特定左颞叶和内侧颞叶结构的癫痫样棘波干扰言语情景记忆编码
Epileptiform spikes in specific left temporal and mesial temporal structures disrupt verbal episodic memory encoding
摘要：
诊断为癫痫的患者会出现认知功能障碍，这可能是由于自发性癫痫样棘波引起的短暂性认知/记忆障碍（TCI/TMI）。我们在一组166名患有难治性局灶性癫痫的成年患者中询问，言语情景记忆编码过程中特定神经解剖区域的尖峰是否会显着降低回忆的概率。我们使用朴素贝叶斯机器学习模型发现，当尖峰出现在左侧Brodmann 21区（BA）21时，正确单词回忆的概率显著降低11.9%（p<0.001），左侧BA 38为49.7%（p=0.01），右侧BA 38为32.2%（p<0.001），左侧BA 36为21.4%（p<0.01）。我们还研究了言语起始区和语言优势半球对这种效应的影响。我们的研究结果表明，自发性癫痫样棘波产生了很大的影响TCI/TMI的大脑区域，已知是重要的语义处理和情节记忆。因此，癫痫患者的记忆障碍可能归因于与异常发作间期电事件相关的细胞事件。
英文摘要：
Patients diagnosed with epilepsy experience cognitive dysfunction that may be due to a transient cognitive/memory impairment (TCI/TMI) caused by spontaneous epileptiform spikes. We asked in a cohort of 166 adult patients with medically refractory focal epilepsy if spikes in specific neuroanatomical regions during verbal episodic memory encoding would significantly decrease the probability of recall. We found using a naïve Bayesian machine learning model that the probability of correct word recall decreased significantly by 11.9% when spikes occurred in left Brodmann area 21 (BA)21, (p<0.001), 49.7% in left BA38 (p=0.01), and 32.2% in right BA38 (p<0.001), and 21.4% in left BA36 (p<0.01). We also examined the influence of the seizure-onset zone and the language dominant hemisphere on this effect. Our results demonstrate that spontaneous epileptiform spikes produce a large effect TCI/TMI in brain regions known to be important in semantic processing and episodic memory. Thus memory impairment in patients with epilepsy may be attributable to cellular events associated with abnormal inter-ictal electrical events.
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