头部MRI阴性的颞叶内侧癫痫患者认知功能障碍研究

目的评估头部MRI阴性额叶内侧癫痫(MTLE)患者认知功能受损特点。方法回顾性分析27名头部MRI阴性的MTLE患者资料,其中左侧MTLE14例(左侧MT1.E组),右侧MTLE13例(右侧MTI.E组)。癫痫患者与性别、年龄和受教育程度严格匹配的14名健康对照者(对照组)均接受蒙特利尔认知评估量表(MoCA)和失礼识别任务的测评结果在MoCA得分方面,两组MTLE患者的MoCA总分及各分项测试得分均低于对照组(P<0.05);右侧MTLE组复制立方体得分低于左侧MTI.E组和对照组(P<0.05);右侧MTLE组的画钟试验得分低于左侧MTLE组(P<0.05);左侧MTLE组句子复述、语言流畅性测试得分低于右侧MTLE组(P<0.05)。在失礼识别任务得分方面,两组MT1.E患者得分均低于对照组(P<0.05);左侧MTLE组比右侧MTLE组更低(P<0.05)。结论头部MRI阴性MTLE患者的一般认知功能及高级社会认知功能均受损。

A study of cognitive impairment in patients with brain MRI-negative medial temporal lobe epilepsy

Objective To evaluate the features of cognitive impairment in patients with brain magnetic resonance imaging (MRI)-negative medial temporal lobe epilepsy (MTLE).Methods A retrospective analysis was performed on the clinical data of 27 patients with brain MRI-negative MTLE (including 14 patients with left-sided MTLE[L-MTLE group] and 13 patients with right-sided MTLE[R-MTLE group]). A total of 14 healthy controls with well-matched sex, age, and education level were enrolled as control group. Montreal Cognitive Assessment (MoCA) was used to assess general cognitive function and faux pas recognition task was used to evaluate advanced social cognitive function.Results For MoCA scores, both MTLE groups had significantly lower MoCA total score and score of each item than the control group (P<0.05); compared with the L-MTLE group, the R-MTLE group had significantly lower scores in cube copying test and clock drawing test and significantly higher scores in sentence repetition test and verbal fluency test (all P<0.05); the R-MTLE group had a significantly lower score in cube copying test than the control group (P<0.05). For faux pas recognition task score, both MTLE groups had a significantly lower score than the control group (P<0.05), and the L-MTLE group had a significantly lower score than the R-MTLE group (P<0.05).Conclusions The general cognitive function and advanced social cognitive function of MTLE patients with MRI-negative MTLE are impaired.