Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.
Epilepsy Society MRI Unit, Chesham Lane, Buckinghamshire, UK.
CNS Neurosci Ther. 2019 Feb;25(2):223-232. doi: 10.1111/cns.13003. Epub 2018 Jun 27.
Medial temporal lobe epilepsy (mTLE) is the most common refractory focal epilepsy in adults. Around 30%-40% of patients have prominent memory impairment and experience significant postoperative memory and language decline after surgical treatment. BDNF Val66Met polymorphism has also been associated with cognition and variability in structural and functional hippocampal indices in healthy controls and some patient groups.
We examined whether BDNF Val66Met variation was associated with cognitive impairment in mTLE.
In this study, we investigated the association of Val66Met polymorphism with cognitive performance (n = 276), postoperative cognitive change (n = 126) and fMRI activation patterns during memory encoding and language paradigms in 2 groups of patients with mTLE (n = 37 and 34).
mTLE patients carrying the Met allele performed more poorly on memory tasks and showed reduced medial temporal lobe activation and reduced task-related deactivations within the default mode networks in both the fMRI memory and language tasks than Val/Val patients.
Although cognitive impairment in epilepsy is the result of a complex interaction of factors, our results suggest a role of genetic factors on cognitive impairment in mTLE.
内侧颞叶癫痫(MTLE)是成人中最常见的难治性局灶性癫痫。大约 30%-40%的患者存在明显的记忆障碍,并在手术后经历显著的记忆和语言下降。BDNF Val66Met 多态性也与认知有关,并且在健康对照组和一些患者组中与结构和功能海马指数的变异性有关。
我们研究了 BDNF Val66Met 变异是否与 MTLE 中的认知障碍有关。
在这项研究中,我们调查了 Val66Met 多态性与认知表现(n=276)、术后认知变化(n=126)以及在记忆编码和语言范式期间的 fMRI 激活模式之间的关系,在两组 MTLE 患者(n=37 和 n=34)中进行。
携带 Met 等位基因的 MTLE 患者在记忆任务上表现更差,与 Val/Val 患者相比,在 fMRI 记忆和语言任务中的内侧颞叶激活减少,默认模式网络中的任务相关去激活减少。
尽管癫痫中的认知障碍是多种因素复杂相互作用的结果,但我们的结果表明遗传因素在 MTLE 中的认知障碍中起作用。