UNASSIGNED:选择性杏仁核海马切除术(SA)是由于海马硬化(HS)引起的癫痫耐药病例的有效治疗方法。然而,它的神经认知结果在以前的研究中是不一致的,指向潜在的特定位置的混杂因素。这里,我们在最近采用这种方法的伊朗中心调查了SA的神经认知结局.
未经批准:30名成年人(53.3%的女性,年龄31.4±6.2岁)合并HS引起的耐药性癫痫纳入研究.根据患者的偏好,将患者分为手术组(n=15)和药物组(n=15)。在干预前和干预后6个月使用威斯康星卡片分类测试(WCST)评估神经认知功能。韦克斯勒成人智力量表修订,和Wechsler内存规模-第三版(WMS-III)。比较两组干预后绩效变化,并对术后预后较差的预测因素进行了调查。
UNASSIGNED:WMS-III和WCST的纵向性能变化在手术和药物治疗的患者之间有显著差异。术后WMS-III表现平均下降25%(平均ΔT2-T1=-25.1%,T=-6.6,P<0.001),WCST性能平均提高了49%(平均ΔT2-T1=+49.1%,T=4.6,P<0.001)。左侧手术和基线教育水平较高的患者的记忆能力下降更严重(平均ΔT2-T1=-31.1%,T=-8.9,P<0.001)。
UNASSIGNED:在我们的中心,SA后执行功能改善或保持稳定,但记忆功能适度下降。左侧SA和高等教育与记忆功能更严重的下降有关,强调这些群体需要特别考虑。
UNASSIGNED: Selective amygdalohippocampectomy (SA) is an effective treatment for drug-resistant cases of epilepsy due to hippocampal sclerosis (HS). However, its neurocognitive outcomes are inconsistent across the previous studies, pointing to potential location-specific confounders. Here, we investigated the neurocognitive outcomes of SA in an Iranian center recently adopting this approach.
UNASSIGNED: Thirty adults (53.3% of females, age 31.4 ± 6.2 years) with drug-resistant epilepsy due to HS were included in the study. Patients were stratified into surgical (n = 15) and medical (n = 15) treatment groups based on their preferences. Neurocognitive function was assessed before and 6 months after intervention using Wisconsin Card Sorting Test (WCST), Wechsler Adult Intelligence Scale-Revised, and Wechsler Memory Scale- Third Edition (WMS-III). Postintervention performance changes were compared between the two groups, and predictors of worse postoperative outcomes were investigated.
UNASSIGNED: Longitudinal changes of performance in WMS-III and WCST were significantly different between the surgically and medically treated patients. Postoperative WMS-III performance showed an average 25% decline (mean ∆T2-T1 = -25.1%, T = -6.6, P < 0.001), and WCST performance improved by an average of 49% (mean ∆T2-T1 = +49.1%, T = 4.6, P < 0.001). The decline in memory performance was more severe in the left-sided surgery and in patients with higher baseline education (mean ∆T2-T1 = -31.1%, T = -8.9, P < 0.001).
UNASSIGNED: In our center, executive functioning improved or remained stable after SA, but memory functions declined moderately. The left-sided SA and higher education were associated with more severe decline in memory functions, highlighting the need for special considerations for these groups.