Trenerry M R, Jack C R, Ivnik R J, Sharbrough F W, Cascino G D, Hirschorn K A, Marsh W R, Kelly P J, Meyer F B
Department of Psychiatry and Psychology, Mayo Clinic and Mayo Foundation, Rochester, MN.
Neurology. 1993 Sep;43(9):1800-5. doi: 10.1212/wnl.43.9.1800.
We investigated the relationship between preoperative MRI hippocampal volumes and clinical neuropsychological memory test data obtained before and after temporal lobectomy and amygdalohippocampectomy for intractable epilepsy in 44 left (LTL) and 36 right (RTL) temporal lobectomy patients. In LTL patients, the difference (right minus left hippocampal volume) between hippocampal volumes (DHF) was significantly (p < 0.001) correlated (r = 0.61) with postoperative verbal memory change as measured by a delayed memory percent retention score from the Wechsler Memory Scale-Revised, Logical Memory subtest. DHF was also positively associated with postoperative memory for abstract geometric designs in LTL patients (r = 0.49, p < 0.005). Resection of a relatively nonatrophic left hippocampus was associated with poorer verbal and visual memory outcome. In RTL patients, larger right adjusted (for total intracranial volume) hippocampal volume was associated with decline in visual-spatial learning, but not memory, following surgery. MRI hippocampal volume data appear to provide meaningful information in evaluating the risk for memory impairment following temporal lobectomy.
我们调查了44例左侧颞叶切除术（LTL）和36例右侧颞叶切除术（RTL）患者术前MRI海马体积与难治性癫痫患者颞叶切除术和杏仁核海马切除术前后获得的临床神经心理学记忆测试数据之间的关系。在LTL患者中，海马体积差异（右侧减去左侧海马体积，即DHF）与韦氏记忆量表修订版逻辑记忆子测验延迟记忆百分比保留分数所测量的术后言语记忆变化显著相关（p < 0.001，r = 0.61）。DHF也与LTL患者术后对抽象几何图形的记忆呈正相关（r = 0.49，p < 0.005）。相对非萎缩性左侧海马的切除与较差的言语和视觉记忆结果相关。在RTL患者中，较大的右侧校正（针对总颅内体积）海马体积与术后视觉空间学习能力下降有关，但与记忆无关。MRI海马体积数据似乎为评估颞叶切除术后记忆损害风险提供了有意义的信息。
