Agah Elmira, Asgari-Rad Nasima, Ahmadi Mona, Tafakhori Abbas, Aghamollaii Vajiheh
School of Medicine, Tehran University of Medical Sciences, Tehran, Iran; NeuroImmunology Research Association (NIRA), Universal Scientific Education and Research Network (USERN), Tehran, Iran; Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Iranian Center of Neurological Research (ICNR), Tehran University of Medical Sciences, Tehran, Iran.
Epilepsy Res. 2017 Jul;133:22-27. doi: 10.1016/j.eplepsyres.2017.03.011. Epub 2017 Apr 5.
Previous studies have demonstrated executive dysfunction in patients with temporal lobe epilepsy (TLE). Frontal assessment battery (FAB) is a short neuropsychological tool that was developed for assessment of frontal lobe function in a clinical setting. The aim of the present study is to evaluate the clinical utility of FAB for detection of executive dysfunction in TLE patients. Forty-eight TLE patients and 48 sex and age-matched healthy controls participated in this study. Compared to healthy participants, the total FAB score was significantly lower among the TLE patients. TLE patients performed significantly worse at the mental flexibility, motor programming, sensitivity to interference and inhibitory control tasks. The duration of time has been passed since the last seizure was the only significant predictor of FAB score and patients who had a seizure less than a week before the evaluation time, had significantly lower FAB scores. The number of antiepileptic drugs (AEDs) did not influence the executive function in this study; however, sodium valproate was found to affect the mental flexibility. In conclusion, impaired executive function is common in TLE patients, and we suggest that FAB is a clinically applicable tool to monitor it. Moreover, we found that the time of the last seizure is a significant predictor of executive functioning and patients' performance may become worse up to seven days after a seizure. We also recommend that clinicians evaluate the cognitive adverse effects of AEDs especially sodium valproate, which was found to affect the mental flexibility in this study.
以往研究已证实颞叶癫痫（TLE）患者存在执行功能障碍。额叶评估量表（FAB）是一种简短的神经心理学工具，专为临床环境中评估额叶功能而开发。本研究的目的是评估FAB在检测TLE患者执行功能障碍方面的临床效用。48例TLE患者和48例性别及年龄匹配的健康对照者参与了本研究。与健康参与者相比，TLE患者的FAB总分显著更低。TLE患者在心理灵活性、运动编程、干扰敏感性和抑制控制任务方面表现明显更差。自上次发作以来经过的时间是FAB评分的唯一显著预测因素，在评估时间前不到一周发作的患者，FAB评分显著更低。抗癫痫药物（AEDs）的数量在本研究中不影响执行功能；然而，发现丙戊酸钠会影响心理灵活性。总之，执行功能受损在TLE患者中很常见，我们建议FAB是监测该功能的一种临床适用工具。此外，我们发现上次发作时间是执行功能的一个显著预测因素，发作后长达七天患者的表现可能会变差。我们还建议临床医生评估AEDs尤其是丙戊酸钠的认知不良反应，本研究发现丙戊酸钠会影响心理灵活性。
