磁共振引导下的激光间质热疗治疗青少年颞叶中叶癫痫后的认知效果

IF 1.8 Q3 CLINICAL NEUROLOGY Epilepsy and Behavior Reports Pub Date : 2024-01-01 DOI:10.1016/j.ebr.2024.100723
Jonathon M. Cavaleri , Jenna A. Chiang , Danielle M. Wishart , Keiko M. Kang , Patrick R. Ng , Leanne Mendoza , Kenneth Hartline , Michele Van Hirtum-Das , Latanya D. Agurs , Madeline Kahan , Brittany Jordan , Charles Y. Liu , Brian Lee , Peter A. Chiarelli , Jason K. Chu
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引用次数: 0

摘要

耐药性颞叶间叶癫痫(MTLE)的手术治疗与认知障碍有关。磁共振引导下的激光间质热疗(MRgLITT)治疗MTLE与开放性手术切除相比,成人患者的认知疗效更佳。然而,有关青少年和儿童患者术后认知效果的数据却很有限。我们对2017年至2023年间接受MRgLITT治疗MTLE的儿科患者病例进行了回顾性连续回顾。我们对术前和术后12个月进行了完整神经心理学评估的患者进行了分析,以了解他们在认知、记忆、执行功能、视觉扫描、图形运动速度和精细运动速度/灵活性等神经心理学领域的变化。分析对象包括六名因MTLE接受MRgLITT治疗的青少年患者(x̄年龄=19.0岁,SD=1.2),他们均接受了完整的术前和术后神经心理学评估。比较术前和术后的认知评估结果,各神经心理学领域均无统计学意义上的显著变化,包括言语记忆得分。在检查特定侧效应时,观察到语音流畅性发生了临床意义上的变化,接受右侧 MRgLITT 的患者的语音流畅性有所改善,但接受左侧 MRgLITT 的患者的语音流畅性有所下降。50%的患者在最后一次随访时达到了恩格尔I型结果。我们的初步研究结果表明,MRgLITT 对青少年 MTLE 的不良神经心理影响极小,包括保留了言语记忆。临床结果与文献报道的结果相似。
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Cognitive outcomes after magnetic resonance-guided laser interstitial thermal therapy for mesial temporal lobe epilepsy in adolescent patients
Surgical treatment of medication-resistant mesial temporal lobe epilepsy (MTLE) is associated with cognitive deficits. Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) for MTLE has been shown to result in superior cognitive outcomes in adults when compared to open surgical resection. However, data regarding postoperative cognitive outcomes in adolescent and pediatric patients is limited. We retrospectively reviewed sequential cases of pediatric patients who underwent MRgLITT for MTLE between 2017 and 2023. Patients who had complete preoperative and 12 month postoperative neuropsychological evaluation were analyzed for changes in the neuropsychological domains of cognition, memory, executive functioning, visual scanning, graphomotor speed, and fine motor speed/dexterity. Six adolescent patients who underwent MRgLITT for MTLE (x̄ age = 19.0 years, SD = 1.2) and had complete preoperative and postoperative neuropsychological evaluations were included in the analysis. There were no statistically significant changes across neuropsychological domains when comparing pre- and postoperative cognitive evaluations, including verbal memory scores. Clinically significant changes in phonemic fluency were observed when examining side-specific effects and improved for patients who received right-sided MRgLITT but declined for patients who received left-sided MRgLITT. 50 % of patients achieved Engel I outcome at last follow-up. Our preliminary results suggest minimal adverse neuropsychologic effects following MRgLITT for adolescent MTLE, including preservation of verbal memory. Clinical outcomes were similar with those reported in the literature.
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来源期刊
Epilepsy and Behavior Reports
Epilepsy and Behavior Reports Medicine-Neurology (clinical)
CiteScore
2.70
自引率
13.30%
发文量
54
审稿时长
50 days
期刊最新文献
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