Thanh Ha Phuong1,2, Marion Houot3,4,5, Marie Méré6, Marisa Denos1, Séverine Samson7, Sophie Dupont8,9,10,11. 1. Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. 2. Neurology Unit, Hôpital Bach Mai, Hanoi, Vietnam. 3. Clinical Investigation Centre, Institut du Cerveau Et de La Moelle Épinière (ICM), Pitié-Salpêtrière Hospital Paris, Paris, France. 4. Department of Neurology, Institute of Memory and Alzheimer's Disease (IM2A), AP-HP, Pitié-Salpêtrière Hospital, Paris, France. 5. Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France. 6. Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. 7. Univ. Lille, ULR 4072-PSITEC-Psychologie: Interactions Temps Émotions Cognition, F-59000, Lille, France. 8. Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. sophie.dupont@aphp.fr. 9. Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France. sophie.dupont@aphp.fr. 10. Université Paris Sorbonne, Paris, France. sophie.dupont@aphp.fr. 11. Centre de Recherche de l'Institut du Cerveau Et de La Moelle Épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France. sophie.dupont@aphp.fr.
Abstract
BACKGROUND: Cognitive impairment is an important comorbidity of refractory temporal lobe epilepsy (TLE). We aimed to explore the impact of (i) specific lesions, such as dysembryoplastic neuroepithelial tumor (DNET), dysplasia, or hippocampal sclerosis, (ii) focus localization (medial versus lateral) and (iii) focus lateralization (right versus left) on the neuropsychological profile of refractory TLE adult patients. METHODS: We examined the neuropsychological characteristics of 312 adults with refractory TLE: 100 patients without hippocampal sclerosis (HS) and 212 with HS. Scores on tests of intelligence (Global IQ, Verbal IQ and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions and language abilities were analyzed. RESULTS: Three main factors influenced the neuropsychological profile of refractory TLE patients: (i) the lesion, patients with HS obtaining poorer cognitive performances than patients without HS and specifically DNET patients performing better than patients with HS, (ii) the focus side, that seems only relevant for verbal memory abilities which are affected in left but not right TLE patients and (iii) the localization of seizure focus, patients with medial TLE exhibiting lower memory performances than patients with lateral TLE. CONCLUSION: Lesion, localization and lateralization are major contributors of the cognitive impairment depicted in TLE. Hippocampal sclerosis appears as the main contributor.
BACKGROUND:Cognitive impairment is an important comorbidity of refractory temporal lobe epilepsy (TLE). We aimed to explore the impact of (i) specific lesions, such as dysembryoplastic neuroepithelial tumor (DNET), dysplasia, or hippocampal sclerosis, (ii) focus localization (medial versus lateral) and (iii) focus lateralization (right versus left) on the neuropsychological profile of refractory TLE adult patients. METHODS: We examined the neuropsychological characteristics of 312 adults with refractory TLE: 100 patients without hippocampal sclerosis (HS) and 212 with HS. Scores on tests of intelligence (Global IQ, Verbal IQ and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions and language abilities were analyzed. RESULTS: Three main factors influenced the neuropsychological profile of refractory TLEpatients: (i) the lesion, patients with HS obtaining poorer cognitive performances than patients without HS and specifically DNET patients performing better than patients with HS, (ii) the focus side, that seems only relevant for verbal memory abilities which are affected in left but not right TLEpatients and (iii) the localization of seizure focus, patients with medial TLE exhibiting lower memory performances than patients with lateral TLE. CONCLUSION: Lesion, localization and lateralization are major contributors of the cognitive impairment depicted in TLE. Hippocampal sclerosis appears as the main contributor.
Authors: Viola L Vogt; Juri-Alexander Witt; Daniel Delev; Alexander Grote; Marec von Lehe; Albert J Becker; Johannes Schramm; Christian E Elger; Christoph Helmstaedter Journal: Epilepsy Behav Date: 2018-09-10 Impact factor: 2.937
Authors: M Jones-Gotman; R J Zatorre; A Olivier; F Andermann; F Cendes; H Staunton; D McMackin; A M Siegel; H G Wieser Journal: Neuropsychologia Date: 1997-07 Impact factor: 3.139
Authors: Elisabeth M S Sherman; Samuel Wiebe; Taryn B Fay-McClymont; Jose Tellez-Zenteno; Amy Metcalfe; Lisbeth Hernandez-Ronquillo; Walter J Hader; Nathalie Jetté Journal: Epilepsia Date: 2011-03-22 Impact factor: 5.864