摘要： 目的 总结左侧颞叶癫痫患者工作记忆维持期神经振荡模式特征，探讨左侧颞叶癫痫伴工作记忆障碍的神经机制。方法 共纳入21例2017年9月至2021年5月在天津医科大学总医院诊断与治疗的左侧颞叶癫痫患者（LTLE组），另以性别、年龄、受教育程度和认知功能相匹配的35例健康志愿者为对照（对照组），完成视觉工作记忆测试，记录反应时间和应答正确率；同时采集34通道脑电信号，计算工作记忆维持期各频段功率谱密度（PSD），选取PSD最高频段作为工作记忆维持期优势频段并分析优势频段神经振荡空间分布模式。结果 工作记忆行为学分析，与对照组相比，LTLE组完成工作记忆反应时间延长（t=3.597，P=0.001），应答正确率降低（t=3.770，P=0.001）。神经振荡模式分析，θ频段为工作记忆维持期优势频段，且θ频段PSD主要集中于额区，尤以额中线Fz通道分布密集；与对照组相比，LTLE组工作记忆维持期全脑（t=2.600，P=0.012）、额区（t=2.252，P=0.029）、Fz通道（t=2.496，P=0.016） θ频段工作记忆效应PSD（P_WM）均降低。结论 左侧颞叶癫痫患者存在工作记忆障碍，且视觉工作记忆维持期θ振荡减弱。θ振荡减弱有可能成为评估颞叶癫痫患者工作记忆障碍的敏感指标。

关键词: 癫痫,颞叶, 记忆,短时, θ节律, 脑电描记术

Abstract: Objective To summarize the characteristics of neural oscillation during the working memory maintenance in patients with left temporal lobe epilepsy (LTLE), and to explore the changes of neural oscillations in working memory disorders. Methods A total of 21 patients with LTLE (LTLE group) admitted to Tianjin Medical University General Hospital from September 2017 to May 2021 and 35 healthy controls (control group) with matched gender, age, education and cognitive function were enrolled. The visual working memory test was performed, response time and accuracy were recorded. Thirty-four channels of EEG signals were collected to calculate the power spectral density (PSD) of each frequency band during working memory maintenance. The PSD and spatial distribution of dominant frequency bands during working memory maintenance were compared between 2 groups. Results Compared with the control group, LTLE group had longer response time (t=3.597, P=0.001) and lower accuracy (t=3.770, P=0.001). θ frequency band was the dominant band during working memory maintenance, and the PSD of θ frequency band was mainly concentrated in the frontal region, especially the Fz channel of frontal midline. Compared with the control group, the P_WM of θ frequency band of the whole brain (t=2.600, P=0.012), frontal region (t=2.252, P=0.029) and Fz channel (t=2.496, P=0.029) in LTLE group decreased. Conclusions LTLE patients with working memory disorders, and decreased θ oscillation during working memory may be a sensitive indicator of working memory disorders in patients with temporal lobe epilepsy.

Key words: Epilepsy, temporal lobe, Memory, short-term, Theta rhythm, Electroencephalography