低代谢与相对较差的言语记忆相关，而非优势颞叶低代谢与较差的非言语记忆相关。未发现任何额叶测量指标的表现与前额叶低代谢之间存在关系。统计参数映射量化的侧化颞叶低代谢与MTLE中材料特异性情景记忆损害相关。相比之下，前额叶低代谢与额叶测量指标的表现无关。我们认为这是因为额叶神经心理学测试可能并非孤立额叶功能的良好测量指标。
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