中华神经科杂志
中華神經科雜誌
중화신경과잡지
Chinese Journal of Neurology
2009年
7期
449-453
,共5页
林际岚%黄华品%车春晖%陈圣根%陈晓春
林際嵐%黃華品%車春暉%陳聖根%陳曉春
림제람%황화품%차춘휘%진골근%진효춘
癫(癎)%记忆障碍%记忆,短时%磁共振波谱学
癲(癎)%記憶障礙%記憶,短時%磁共振波譜學
전(간)%기억장애%기억,단시%자공진파보학
Epilepsy%Memory disorders%Memory,short-term: Magnetic resonance spectroscopy
目的 探讨原发性癫(癎)全面性发作患者记忆功能损害的特征以及磁共振波谱(magnetic resonance spectroscopy,MRS)检查与记忆功能的关系.方法 对45例癫(癎)全面性发作的患者和20例健康对照组进行临床记忆量表的测量,双侧海马行1H-MRS检测及体积测量,比较2组间记忆量表的各项量表分、记忆商和1H-MRS的各项指标,并对记忆量表的结果与海马1H-MRS结果进行相关分析.结果 癫(癎)组包括服药组(指向记忆15.68±4.79,联想学习18.70±5.84,图像自由回忆13.19±6.22,人像特点回忆12.02±4.31)与未服药组(指向记忆17.19±5.86,联想学习20.00±6.77,图像自由回忆18.44±6.62,人像特点回忆13.19±6.62)以及不同发作频率组的多数项量表分及记忆商(服药组74.64 ±18.52,未服药组79.07±20.20,≥3次/月组78.10±21.22,<3次/月组73.81±17.72)显著低于对照组(t=4.794-10.224,P<0.01);且癫(癎)服药组和发作频率≥3次/月组的各项量表分及记忆商显著低于服药组和发作频率<3次/月组(t=3.267～6.537,P<0.01).癫(癎)组海马体积(左侧2.45±0.25,右侧2.56±0.31)、N-乙酰天门冬氨酸(NAA,左侧12.93±1.73,右侧11.88±1.69)及NAA/胆碱(Cho)+肌酸(Cr,左侧0.48±0.08,右侧0.39±0.07)显著低于对照组,Cho(左侧15.02±0.86,右侧14.94±0.96)、Cr(左侧11.86±0.71,右侧10.71±0.42)显著高于对照组(t=4.103～5.768,P<0.01);癫(癎)组的各项量表分及记忆商与左右侧NAA浓度、NAA/Cho+Cr均呈明显正相关(r=O.489～0.727,P<O.01),与左右侧海马Cho浓度均呈明显负相关(r=-0.604～-0.484,P<0.01),与左右侧海马的Cr浓度无明显相关性.结论 癫(癎)全面性发作的患者存在短时记忆障碍;发作次数、频繁及使用抗癫(癎)药物可能对短时记忆功能造成影响.癫(癎)全面性发作患者的记忆障碍与海马NAA的浓度、Cho浓度及NAA/Cho+cr的相关关系表明海马神经元缺失或胶质增生可能是其短时记忆力下降的机制之一.
目的 探討原髮性癲(癎)全麵性髮作患者記憶功能損害的特徵以及磁共振波譜(magnetic resonance spectroscopy,MRS)檢查與記憶功能的關繫.方法 對45例癲(癎)全麵性髮作的患者和20例健康對照組進行臨床記憶量錶的測量,雙側海馬行1H-MRS檢測及體積測量,比較2組間記憶量錶的各項量錶分、記憶商和1H-MRS的各項指標,併對記憶量錶的結果與海馬1H-MRS結果進行相關分析.結果 癲(癎)組包括服藥組(指嚮記憶15.68±4.79,聯想學習18.70±5.84,圖像自由迴憶13.19±6.22,人像特點迴憶12.02±4.31)與未服藥組(指嚮記憶17.19±5.86,聯想學習20.00±6.77,圖像自由迴憶18.44±6.62,人像特點迴憶13.19±6.62)以及不同髮作頻率組的多數項量錶分及記憶商(服藥組74.64 ±18.52,未服藥組79.07±20.20,≥3次/月組78.10±21.22,<3次/月組73.81±17.72)顯著低于對照組(t=4.794-10.224,P<0.01);且癲(癎)服藥組和髮作頻率≥3次/月組的各項量錶分及記憶商顯著低于服藥組和髮作頻率<3次/月組(t=3.267～6.537,P<0.01).癲(癎)組海馬體積(左側2.45±0.25,右側2.56±0.31)、N-乙酰天門鼕氨痠(NAA,左側12.93±1.73,右側11.88±1.69)及NAA/膽堿(Cho)+肌痠(Cr,左側0.48±0.08,右側0.39±0.07)顯著低于對照組,Cho(左側15.02±0.86,右側14.94±0.96)、Cr(左側11.86±0.71,右側10.71±0.42)顯著高于對照組(t=4.103～5.768,P<0.01);癲(癎)組的各項量錶分及記憶商與左右側NAA濃度、NAA/Cho+Cr均呈明顯正相關(r=O.489～0.727,P<O.01),與左右側海馬Cho濃度均呈明顯負相關(r=-0.604～-0.484,P<0.01),與左右側海馬的Cr濃度無明顯相關性.結論 癲(癎)全麵性髮作的患者存在短時記憶障礙;髮作次數、頻繁及使用抗癲(癎)藥物可能對短時記憶功能造成影響.癲(癎)全麵性髮作患者的記憶障礙與海馬NAA的濃度、Cho濃度及NAA/Cho+cr的相關關繫錶明海馬神經元缺失或膠質增生可能是其短時記憶力下降的機製之一.
목적 탐토원발성전(간)전면성발작환자기억공능손해적특정이급자공진파보(magnetic resonance spectroscopy,MRS)검사여기억공능적관계.방법 대45례전(간)전면성발작적환자화20례건강대조조진행림상기억량표적측량,쌍측해마행1H-MRS검측급체적측량,비교2조간기억량표적각항량표분、기억상화1H-MRS적각항지표,병대기억량표적결과여해마1H-MRS결과진행상관분석.결과 전(간)조포괄복약조(지향기억15.68±4.79,련상학습18.70±5.84,도상자유회억13.19±6.22,인상특점회억12.02±4.31)여미복약조(지향기억17.19±5.86,련상학습20.00±6.77,도상자유회억18.44±6.62,인상특점회억13.19±6.62)이급불동발작빈솔조적다수항량표분급기억상(복약조74.64 ±18.52,미복약조79.07±20.20,≥3차/월조78.10±21.22,<3차/월조73.81±17.72)현저저우대조조(t=4.794-10.224,P<0.01);차전(간)복약조화발작빈솔≥3차/월조적각항량표분급기억상현저저우복약조화발작빈솔<3차/월조(t=3.267～6.537,P<0.01).전(간)조해마체적(좌측2.45±0.25,우측2.56±0.31)、N-을선천문동안산(NAA,좌측12.93±1.73,우측11.88±1.69)급NAA/담감(Cho)+기산(Cr,좌측0.48±0.08,우측0.39±0.07)현저저우대조조,Cho(좌측15.02±0.86,우측14.94±0.96)、Cr(좌측11.86±0.71,우측10.71±0.42)현저고우대조조(t=4.103～5.768,P<0.01);전(간)조적각항량표분급기억상여좌우측NAA농도、NAA/Cho+Cr균정명현정상관(r=O.489～0.727,P<O.01),여좌우측해마Cho농도균정명현부상관(r=-0.604～-0.484,P<0.01),여좌우측해마적Cr농도무명현상관성.결론 전(간)전면성발작적환자존재단시기억장애;발작차수、빈번급사용항전(간)약물가능대단시기억공능조성영향.전(간)전면성발작환자적기억장애여해마NAA적농도、Cho농도급NAA/Cho+cr적상관관계표명해마신경원결실혹효질증생가능시기단시기억력하강적궤제지일.
Objective To investigate the features of the memory function disturbance in patients of generalized seizures and the correlation between the memory function and proton magnetic resonance spectroscopy(1H-MRS).Methods The clinical memory scale of 45 general seizures and 20 normal age and sex-matched controls wss measured and a1 H-MRs was performed in the bilateral hippoeampal.The levels of NAA.Cho.Cr and the ratios of NAA/Cr+Cho were compared between these two groups.Meanwhile,tHe correlation coefficients was calculated and the results of clinical memory scale scoreB and the level of NAA,Cho.Cr and the ratios of NAA/Cr+Cho in groups were compared.Results As compared with the controls.the scores of pointing memory(17.19±5.86),associational learning(20.00±6.77),image free memory(18.44±6.62),association memory of portrait(13.19±6.62)and memory quotient (MQ,79.07±20.20)excepts insignificant figure recognition wcrc significandy decreased in patients of seizures(t=4.794-10.224,all P<0.01);The scores of scale and MQ of both the group of patients who wok antiepileptic drugs(AEDs)and the group of patients whose frequency exceeded 3 per month were significantly lower than the group who didn't take AEDs and the group whose frequency was lower than 3 per month(t=3.267-6.537,all P<0.01).The volumes of hippocampal formations(2.45 ±0.25 on left and 2.56 ±0.31 on right),the level of NAA(12.93 ±1.73 on left and 11.88 ±1.69 on right),Cho(15.02 ±0.86 on left and 14.94 ±0.96 on right),Cr(11.86 ±0.71 on left and 10.71 ±0.42 on right)and the ratios of NAA/Cr+Cho(0.48 ±0.08 on left and 0.39 ±0.07 on riht)in the group of pailents of generalized seizures were significantly difference than those in the controls(t=4.103-5.768,all P<0.01).Patients with seizures showed significant correlation between tlle scores of all items.MQ in clinical memory scale and NAA,NAA/Cr+Cho ratio(r=0.489-0.727,all P<0.01),and inverse correlation between the scores and MQ and Cho of in the bilateral hippocampal(r=-0.604-0.484,all P<0.01).However,there was no correlation between the scores and MQ and Cr of in the bilateral hippocampal.Condusions The patients of the general seizures do have the problem of the disturbance of short-term memory including acoustic memory and some visual memory.Both the high frequency of seizure and AEDs could affect the short-term memory function.The correlation between the scores of all the items and MQ in clinical memory scale proved that lack of nerve cell and hyperplasia of gliocyte was one of the reasons of the short-term memory disorder in epileptic.
