Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece.
Epilepsy Surgery Unit, Department of Neurosurgery, School of Medicine, Evangelismos Hospital, University of Athens, Greece; International University of Rome "Guglielmo Marconi", Italy.
Epilepsy Behav. 2019 May;94:137-143. doi: 10.1016/j.yebeh.2019.02.021. Epub 2019 Mar 22.
Despite the extensive body of research in clinical neurology on the functional organization of posterior cortices, parietal and occipital lobe epilepsy (PLE and OLE) have not as yet received the attention afforded frontal and temporal lobe epilepsy (FLE and TLE), perhaps due to their low prevalence. Posterior epilepsies however, represent a challenge for epileptology in general and neuropsychological differential diagnosis in particular. Our main purpose was to examine the likely existence of a pattern of cognitive dysfunction characterizing patients suffering from seizures with a parietal and/or occipital ictal onset. We hypothesized that such patients would present difficulties in the visuospatial and visuoconstructive domains, since spatial analysis and synthesis is an inherent feature of posterior cortical systems. Participants were 14 patients with epilepsy and 14 healthy controls matched for demographic characteristics (gender, age, and education level). We used an extensive battery of neuropsychological tests to assess auditory-verbal memory and learning, episodic memory, attention and working memory, verbal abilities, haptic perception, arithmetic abilities, and executive functions. Special attention was given to visuospatial abilities. Depression and anxiety symptoms were assessed through a self-administered questionnaire. Nonparametric (Mann-Whitney U test) statistical tests were conducted. We found that patients with epilepsy performed significantly worse in visuoconstruction, verbal, and executive functions compared to their healthy matches. Finally, we interpret our findings from the perspective of Luria of mental functions organized into functional systems and the current trends in epileptology to view epilepsy as a system (network) problem.
尽管在临床神经病学领域有大量关于后皮质、顶叶和枕叶癫痫（PLE 和 OLE）功能组织的研究，但由于其发病率较低，这些疾病尚未像额叶和颞叶癫痫（FLE 和 TLE）那样受到关注。然而，后部癫痫对癫痫学，尤其是神经心理学鉴别诊断来说是一个挑战。我们的主要目的是研究可能存在的一种认知功能障碍模式，这种模式可以用来描述以顶叶和/或枕叶起始发作的癫痫患者。我们假设这些患者在视觉空间和视觉构建领域会遇到困难，因为空间分析和综合是后皮质系统的固有特征。参与者包括 14 名癫痫患者和 14 名匹配人口统计学特征（性别、年龄和教育水平）的健康对照组。我们使用了广泛的神经心理学测试来评估听觉言语记忆和学习、情景记忆、注意力和工作记忆、言语能力、触觉感知、算术能力和执行功能。特别关注视觉空间能力。通过自我管理的问卷评估抑郁和焦虑症状。采用非参数（Mann-Whitney U 检验）统计检验进行分析。我们发现癫痫患者在视觉构建、言语和执行功能方面的表现明显低于健康对照组。最后，我们从心理功能组织为功能系统的 Luria 理论和当前癫痫学的趋势出发，将癫痫视为一种系统（网络）问题来解释我们的发现。
