Center for Neuroscience Research, Children's National Medical Center, 111 Michigan Avenue NW, Washington, D.C., 20010, USA.
Clinical Epilepsy Section, National Institutes for Neurological Disorders and Stroke, National Institutes of Health, 10 Center Drive, Bethesda, MD, 20892, USA.
J Neurodev Disord. 2018 Dec 13;10(1):40. doi: 10.1186/s11689-018-9255-8.
Epilepsy affects 2.2 million adults in the USA, with 1 in 26 people developing epilepsy at some point in their lives. Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy as medial structures, and the hippocampus in particular, are prone to generating seizures. Selective anterior temporal resection (which removes the hippocampus) is the most effective intractable TLE treatment, but given the critical role of the mesial temporal lobe in memory functioning, resection can have negative effects on this crucial cognitive skill. To minimize the adverse impact of temporal lobe surgery on memory functioning, reliable pre-surgical guides are needed. Clinical functional magnetic resonance imaging (fMRI) provides reliable, noninvasive guidance of language functioning and plays a growing role in the pre-surgical evaluation for epilepsy patients; however, localization of memory function in children with epilepsy using fMRI has not been established. Aside from the lack of neuroimaging memory studies in children with TLE, studies of typical development are limited. This review will focus on the functional anatomy of memory systems throughout development, with a focus on TLE. TLE provides the ideal model from which to understand memory function and the limits of plasticity and compensation/reorganization throughout development.
癫痫影响了美国 220 万成年人,每 26 个人中就有 1 人在其一生中的某个阶段会患上癫痫。颞叶癫痫(TLE)是最常见的局灶性癫痫,因为内侧结构,特别是海马体,容易引发癫痫发作。选择性前颞叶切除术(切除海马体)是治疗难治性 TLE 最有效的方法,但由于内侧颞叶在记忆功能中起着关键作用,切除可能会对这一关键认知技能产生负面影响。为了最大限度地减少颞叶手术对记忆功能的不良影响,需要可靠的术前指导。临床功能磁共振成像(fMRI)为语言功能提供了可靠、无创的指导,并在癫痫患者的术前评估中发挥着越来越重要的作用;然而,使用 fMRI 对癫痫儿童的记忆功能进行定位尚未建立。除了 TLE 儿童缺乏神经影像学记忆研究外,典型发育的研究也很有限。本综述将重点关注记忆系统在整个发育过程中的功能解剖结构,重点关注 TLE。TLE 为理解记忆功能以及整个发育过程中的可塑性和补偿/重组的极限提供了理想的模型。