偏侧性颞叶癫痫对患者汉字空间信息加工能力的影响

The lateral epilepsy location affects the processing of spatial information of Chinese characters in temporal lobe epilepsy patients

目的探讨左、右偏侧的颞叶癫痫对患者汉字空间信息加工的影响。方法招募明确定位单侧病灶的颞叶癫痫患者,根据患者患病偏侧纳入左颞组或右颞组,同期纳入健康志愿者作为对照组。采用真假字判断实验评估被试汉字识别能力,记录被试正确率与反应时。结果共纳入颞叶癫痫患者24例(左颞组,右颞组各12例),对照组25名。在汉字字形三种变形条件下,右颞组汉字识别反应时较对照组均延长(均P<0.05),且在变形程度最大时(3/3位移)出现正确率下降[右颞组(63.64%±4.84%)vs.对照组(79.00%±2.85%),P<0.05],而左颞组真假字识别能力与对照组无明显差异。所有被试识别真字时随变形程度加大正确率线性下降(对照组R^(2)=0.99;左颞组R^(2)=0.97;右颞组R^(2)=0.99,均P<0.05),反应时线性延长(对照组R^(2)=0.97;左颞组R^(2)=0.92;右颞组R^(2)=0.93,均P<0.05),假字未发现该现象。字词效应是指被试识别高频汉字更快更准确的现象,三组被试识别标准字符均存在字词效应。在引入空间形变后,除左颞组在较小变形时(1/3,2/3位移)表现出反应时的字词效应外,余下两组无字词效应;对于正确率来说,三组被试均未出现字词效应,在最大变形时(3/3位移),出现了正确率的“反字词效应”,即假字正确率高于真字(均P<0.05)。结论右颞癫痫对患者汉字空间加工影响尤为明显,随空间信息负荷增加,影响更显著;汉字空间信息增加时,癫痫患者与正常对照均表现对变形汉字的“反”字词效应。

Objective To investigate whether the location of epilepsy affects the processing of spatial information of Chinese character in patients with temporal lobe epilepsy(TLE).Methods TLE patients with either left side TLE(LTLE)or right side TLE(RTLE)were recruited from the Department of Neurology,Xuanwu Hospital Affiliated to Capital Medical University between July 2016 and January 2019 for the study.Age and sex compared control group was recruited at the same time.Computer-designed shifting character tests were used to investigate the processing of Chinese characters.The shifting character was made by moving one of three radicals in characters about 1/3-,2/3-,and 3/3-word length,respectively.The differences in accuracy(ACC)and response time(RT)between epilepsy and control groups were recorded and analyzed.Results Twenty-four TLE patients(12 in the LTLE group,12 in the RTLE group)were eventually enrolled in the study,and 25 healthy people served as the control group.RTLE group showed longer RT than the control group in character processing under every condition(P<0.05).In the 3/3 shifting condition,the RTLE group showed lower ACC compared with the control group.[(63.64%±4.84%)vs.(79.00%±2.85%),P<0.05].All subjects showed linearly decreased ACC(Control:R^(2)=0.99;LTLE:R^(2)=0.97;RTLE:R^(2)=0.99,P<0.05)and linearly prolonged RT(Control:R^(2)=0.97;LTLE:R^(2)=0.92;RTLE:R^(2)=0.93,P<0.05)with the increment of the shifting degree in processing real-characters.This phenomenon is not observed in pseudo-characters processing.Word effects pertaining to the efficiency(quicker RT and higher ACC)of processing characters with high orthographic frequency.All subjects showed word effects under standard character conditions.While word effects in the aspect of RT within control and RTLE group disappeared under shifting conditions,only the LTLE group showed remaining word effects under minor shifting conditions(1/3,2/3 shifting).None of the three groups showed word effects in the aspect of ACC under any shifting conditions.There was even an'antiword-effects'at the maximum shifting(3/3)in all the three groups,which means a higher ACC in processing pseudocharacters than real-characters(P<0.05).Conclusion The increase in spatial information load significantly affects Chinese character processing of TLE patients,especially RTLE patients.Both TLE patients and normal controls demonstrate the"anti-word-effects"in processing pseudo-characters when spatial information is increased.