颞叶癫痫情景记忆损害的研究

Effects of temporal lobe epilepsy on episodic memory

目的:研究颞叶癫痫对情景记忆损害的特点及其影响因素。方法:采用听觉词汇测试(auditoryverbal memory test,AVMT),测试62例颞叶癫痫患者(包括29例新诊断颞叶癫痫未服药患者和33例门诊随访且规律服药患者)和年龄、受教育程度相匹配的30例健康者的情景记忆。结果:颞叶癫痫组自由回忆(27.52±1.23)分、延时回忆(9.21±0.63)分、再认测试(11.83±0.54)分,均低于正常对照组成绩,且两组间差异有统计学意义(t=5.73～6.99;P<0.05)。其中颞叶癫痫服药组与未服药组相比,服药组自由回忆测试(24.42±1.15)分、延时回忆测试(7.24±0.64)分、再认测试(11.00±0.47)分,得分均较低,且延时回忆测试得分的差异有统计学意义(t=2.18;P<0.05);两组间自由回忆和再认测试的差异无统计学意义(t=1.20～1.84;P>0.05)。结论:颞叶癫痫患者存在情景记忆的损害,对自由回忆、延时回忆以及再认都有损害,提示颞叶参与情景记忆的神经机制学说;与未服药组相比服药组癫痫患者存在更加明显的情景记忆损害,提示抗癫痫药物是影响记忆的重要因素之一。

Objective： To investigate the features of episodic memory in temporal lobeepilepsy patients （TLE）. Methods： Sixty-two patients with temporal lobe epilepsy were evalu- ated with neuropsychologic tests, twenty-nine of whom were newly diagnosed, and 30 aged- and education-level-matched healthy adults were performed with neuropsychological battery of tests including auditory verbal memory test. Results： Compared with the healthy adults （AVMT 1-3：34.07 ± 0.80, AVMT4：12.97 ± 0.36, AVMT5：13.90 ± 0.25）, newly diagnosed patients had a significant loss in AVMT 1-3 （27.52 ± 1.23, P〈0.05）, AVMT4 （9.21± 0.63, F〈0.05） and AVMT5 （11.83 ±0.54, P〈0.05）. In comparison with the newly dignosed patients, the thirty- three follow-up patients did worse than the newly dignosed in the Auditory Verbal Memory test （AVMT1-3, 24.42± 1.15, F〈0.05, AVMT4：7.24 ± 0.64, P〈0.05, AVMTS： 11.00 ± 0.47, P〉0.05）. Conclusion： The epilepsy patients have general cognitive deficits, such as verbal learning capacity, verbal memory, episodic memory. It is possible that temporal lobe is involved in the episodic memory network. When compared with the newly diagnosed epilepsy patients, the follow-up patients imparled in the neuropsychological of Auditory Verbal Memory test. The results suggest that antiepileptic drugs is one of the important factors in episodic memory of epilepsy patients.