Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA.
Department of Neurology, Dell Medical School, The University of Texas at Austin, Austin, TX, USA; Comprehensive Pediatric Epilepsy Center, Dell Children's Medical Center, Austin, TX, USA; Department of Neurosurgery, Dell Medical School, The University of Texas at Austin, Austin, TX, USA; Department of Neurology, University of Florida, Gainesville, FL, USA.
Epilepsy Behav. 2022 Oct;135:108891. doi: 10.1016/j.yebeh.2022.108891. Epub 2022 Aug 29.
An emerging literature suggests that the neuropsychological sequelae of pediatric temporal lobe epilepsy (TLE) are characterized by a continuum of cognitive phenotypes that range in type and severity. The goal of the present investigation was to better characterize the neuropsychological networks that underlie these phenotypes.
The study included 59 patients with TLE who were empirically categorized into three cognitive phenotypes (normal, focal, and generalized impairment). Nine neuropsychological measures representing multiple cognitive domains (i.e., reasoning, language, visouperception, memory, and executive function) were examined by graph theory to characterize the global network properties of the cognitive phenotypes.
Across the cognitive phenotype groups (i.e., normal, focal, generalized impaired) the following findings emerged: (1) the adjacency matrices demonstrated different patterns of association between cognitive measures within the neuropsychological network; (2) global measures including global efficiency (GE) and average clustering coefficient (aCC) showed a stepwise increase across the range of impaired pediatric TLE phenotypes; however, modularity (M) demonstrated the opposite pattern.
Cognitive networks in pediatric TLE demonstrate stepwise perturbation in underlying neuropsychological networks. Graph theory offers a novel approach to examine cognitive abnormalities in pediatric TLE that may be applied to other pediatric epilepsies.
越来越多的文献表明，儿童颞叶癫痫（TLE）的神经心理学后遗症表现为认知表型的连续体，其类型和严重程度各不相同。本研究的目的是更好地描述这些表型所依赖的神经心理学网络。
本研究纳入了 59 例 TLE 患者，通过实证分类为三种认知表型（正常、局灶性和广泛损害）。通过图论分析了 9 项代表多个认知领域（即推理、语言、视知觉、记忆和执行功能）的神经心理学测量指标，以描述认知表型的全局网络特性。
在认知表型组（即正常、局灶性、广泛损害）中，出现了以下发现：（1）关联矩阵显示了神经心理学网络中认知测量值之间的不同关联模式；（2）全局指标包括全局效率（GE）和平均聚类系数（aCC），在受损的儿科 TLE 表型范围内呈逐步增加的趋势；然而，模块性（M）则呈现相反的模式。
儿科 TLE 的认知网络显示出潜在神经心理学网络的逐步扰动。图论提供了一种新的方法来检查儿科 TLE 中的认知异常，可能适用于其他儿科癫痫。
