KMID : 0877220030070010027
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Journal of Korean Epilepsy Society 2003 Volume.7 No. 1 p.27 ~ p.32
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Wisconsin Card Sorting Test Performance in Mesial Temporal Lobe Epilepsy
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Kim Chul-Ho
Lee Sang-Ahm Yoo Hee-Jung Kang Joong-Koo Lee Jung-Kyo
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Abstract
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Purpose£ºTo investigate the origin of frontal lobe dysfunction identified by the Wisconsin Card Sorting Test (WCST) in mesial temporal lobe epilepsy (MTLE).
Methods£ºWe included 85 patients with unilateral MTLE and 34 patients with neocortical temporal lobe epilepsy (NTLE). We in-cluded only MTLE patients who postoperatively became seizure free at least for 1 year. Comparisons were made on the WCST per-formance between MTLE and NTLE and between preoperative and postoperative test in MTLE. Standardized regression based (SRB) methodology was used for correcting test-retest bias.
Results£º1) There were no significant differences in frontal lobe dysfunction defined as more than 17 perseverative errors between MTLE (64%) and NTLE (76%). 2) No significant differences in WCST performance between MTLE and NTLE were noted, except in categories completed (p=0.05). NTLE achieved significantly fewer categories than MTLE. 3) The proportions of patients with MTLE who postoperatively showed a clinically meaningful impro-vement on WCST performance were higher than those who displ-ayed a significant decline. In case of perseverative responses, 52% of patients with MTLE postoperatively showed an improvement whereas 18% displayed a decline. 4) Postoperatively, mean values of perseverative responses and total errors were significantly de-creased (p<0.05). 5) Significant negative correlations were found between preoperative WCST performance and postoperative SRB change scores for WCST (r=-0.3~-0.4, p<0.05).
Conclusions£ºOur results could not be explained by any one of ¢¥neural noise¢¥ or ¢¥hippocampal¢¥ hypothesis. Our data suggest that poor WCST performance in patients with MTLE might be attri-buted to dysfunction of neural system including both hippocampus and frontal lobe cortex. Further studies are needed to make new hypothesis.
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KEYWORD
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Temporal lobe epilepsy, Wisconsin card sorting test, Hippocampus
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