颞叶癫痫患者注意网络的研究

The attentional networks in patients with temporal lobe epilepsy

目的探讨颞叶癫痫患者注意网络的状况及影响因素。方法连续收录2007年1月至2008年12月在我院就诊的44例颞叶癫痫患者,选择相匹配的健康志愿者40名作为对照研究。应用注意网络测试(attentional networks test,ANT)软件,评估被试者注意网络状况,比较两组注意网络各指标的差异,采用非条件Logistic分析受教育年限、病程等因素对注意网络指标的影响。结果与对照组比较,患者组的ANT平均反应时间较慢[患者组:(688.2±138.1)ms;对照组:(625.1±100.1)ms,t=2.06,P<0.05];患者组ANT中执行功能效率显著下降[患者组:(155.7±57.0)ms;对照组:(108.0±33.8)ms,t=4.62,P<0.01];两组MMSE、ANT的警觉功能与定向功能效率无统计学差异。非条件Logistic分析显示,存在脑电图痫性放电(95%CI:1.03～42.33,OR=6.603,P=0.043)为患者执行功能损害可能原因。结论初步证实颞叶癫痫患者存在注意网络的执行功能损害,痫性放电可能是导致患者注意执行功能损害的原因。

Objective To investigate the attentional network in patients with temporal lobe epilepsy（TLE） and the disease-related factors.Methods Fity-four patients with TLE and 40 controls were enrolled in our hospital from January 2007 to December 2008.The computerized ANT software was used for evaluating the attentional network efficiency and the clinical date of the patients with TLE were recorded.Logistic regression was used to identify the risk factors of attentional network efficiency.Results The mean reaction time（TLE：688.2±138.1 ms;Control：625.1±100.1 ms,t=2.06,P0.05）and executive control network efficiency （TLE：155.7±57.0 ms;Control：108.0±33.8 ms,t=4.62,P0.01） of the TLE group were lower than the healthy control group.The efficiency of alerting network and orienting network between the two groups were no significant difference.Logistic regression analysis showed that the positive epileptiform activity was an independent risk factor of the attentional impairment（95%CI：1.03～42.33,OR=6.603,P=0.043）.Conclusions The ANT demonstrate that patients with TLE may accompany with attentional executive control network efficiency impairment.Epileptiform discharge may cause attentional executive network efficiency impairment.