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Neurology:已证实!颞叶癫痫患者主观记忆抱怨背后,客观记忆缺陷确存在

2022-01-08 Naomi MedSci原创

近日,有研究者对47名颞叶癫痫(TLE)患者在3周后接受了2次出其不意的记忆测试。研究提示,无论是否与病变相关,长期记忆的评估应该扩大到有记忆主诉的TLE患者,而不局限于癫痫综合征。

      超过半数的癫痫患者抱怨他们的记忆功能中重度地限制了他们的日常功能。即使对这类患者进行了神经心理评估,这项结论亦可能不会被证实,这些主诉可能来自诸如焦虑、抑郁带来的纯粹主观感受。一些抗癫痫药物可能会损害记忆效率。

      然而,非常长期的记忆评估,通常仅限于特定的自传性记忆症状,可以暴露加速的长期遗忘(ALF,正常学习新信息,但在随后的几天或几周内加速忘记该信息)。阿尔茨海默病在短暂性癫痫性遗忘症(TEA)中尤其常见,这是一种以癫痫发作和密集的短暂性遗忘症为主要特征的综合征,其中有发作间期ALF和逆行记忆缺陷的高患病率)。然而,尚不清楚其他TLE患者是否也患有发作间期ALF,这些患者没有特别提示TEA,具有不同的表型(如海马硬化、杏仁核增大等相关症状)。

      近日,有研究者对47名颞叶癫痫(TLE)患者在3周后接受了2次出其不意的记忆测试,以求验证这些有主观记忆主诉的TLE患者确实存在与ALF相关的客观、非常长期的记忆缺陷的假设。

     这些颞叶癫痫(TLE)患者一般都有记忆力方面的主诉,但标准的神经心理学评估在标准延迟20分钟后没有发现记忆障碍。两项突击记忆测试:1.自由和线索选择性提醒测试(FCSRT),是标准的,适用于非常长期的评估。2.Epireal测试,是一项专门设计的新测试,旨在捕捉自传体记忆中更自然的部分,如情节和回忆。研究者认为,需要将两种测试结合起来,才能揭示一些患者是否表现出ALF。他们的表现与35名匹配的健康对照组的表现进行了比较。

  • 47例TLE患者(海马硬化12例,杏仁核增大12例,广泛病变11例,MRI正常12例)在3周后接受了两次突击记忆测试。他们与35名健康的对照组受试者进行了比较;
  • 3周后,患者的FCSRT和表皮回忆评分显著低于对照组(p<0.001);
  • FCSRT与Epireal评分无显著相关性(p=0.99);
  • 无论病变的存在和类型,或者对抗癫痫药物的反应,76%的TLE患者在这些非常长期的记忆测试中至少有一项存在客观损害;
  • 使用方便,Epireal的有效范围更大,在28%的患者中检测到缺陷,是标准检查的有用补充。

      长期记忆的评估应该扩大到有记忆主诉的TLE患者,而不局限于癫痫综合征,无论是否与病变相关。这可能会导致研究者重新思考与记忆相关的TLE病因学。

文献来源:Lemesle B, Barbeau EJ, Rigal EM, et al. Hidden Objective Memory Deficits Behind Subjective Memory Complaints in Patients With Temporal Lobe Epilepsy [published online ahead of print, 2021 Dec 14]. Neurology. 2021;10.1212/WNL.0000000000013212. doi:10.1212/WNL.0000000000013212

 

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    2022-03-03 yinhl1978
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    2022-01-18 SR~young海东

    关注医学

    0

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    2022-01-11 355366180

    了解

    0

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  6. [GetPortalCommentsPageByObjectIdResponse(id=2009238, encodeId=6a722009238e6, content=<a href='/topic/show?id=1a35e15712e' target=_blank style='color:#2F92EE;'>#癫痫患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=43, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71571, encryptionId=1a35e15712e, topicName=癫痫患者)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=2e6f107, createdName=liye789132251, createdTime=Sat Nov 19 06:09:42 CST 2022, time=2022-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2001672, encodeId=b1d620016e21d, content=<a href='/topic/show?id=d5df12695e6' target=_blank style='color:#2F92EE;'>#Neurol#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=45, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=12695, encryptionId=d5df12695e6, topicName=Neurol)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=8217292, createdName=yinhl1978, createdTime=Thu Mar 03 03:09:42 CST 2022, time=2022-03-03, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1185717, encodeId=afa81185e1706, content=关注医学, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210313/9df56058b3964a8cac82563f95f0389d/c1b478592e8e4463bef44d32712e98fd.jpg, createdBy=ea905324251, createdName=SR~young海东, createdTime=Tue Jan 18 20:00:56 CST 2022, time=2022-01-18, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1183232, encodeId=5e5311832323b, content=了解, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201126/cd191656b97f470781c0bd36448d9422/aa9a30b60c6646ad94bf6f39648feb47.jpg, createdBy=58b01524016, createdName=355366180, createdTime=Tue Jan 11 15:09:44 CST 2022, time=2022-01-11, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1512252, encodeId=f0c21512252a8, content=<a href='/topic/show?id=488f100e806b' target=_blank style='color:#2F92EE;'>#颞叶癫痫#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=57, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100780, encryptionId=488f100e806b, topicName=颞叶癫痫)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=d4f010449023, createdName=ms3994565386320060, createdTime=Mon Jan 10 06:09:42 CST 2022, time=2022-01-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182545, encodeId=9fd8118254560, content=学习了,谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7c592194322, createdName=1209e435m98(暂无昵称), createdTime=Sun Jan 09 16:05:18 CST 2022, time=2022-01-09, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182396, encodeId=04f61182396c2, content=<a href='/topic/show?id=23e3454e353' target=_blank style='color:#2F92EE;'>#学习#</a>学以致用, beContent=null, objectType=article, channel=null, level=null, likeNumber=56, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=45473, encryptionId=23e3454e353, topicName=学习)], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20210723/2629e103afc5400bb877f512afb1eef5/4eccf7d5ce6a443a8907a265a71b55d8.jpg, createdBy=83365555694, createdName=ms3000001887035676, createdTime=Sat Jan 08 23:56:45 CST 2022, time=2022-01-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1182362, encodeId=dc8211823626c, content=颞叶癫痫容易出现记忆受损, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=82d31990773, createdName=robbert123, createdTime=Sat Jan 08 21:56:34 CST 2022, time=2022-01-08, status=1, ipAttribution=)]
    2022-01-09 1209e435m98(暂无昵称)

    学习了,谢谢分享

    0

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    2022-01-08 ms3000001887035676

    #学习#学以致用

    0

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    2022-01-08 robbert123

    颞叶癫痫容易出现记忆受损

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拓展阅读

Brain:颞叶癫痫的皮层微结构变化新方法

为概念化TLE的微观结构特征提供了一种新的方法,同时为研究其对临床表现和决策的贡献开辟了新的途径。

Euro Radio:结合[18F]FDG-PET与MRI预测颞叶癫痫患者术后癫痫复发的可能

在MDT中,18F-氟脱氧葡萄糖正电子发射断层扫描([18F]FDG-PET)是最常用的功能成像方式,在术前评估中经常与MRI组合使用。

Neurology:核磁共振确定的脑颞叶癫痫症亚型的癫痫发作持续时间和扩散动力学

近日,一项发表在Neurology上的研究报道了一项回顾性队列研究,以调查特定三个组之间的电临床差异。研究证实,癫痫发作的电临床特征不同于核磁共振和病变性癫痫。

Neurology:儿童癫痫手术后的连接特征和认知轨迹

儿童颞叶癫痫手术后的神经认知结果是不同的。近日,研究报道了以弥漫性连接为特征的连接,这让人联想到发育不成熟的网络,与手术前认知较差和手术后认知改善有关。这为了解颞叶癫痫术后认知与预后变化提供潜在手段。

JNNP:使用扩散成像预测颞叶癫痫手术结果

癫痫是50岁以上患者最常见的致残性神经系统疾病之一。颞叶癫痫(TLE)是最常见的局灶性癫痫,尽管服用抗癫痫药物进行治疗,但仍有约30%-40%的患者持续出现衰弱性癫痫发作。

Neurology:颞叶癫痫手术灶解剖定位与术后癫痫预后的关系

 更好的术后癫痫自由与颞叶特定结构和连接的外科损伤有关。这些发现阐明了TLE致痫网络的关键组成部分,并为未来外科干预的改进提供了一个有希望的新证据来源。

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