Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan.
Department of Rehabilitation, Sendai-Nishitaga National Hospital, Sendai, Japan.
PLoS One. 2021 Apr 1;16(4):e0248785. doi: 10.1371/journal.pone.0248785. eCollection 2021.
Anterior temporal lobectomy (ATL) is the most common surgical treatment for drug-resistant temporal lobe epilepsy (TLE). Right ATL has been reported to reduce facial memory ability in patients with TLE, as indicated by poor performance on the Warrington Recognition Memory Test for Faces (RMF), which is commonly used to evaluate visual memory in these patients. However, little is known about whether patients with TLE exhibit difficulties in identifying faces in daily life after ATL. The aim of this study was to investigate facial memory ability and self-awareness of face identification difficulties in patients with TLE after ATL. Sixteen patients with TLE after right ATL, 14 patients with TLE after left ATL, and 29 healthy controls were enrolled in this study. We developed the multiview face recognition test (MFRT), which comprises a learning phase (one or three frontal face images without external facial feature information) and a recognition phase (frontal, oblique, or noise-masked face images). Facial memory abilities were examined in all participants using the MFRT and RMF, and self-awareness of difficulties in face identification was evaluated using the 20-item prosopagnosia index (PI20), which has been widely used to assess developmental prosopagnosia. The MFRT performance in patients with TLE after ATL was significantly worse than that in healthy controls regardless of the resected side, whereas the RMF scores in patients with TLE were significantly worse than those in healthy controls only after right ATL. The MFRT performance in patients with TLE after both left and right ATL was more influenced by working memory load than that in healthy controls. The PI20 scores revealed that patients with TLE after left ATL were aware of their difficulties in identifying faces. These findings suggest that patients with TLE not only after right ATL but also after left ATL might have difficulties in face identification.
前颞叶切除术（ATL）是治疗耐药性颞叶癫痫（TLE）的最常见手术治疗方法。已有报道称，右侧 ATL 会降低 TLE 患者的面部记忆能力，这表现在他们在常用于评估这些患者视觉记忆的沃灵顿面孔识别记忆测试（RMF）中的表现较差。然而，对于 TLE 患者在 ATL 后是否在日常生活中表现出识别面孔的困难，人们知之甚少。本研究旨在调查 TLE 患者在接受右侧 ATL 或左侧 ATL 后是否存在面部记忆能力和对面部识别困难的自我意识。本研究纳入了 16 例接受右侧 ATL 的 TLE 患者、14 例接受左侧 ATL 的 TLE 患者和 29 例健康对照者。我们开发了多视图面孔识别测试（MFRT），该测试包括学习阶段（一个或三个没有外部面部特征信息的正面面孔图像）和识别阶段（正面、倾斜或噪声掩蔽的面孔图像）。我们使用 MFRT 和 RMF 测试所有参与者的面部记忆能力，并使用广泛用于评估发育性面孔失认症的 20 项面孔失认症指数（PI20）评估他们对面部识别困难的自我意识。无论切除侧如何，ATL 后 TLE 患者的 MFRT 表现均明显差于健康对照组，而仅在接受右侧 ATL 后，TLE 患者的 RMF 评分明显差于健康对照组。接受左侧和右侧 ATL 的 TLE 患者的 MFRT 表现受工作记忆负荷的影响比健康对照组更大。PI20 评分显示，接受左侧 ATL 的 TLE 患者意识到自己在识别面孔方面存在困难。这些发现表明，不仅接受右侧 ATL 的 TLE 患者，而且接受左侧 ATL 的 TLE 患者可能在识别面孔方面存在困难。
