The Impairment Of The Attentional Networks In Patients With Temporal Lobe Epilepsy

Objective:Study 1:To investigate the patients with temporal lobe epilepsy attentional impairment and the clinical character by performing the attentional networks test(ANT).Study 2:To explore neural basis of executive networks functions in patients with temporal lobe epilepsy using functional magnetic resonance imaging(fMRI).Methods:Study 1:The mini-mental state examination (MMSE) and computer computerize ANT software were performed in 44 patients with TLE(temporal lobe epilepsy) and 40 controls,to evaluate the cognitive functions.Recorded the clinical date of TLE patients.Logistic regression was used to identify the risk factors of attentional impairment.Study 2:12 patients with TLE and 12 healthy volunteers were included in the fMRI study.An adapted ANT executive network test used as target stimulus,block design fMRI was used to acquire resource data.Image analysis was performed using statistical parameter mapping 2(SPM2).Results:The mean reaction time(688.2±138.1 ms) and executive control network reaction time(155.7±57.0 ms)of the TLE group's ANT which were lower than those of the healthy control group(625.1±100.1 ms,108.0±33.8ms, P<0.05,P<0.01),Logistic regression analysis showed that the positive epileptiform activity EEG was independent risk factor of attentional impairment(95%CI:1.03～42.33,OR=6.603,P=0.043).Compared with controls,the patients had less activation of right cerebral hemisphere.Medial prefrontal cortex,cingulate gyms,parietal lobe were decreased(P＜0.001,uncorrected)when the patients with TLE performed the executive network task.fMRI activation result regress against reaction time.in the heath control group,the right Medial Frontal Gyms,left Inferior Occipital Gyrus and left Middle Frontal Gyms negative correlation with reaction time(P＜0.001).There is no fMRI activation result negative correlation in the TLE group.Conclusions:In the present study results confirmed the existence of with attention impairment in TLE patients.The existence of epileptic discharge may cause TLE patients with attentional executive network impairment.The TLE patients have attentional executive network deficiency,the abnormal brain network of medial prefrontal cortex,cingulate cortex,parietal lobe is the neural basis of attentional executive network impairment of TLE patients.