Correlação entre atrofia hipocampal e déficit de memória em pacientes com epilepsia de lobo temporal mesial / Correlation between hippocampal atrophy and memory deficits in patients with mesial temporal lobe epilepsy

AUTOR(ES)
FONTE

IBICT - Instituto Brasileiro de Informação em Ciência e Tecnologia

DATA DE PUBLICAÇÃO

17/02/2012

RESUMO

Mesial Temporal Lobe Epilepsy (MTLE) is the most common focal epilepsy in adults and is usually associated with hippocampal atrophy (HA) which is recognized by highresolution magnetic resonance imaging (MRI). It consists of a syndrome that is often refractory to clinical treatment and patients may have memory deficits due to hippocampal system damage, however, little is known about the impact of seizure frequency on memory. Therefore, the main purpose of this study was to compare the neuropsychological performance between patients with refractory clinical treatment MTLE and patients with benign MTLE (good response to clinical treatment) but also to investigate the association between memory deficits with the hippocampal volume (HV) and the clinical response to treatment. MRIs were acquired from 25 patients with refractory MTLE, 21 patients with benign MTLE and 30 healthy subjects for comparison of volumetric data. The manual segmentation of the hippocampus was performed using the DISPLAY software without prior knowledge of disease history and participant s identification. The neuropsychological assessment included: the Edinburgh handedness inventory; subtests of the Wechsler Memory Scale - Revised (WMS-R); Rey Auditory Verbal Learning Test (RAVLT) and subtests vocabulary and block design of the Wechsler Adult Intelligence Scale - III. The groups were homogeneous regarding age, age of onset, duration of epilepsy, educational level, estimated IQ and handedness, but there was difference between the HA laterality which was, most frequently at right in the refractory group. We observed a reduction of ipsilateral and contralateral HV in patients when compared to the control group. When comparing the two patient s groups regarding their performance on neuropsychological evaluation, both groups showed memory impairment, however there wasn t significant difference between them. We also observed correlation between duration of epilepsy with estimated IQ and performance on the WMS-R evocation, between seizure frequency with ipsilateral and contralateral HV, as well as between the right HV with RAVLT A6 and RAVLT recognition and between the left HV with RAVLT A6, demonstrating the relevance of the mesial structures for memory consolidation. We conclude that patients with MTLE exhibit memory deficits related to the presence of HA, but independent of seizure frequency.

ASSUNTO(S)

hipocampo cognição epilepsia - diagnóstico ressonância magnética hippocampus cognition epilepsy diagnosis magnetic resonance

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