颞叶癫(癎)后认知功能障碍与海马萎缩的相关性

目的 比较颞叶癫(癎)患者与健康者认知障碍、海马萎缩的差异,探讨颞叶癫(癎)患者认知障碍与海马萎缩的相关性.方法 随机选取颞叶癫(癎)患者49例和健康对照者20名,神经心理量表评价其认知状态并测量双侧海马体积.结果 与健康者相比,颞叶癫(癎)患者的记忆商(83.2±21.0)和智商(91.0±12.3)显著下降(t=-3.365,-4.291,P=0.001,0.000),双侧海马显著萎缩(P=0.000),不对称指数显著增高(t=3.975,P=0.000),差异有统计学意义.颞叶癫(癎)患者记忆力与癫(癎)病程显著负相关(r=-0.339,P=0-017),左右两侧海马萎缩程度与认知指数均显著负相关(左侧:r=-0.297,P=0.038;右侧:r=-0.305,P=0.033),不对称指数与认知指数显著负相关(r=-0.441,P=0.002).结论 颞叶癫(癎)患者双侧海马的萎缩程度越高、对称性越差,认知损伤也就越显著.海马体积测量可以作为颞叶癫(癎)患者智力下降的评价因子.

Correlation of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy

Objective To compare the differences of cognitive dysfunction and hippocampal atrophy among patients with temporal lobe epilepsy (TLE) and healthy controls and probe into the relativity of cognitive dysfunction with hippocampal atrophy after temporal lobe epilepsy. Methods Forty-nine TLE cases and 20 healthy individuals were randomly selected. The WAMS-R and WAIS-R scales were adopted to assess the memory and intelligence of all the subjects. Hippocampal volumes were measured by semiautomatic measurement on the head magnetic resonance imaging (MRI). The degree of hippocampal atrophy (DHA) and asymmetry index (AsI) were caculated by adjusting hippocampal volumes and ratio of difference of two lateral hippocampal volumes. Results Compared with the healthy controls, not only did the TLE patients exhibit more memory deficits (83.2±21.0,t=-3.365 ,P=0.001 ), but also more fullscale intelligence (91.0±12.3, t=- 4.291, P=0.000). The bilateral hippocampi of all TLE patients significantly decreased in volume ( P=0.000 ) and increased in AsI ( t=3.975, P=0.000 ). The MQ of TLE patients was significantly negatively related to the duration of the illness ( r=-0.339, P=0.017 ). The bilateral DHA and the hippocampal AsI were negatively related to Z scores (left: r=-0.297, P= 0.038, right: r=-0.305, P=0.033, AsI: r=-0.441, P=0.002), repectively. Conclusions The more the DHA and asymmetry of bilateral hippocampi, the worse the cognitive dysfunction. The quantitative measurements of hippocampal volume could be used as a clinically effective factor for evaluating the decrease of the intelligence of TLE patients.