Krámská Lenka, Vojtěch Zdeněk, Lukavský Jiří, Stará Michaela, Malíková Hana
Department of Clinical Psychology, Center for Epilepsy, Na Homolce Hospital, Prague, Czech Republic.
Stereotact Funct Neurosurg. 2017;95(3):149-157. doi: 10.1159/000468527. Epub 2017 May 13.
To assess the neuropsychological performance recoded over a period of 5 years after stereotactic radiofrequency amygdalohippocampectomy (SAHE) in the treatment of mesial temporal lobe epilepsy.
Thirty patients (mean age 38 years, 14 females/16 males) were included in this study. Twenty-one patients were treated on the left side, 9 on the right. Patients underwent neuropsychological evaluation by the Wechsler Adult Intelligence Scale-Revised and the Wechsler Memory Scale-Revised preoperatively and 5 years after SAHE.
Twenty-three (77%) patients were classified as Engel class I. At the group level, we found significant increases in all intelligence domains (Global, Visual, and Performance) by 19.1 (7.4), 15.8 (6.1), and 19.1 (7.9) points, respectively. Significant improvements were also detected in all memory measures (Global, Verbal, Visual, Attention/Concentration, Delayed Recall) by 19.4 (14.2), 16.9 (13.3), 19.0 (14.7), 15.3 (15.0), and 24.6 (13.4), respectively. Patients with left-sided surgery improved significantly more in Attention/Concentration. Otherwise, there were no statistically significant differences in memory function improvements between subgroups according to the operated side.
After SAHE, we found favorable long-term neuropsychological outcomes. These results could be caused by incomplete destruction of target structures and minimization of collateral damage that possibly enables adaptive postoperative neuronal reorganization.
评估立体定向射频杏仁核海马切除术（SAHE）治疗内侧颞叶癫痫后5年期间记录的神经心理学表现。
本研究纳入30例患者（平均年龄38岁，14例女性/16例男性）。21例患者接受左侧手术，9例接受右侧手术。患者在术前以及SAHE术后5年接受韦氏成人智力量表修订版和韦氏记忆量表修订版的神经心理学评估。
23例（77%）患者被归类为恩格尔I级。在组水平上，我们发现所有智力领域（总体、视觉和操作）分别显著提高了19.1（7.4）、15.8（6.1）和19.1（7.9）分。所有记忆指标（总体、言语、视觉、注意力/集中力、延迟回忆）也分别有显著改善，分别提高了19.4（14.2）、16.9（13.3）、19.0（14.7）、15.3（15.0）和24.6（13.4）。左侧手术的患者在注意力/集中力方面改善更为显著。否则，根据手术侧别分组，记忆功能改善在各亚组之间无统计学显著差异。
SAHE术后，我们发现了良好的长期神经心理学结果。这些结果可能是由于靶结构的不完全破坏以及附带损伤的最小化，这可能使术后神经元能够进行适应性重组。
