Zhao Lili, An Dongmei, Mao Limei, Tang Xiangdong, He Li, Zhou Dong
Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Department of Electroneurophysiology, West China Hospital, Sichuan University, Chengdu, Sichuan, China.
Epilepsy Behav. 2017 Mar;68:35-40. doi: 10.1016/j.yebeh.2016.11.007. Epub 2017 Jan 19.
We investigated the changes of mismatch negativity (MMN) in patients with temporal lobe epilepsy (TLE) and explored the possible role of MMN in lateralizing their seizure focus. Thirty patients with TLE and thirty healthy controls were included. MMN was elicited in each subject. Patients with TLE were divided into three subgroups: unilateral left TLE; unilateral right TLE, and bilateral TLE. MMN amplitudes and latencies were compared between the patients with TLE and the control group, and also among the three subgroups of TLE, using repeated measures analyses of variance (ANOVA). To assess the lateralizing value of MMN, MMN latencies and amplitudes at the mastoid sites between the ipsilateral and contralateral sides of epileptic focus in patients with unilateral TLE were compared using t-test. Compared with controls, each subgroup of patients with TLE had longer latencies of MMN at both fronto-central and mastoid sites, but the amplitudes of MMN were not significantly different. The amplitudes and latencies of MMN were not significantly different between the ipsilateral and contralateral sides of seizure focus at mastoid sites. The present findings of prolonged latencies of MMN are suggestive of cognitive impairment in TLE. Both the mastoid sites and the fronto-central sites are involved, which likely reflect widespread cortical abnormalities in TLE. However, the changes of MMN during the interictal phase are not useful for lateralizing the seizure focus in patients with TLE.
我们研究了颞叶癫痫（TLE）患者失匹配负波（MMN）的变化，并探讨了MMN在确定其癫痫发作灶侧别方面的可能作用。纳入了30例TLE患者和30名健康对照者。对每位受试者诱发MMN。TLE患者被分为三个亚组：左侧单侧TLE；右侧单侧TLE和双侧TLE。使用重复测量方差分析（ANOVA）比较TLE患者与对照组之间以及TLE的三个亚组之间的MMN波幅和潜伏期。为了评估MMN的定侧价值，使用t检验比较单侧TLE患者癫痫灶同侧和对侧乳突部位的MMN潜伏期和波幅。与对照组相比，各TLE患者亚组在额中央和乳突部位的MMN潜伏期均较长，但MMN波幅无显著差异。在乳突部位，癫痫发作灶同侧和对侧的MMN波幅和潜伏期无显著差异。MMN潜伏期延长的当前研究结果提示TLE患者存在认知障碍。乳突部位和额中央部位均受累，这可能反映了TLE患者广泛的皮质异常。然而，发作间期MMN的变化对TLE患者癫痫发作灶的定侧并无帮助。
