颞叶内侧癫痫病人的项目记忆和源记忆的神经心理学研究

目的检验内侧颞叶参与源记忆执行的假说及源记忆与项目记忆相互分离的假说。方法选用实义词和实物简图，测试20名健康志愿者（对照组）和18名内侧颞叶癫痫（mesial temporal lole epilepsy，MTLE）行选择性海马杏仁核切除的病人（病例组），手术前、手术后3个月的项目记忆和源记忆，并对结果进行分析。结果病例组与对照组比较，MTLE病人术前源记忆差异有统计学意义（P〈0.05），而项目记忆差异无统计学意义（P〉0.05）；术后源记忆和项目记忆差异均有显著统计学意义（P〈0.01）。与对照组比较，行左侧选择性海马杏仁核切除的MTLE病人，术前源记忆差异有统计学意义（P〈0.01），项目记忆差异无统计学意义（P〉0.05）；术后源记忆和项目记忆均有显著统计学意义（P〈0.01）。与对照组比较，行右侧选择性海马杏仁核切除的MTLE病人。术前源记忆和项目记忆差异均无统计学意义（P〉0.05）；术后源记忆差异有统计学意义（P〈0.05），而项目记忆差异有显著统计学意义（P〈0.01）。结论内侧颞叶参与源记忆执行，源记忆与项目记忆存在相互分离，且左右侧具有不对称性。

Neuropsychological study of item memory and source memory in mesial temporal lobe epilepsy patients

Objective To test the hypothesis that neuronal substrate of source memory （SM） includes mesial temporal lobe and that SM and item memory （IM） are dissociative each other. Methods Eighteen mesial temporal lobe epilepsy （MTLE） patients underwent selective hippocampus amygdala resection, and a neuropsychological battery was established to measure the performance oflM and SM pre-operation and 3 months post-operation, and the results were compared with 20 normal Chinese adult. Results Compared with normal Chinese adult, MTLE patient＇s preoperation SM was impaired （P〈0.05）, but IM was not impaired （P 〉 0.05）, both postoperation IM and SM were impaired （P〈0.01）. Compared with normal Chinese adult, left selective hippocampus-amygdala resection （LSHAS） patients were impaired ofpre-operation SM （P〈0.01）, but their/M was not impaired （P〉0.05）; right selective hippocampus amygdala resection （RSHAS） patients were not impaired of both preoperation SM and IM （P〉0.05）. LSHAS patients were impaired of both post-operation SM and IM （P〈0.01）, RSHAS patients were but impaired of post-operation IM and SM （P〈0.01 and 〈0.05 respectively）. Conclusion Mesial temporal lobe may participate in the performance of SM, the evidence of dissociation between IM and SM in MTLE patients supports the dual-process model of SM and IM, also the left side and right side is asymmetric.