Hasegawa Naoya, Saito Natsumi, Fukuda Masafumi
Department of Psychiatry, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, Niigata, Japan.
Department of Neurology, National Hospital Organization, Nishiniigata Chuo Hospital Epilepsy Center, Niigata, Japan.
Epileptic Disord. 2025 Aug;27(4):600-608. doi: 10.1002/epd2.70034. Epub 2025 Apr 29.
A global increase in the aging population has resulted in more patients with late-onset epilepsy. Late-onset temporal lobe epilepsy (LOTLE) is one of the most common types of late-onset epilepsy and is frequently accompanied by memory impairments. Here, we investigated the relationships between memory function and clinical characteristics, including findings from long-term video-electroencephalograph (LVEEG) monitoring, in LOTLE.
We evaluated patients who had been diagnosed with LOTLE and Underwent LVEEG and neuropsychological tests (e.g., the Wechsler Memory Scale-Revised [WMS-R]) before the introduction of anti-seizure medications at our epilepsy center. We then performed multiple regression analyses using patients' clinical characteristics, including LVEEG data, as the independent variables, and cognitive scores as the dependent variables.
We included 17 patients with LOTLE. The mean age at onset was 65.18 ± 8.35 (47-78) years old. Among the WMS-R domains, verbal memory (β = -.79, p < .001), visual memory (β = -.645, p = .005), general memory (β = -.838, p < .001), and attention (β = -1.334, p < .001) showed negative relationships with the number of seizures of left temporal origin captured by LVEEG. Furthermore, patients who experienced transient amnestic episodes had relatively better delayed recall scores at 30 min (β = -.606, p = .005).
Our findings suggest that frequent seizures originating from the left temporal lobe impair various cognitive functions. They also indicate that the patterns of cognitive dysfunction in LOTLE may be divided into two types: one showing preserved delayed recall with transient epileptic amnesia, and one showing impaired delayed recall.
全球老龄化人口增加导致晚发性癫痫患者增多。晚发性颞叶癫痫（LOTLE）是最常见的晚发性癫痫类型之一，常伴有记忆障碍。在此，我们研究了LOTLE患者记忆功能与临床特征之间的关系，包括长期视频脑电图（LVEEG）监测结果。
我们评估了在我们癫痫中心开始使用抗癫痫药物之前被诊断为LOTLE并接受LVEEG和神经心理学测试（如韦氏记忆量表修订版[WMS-R]）的患者。然后，我们以患者的临床特征（包括LVEEG数据）作为自变量，认知分数作为因变量进行多元回归分析。
我们纳入了17例LOTLE患者。发病的平均年龄为65.18±8.35（47 - 78）岁。在WMS-R各领域中，言语记忆（β = -0.79，p < 0.001）、视觉记忆（β = -0.645，p = 0.005）、一般记忆（β = -0.838，p < 0.001）和注意力（β = -1.334，p < 0.001）与LVEEG捕捉到的左颞叶起源癫痫发作次数呈负相关。此外，经历过短暂遗忘发作的患者在30分钟时的延迟回忆分数相对较好（β = -0.606，p = 0.005）。
我们的研究结果表明，源自左颞叶的频繁癫痫发作会损害多种认知功能。它们还表明，LOTLE中的认知功能障碍模式可能分为两种类型：一种表现为短暂性癫痫性遗忘时延迟回忆保留，另一种表现为延迟回忆受损。
