Faculty of Medicine, Vilnius University, Vilnius, Lithuania.
Center for Neurology, Vilnius University, Vilnius, Lithuania.
Epilepsia. 2022 Feb;63(2):474-482. doi: 10.1111/epi.17144. Epub 2021 Dec 10.
Accelerated long-term forgetting (ALF) has been demonstrated among children but not adults with genetic generalized epilepsy (GGE). We investigated (1) how forgetting patterns of verbal and visuospatial material differ between patients with GGE and healthy controls (HCs) and (2) whether ALF is associated with ictal or interictal epileptic activity.
Forty-two patients with GGE (39, 92.9% experiencing seizures) were compared to 57 HCs in word, logical story, and Rey-Osterrieth complex figure recall tasks by testing after intervals of 30 min and 4 weeks. Ambulatory electroencephalography (EEG) was performed before testing to detect generalized epileptic activity, and patients were asked to document the number of seizures during the 4-week interval.
A two-way repeated measures ANOVA indicated that individuals with GGE have different forgetting patterns in comparison to HCs in tasks of word (delay by group interaction F = 4.5, p = .02, = .04) and figure (F = 15.9, p < .001, = .14) but not story (F = .5, p = .58, = .005) recall. Last learning trial-adjusted scores of word recall were comparable between HCs and patients with epilepsy (PWEs) at 30 min (p = .21) but not at 4 weeks (p = .006). Individuals with GGE performed worse than HCs in figure recall at 30 min and 4 weeks (p < .001), with lower performance after the 4-week interval present only among seizure-positive and EEG-positive individuals (p < .001) during subgroup analysis. Performance on memory tests was unrelated to overall seizure frequency, the number of antiseizure drugs used, and epilepsy duration.
Our study supports the presence of ALF in a task of word recall among adult patients with GGE. The pattern of forgetting visuospatial information suggests greater forgetting of material before the first delay and ongoing deficits among PWEs with epileptic activity. Future studies should confirm our findings and investigate the functional or pathological mechanisms of memory dysfunction in GGE.
在遗传性全面性癫痫（GGE）患者中已证实存在加速的长期遗忘（ALF），但在成人中尚未证实。我们研究了（1）GGE 患者与健康对照（HCs）之间言语和视空间材料的遗忘模式有何不同，以及（2）ALF 是否与癫痫发作或发作间期的癫痫活动有关。
在 30 分钟和 4 周的测试间隔后，我们比较了 42 名 GGE 患者（39 名，92.9%有癫痫发作）和 57 名 HCs 在单词、逻辑故事和 Rey-Osterrieth 复杂图形回忆任务中的表现，通过测试来完成。在测试前进行了动态脑电图（EEG）以检测全面性癫痫活动，并要求患者记录 4 周间隔期间的癫痫发作次数。
双向重复测量方差分析表明，与 HCs 相比，GGE 患者在单词（组间延迟交互 F=4.5，p=0.02， =0.04）和图形（F=15.9，p<0.001， =0.14）任务中的遗忘模式不同，但在故事（F=0.5，p=0.58， =0.005）回忆中没有差异。在 30 分钟时，HCs 和癫痫患者（PWEs）的单词回忆末次学习试验调整后评分无差异（p=0.21），但在 4 周时差异有统计学意义（p=0.006）。在 30 分钟和 4 周时，GGE 患者的图形回忆均差于 HCs（p<0.001），仅在亚组分析中存在癫痫发作阳性和 EEG 阳性个体在 4 周间隔后表现更差的情况（p<0.001）。记忆测试的表现与总癫痫发作频率、使用的抗癫痫药物数量和癫痫持续时间无关。
我们的研究支持 GGE 成年患者在单词回忆任务中存在 ALF。视空间信息遗忘模式提示，在首次延迟之前，材料的遗忘速度更快，且存在癫痫活动的 PWE 中存在持续的记忆缺陷。未来的研究应证实我们的发现，并研究 GGE 中记忆功能障碍的功能或病理机制。
