国际抗癫痫联盟诊断方法委员会神经精神协作组报告——常规癫痫治疗中进行神经心理评估的适应证及重要性_Journal of Epilepsy

Authors：

 童馨 ,  慕洁

四川大学华西医院神经内科(成都, 610041);

Corresponding author：

慕洁, Email: mujie2010@foxmail.com

Keywords：

癫痫; 神经心理; 训练; 最低标准; 成人; 儿科

DOI：

10.7507/2096-0247.20150027

Video：

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国际抗癫痫联盟(ILAE)诊断方法委员会下属的神经精神协作组提出了一系列建议, 以解决以下问题:①神经心理评估的作用是什么？②由谁来进行神经心理评估？③癫痫患者何时应该被建议进行神经心理评估？④神经心理评估能达到怎样的效果？这些建议主要是写给已建立癫痫中心的临床医生的, 也同样适用于那些正在发展新服务的中心。这些建议是基于对国际较好的癫痫中心的神经心理评估实践的详实调查, 和来自世界各地的癫痫专业顶级神经心理学家发起的对推进癫痫临床治疗的特别建议。文章总结并整合了最新的研究结果, 以建立培训和实践的最低标准, 反映了神经心理评估在儿童和成人癫痫患者常规治疗中的作用。这些建议包括对新发癫痫患者进行常规的认知、情绪和行为筛查, 并且描述了需进行更详细且正式的神经心理评估的种种情形。指出了一系列应当评估的认知和心理核心领域, 以对个体的认知、情感和心理功能, 包括可能在定性和定量检查中造成缺陷的因素, 提供客观的描述。这些建议包括鼓励将评估结果对患者、家属以及主管医生提供常规反馈, 也包括关于如何提高患者的认知或心理功能, 以及减轻任何已知困难所致痛苦的临床建议。通过考察神经心理评估的广度和深度, 报告阐释了此无创和低成本的深入检查在癫痫治疗中所起的关键作用。

Citation： 童馨, 慕洁. 国际抗癫痫联盟诊断方法委员会神经精神协作组报告——常规癫痫治疗中进行神经心理评估的适应证及重要性. Journal of Epilepsy, 2015, 1(2): 173-179. doi: 10.7507/2096-0247.20150027 Copy

1.	Helmstaedter C, Hermann B, Lassonde M, et al. Neuropsychology in the care of people with epilepsy. Progress in epileptic disorders. Montrouge, France:John Libbey Eurotext, 2011:13-26.
2.	Jones-Gotman M, Smith ML, Risse GL, et al. The contribution ofneuropsychology to diagnostic assessment in epilepsy. Epilepsy Behav, 2010, 18(3):3-12.
3.	Wilson SJ, Engel JJr. Diverse perspectives on developments inepilepsy surgery. Seizure, 2010, 19(2):659-668.
4.	Wilson SJ, Baxendale S. The new approach to classification:rethinking cognition and behavior in epilepsy. Epilepsy Behav, 2014, 41(7):307-310.
5.	Baxendale S, Thompson P. Beyond localization:the role of traditionalneuropsychological tests in an age of imaging. Epilepsia, 2010, 51(5):2225-2230.
6.	Taylor J, Kolamunnage-Dona R, Marson AG, et al. Patients withepilepsy:cognitively compromised before start of antiepileptic drugtreatment? Epilepsia, 2009, 51(10):48-56.
7.	Witt JA, Helmstaedter C. Should cognition be screened in new-onsetepilepsies? A study in 247 untreated patients. J Neurol, 2012, 259(11):1727-1731.
8.	Witt JA, Werhahn KJ, Kreamer G, et al. Cognitive-behavioralscreening in elderly patients with new-onset epilepsy before treatment.Acta Neurol Scand, 2014, 130(9):172-177.
9.	Velissaris SL, Wilson SJ, Saling MM, et al. The psychological impactof a newly diagnosed seizure:losing and restoring perceived control.Epilepsy Behav, 2007, 10(4):223-233.
10.	Velissaris SL, Saling MM, Newton MR, et al. Psychologicaltrajectories in the year after a newly-diagnosed seizure. Epilepsia, 2012, 53(11):1774-1781.
11.	Rayner G, Wrench JM, Wilson SJ. Differential contributions ofobjective memory and mood to subjective memory complaints inrefractory focal epilepsy. Epilepsy Behav, 2010, 19(6):359-364.
12.	Loughman A, Bowden SC, D'Souza W. Cognitive functioning inidiopathic generalised epilepsies:a systematic review and metaanalysis. Neurosci BiobehavRev, 2014, 43(12):20-34.
13.	Caplan R, Siddarth P, Stahl L, et al. Childhood absence epilepsy:behavioral, cognitive, and linguistic comorbidities. Epilepsia, 2008, 49(7):1838-1846.
14.	Overvliet GM, Aldenkamp AP, Klinkenberg S, et al. Correlationbetween language impairment and problems in motor developmentin children with rolandic epilepsy. Epilepsy Behav, 2011, 22(8):527-531.
15.	Gascoigne MB, Smith ML, Barton B, et al. Accelerated long-termforgetting in children with temporal lobe epilepsy. Neuropsychologia, 2014, 59(3):93-102.
16.	Helmstaedter C, Elger CE. Chronic temporal lobe epilepsy:aneurodevelopmental or progressively dementing disease? Brain, 2009, 132(12):2822-2830.
17.	Jackson DC, Dabbs K, Walker NM, et al. The neuropsychological andacademic substrate of new/recent-onset epilepsies. J Pediatr, 2013, 162(10):1047-1053.
18.	Blume WT. The progression of epilepsy. Epilepsia, 2006, 47(Suppl 1):71-78.
19.	Neligan A, Shorvon SD. Prognostic factors morbidity and mortality intonic-clonic status epilepticus:a review. Epilepsy Res, 2011, 93(5):1-10.
20.	Helmstaedter C. Cognitive outcome of status epilepticus in adults.Epilepsia, 2007, 48(Suppl 8):85-90.
21.	Tinuper P, Cerullo A, Marini C, et al. Epileptic drop attacks in partialepilepsy:clinical features, evolution and prognosis. J NeurolNeurosurg Psychiatry, 1998, 64(10):231-237.
22.	Baker GA, Taylor J, Aldenkamp AP. Newly diagnosed epilepsy:cognitive outcome after 12 months. Epilepsia, 2011, 52(6):1084-1091.
23.	Butler CR, Zeman A. Recent insights into the impairment of memoryin epilepsy:a systematic review of transient epileptic amnesia accelerated long-term forgetting and remote memory impairment. Brain, 2008, 131(2):2243-2263.
24.	Calamia M, Markon K, Tranel D. The robust reliability ofneuropsychological measures:meta-analyses of test-retestcorrelations. Clin Neuropsychol, 2013, 27(2):1077-1105.
25.	Loring DW, Lowenstein DH, Barbaro NM, et al. Common dataelements in epilepsy research:development and implementation of theNINDS epilepsy CDE project. Epilepsia, 2011, 52(6):1186-1191.
26.	Helmstaedter C, Witt J. Clinical neuropsychology in epilepsy:theoretical and practical issues//Stefan H, Theodore WH, ed.Epilepsy Part I:Basic principles and diagnosis. Handbook of clinicalneurology, 3rd series, Vol. 107. Amsterdam:Elsevier, 2012:437-459.
27.	Giovagnoli AR. Theory of mind in epilepsy patients and implicationsfor behaviour//Helmstaedter C, Hermann B, Lassonde M, ed. Neuropsychology in the care of people withepilepsy. Progress in epileptic disorders. Montrouge, France:John Libbey Eurotext, 2011:263-271.
28.	Hermann BP, Seidenberg M, Schoenfeld J, et al. Empirical techniquesfor determining the reliability, magnitude, and pattern ofneuropsychological change after epilepsy surgery. Epilepsia, 1996, 37(4):942-950.
29.	Hermann B, Seidenberg M, Sager M, et al. Growing old with epilepsy:the neglected issue of cognitive and brain health in aging and elderpersons with chronic epilepsy. Epilepsia, 2008, 49(1):731-740.
30.	Wiebe S, Matijevic S, Eliasziw M, et al. Clinically important changein quality of life in epilepsy. J Neurol Neurosurg Psychiatry, 2002, 73(3):2116-2120.
31.	Hesdorffer DC, French JA, Posner K, et al. Suicidal ideation andbehavior screening in intractable focal epilepsy eligible for drug trials. Epilepsia, 2013, 54(2):879-887.
32.	Jones JE, Siddarth P, Gurbani S, et al. Screening for suicidal ideationin children with epilepsy. Epilepsy Behav, 2013, 29(6):521-526.
33.	Gorske TT, Smith SR. Collaborative therapeutic neuropsychologicalassessment. New York, NY:Springer Publications, 2009.
34.	Kleim JA, Jones TA. Principles of experience-dependent neuralplasticity:implications for rehabilitation after brain damage. J SpeechLang Hear Res, 2008, 51(Suppl 1):225-239.
35.	Engelberts NHJ, Klein M, Ader HJ, et al. The effectiveness ofcognitive rehabilitation for attention deficits in focal seizures:arandomized controlled study. Epilepsia, 2002, 43(10):587-595.
36.	Helmstaedter C, Loer B, Wohlfahrt R, et al. The effects of cognitiverehabilitation on memory outcome after temporal lobe epilepsysurgery. Epilepsy Behav, 2008, 12(6):402-409.
37.	Kerr EN, Alavie N, Blackwell M. The impact of intervention onworking memory in children with intractable epilepsy:preliminary results from a repeated measure study. Epilepsia, 2013, 54(3):27.
38.	Thorbecke R, May TW, Koch-Stoecker S, et al. Effects of an inpatientrehabilitation program after temporal lobe epilepsy surgery and otherfactors on employment 2 years after epilepsy surgery. Epilepsia, 2014, 55(4):725-733.
39.	Blocher JB, Fujikawa M, Sung C, et al. Computer-assisted cognitivebehavioral therapy for children with epilepsy and anxiety:a pilotstudy. Epilepsy Behav, 2013, 27(9):70-76.
40.	Wagner JL, Smith G, Ferguson P, et al. Feasibility of a pediatriccognitive-behavioral self-management intervention:Coping Openlyand Personally with Epilepsy (COPE). Seizure, 2011, 20(6):462-467.
41.	Walker ER, Obolensky N, Dini S, et al. Formative and processevaluations of a cognitive-behavioral therapy and mindfulnessintervention for people with epilepsy and depression. Epilepsy Behav, 2010, 19(11):239-246.

1. Helmstaedter C, Hermann B, Lassonde M, et al. Neuropsychology in the care of people with epilepsy. Progress in epileptic disorders. Montrouge, France:John Libbey Eurotext, 2011:13-26.
2. Jones-Gotman M, Smith ML, Risse GL, et al. The contribution ofneuropsychology to diagnostic assessment in epilepsy. Epilepsy Behav, 2010, 18(3):3-12.
3. Wilson SJ, Engel JJr. Diverse perspectives on developments inepilepsy surgery. Seizure, 2010, 19(2):659-668.
4. Wilson SJ, Baxendale S. The new approach to classification:rethinking cognition and behavior in epilepsy. Epilepsy Behav, 2014, 41(7):307-310.
5. Baxendale S, Thompson P. Beyond localization:the role of traditionalneuropsychological tests in an age of imaging. Epilepsia, 2010, 51(5):2225-2230.
6. Taylor J, Kolamunnage-Dona R, Marson AG, et al. Patients withepilepsy:cognitively compromised before start of antiepileptic drugtreatment? Epilepsia, 2009, 51(10):48-56.
7. Witt JA, Helmstaedter C. Should cognition be screened in new-onsetepilepsies? A study in 247 untreated patients. J Neurol, 2012, 259(11):1727-1731.
8. Witt JA, Werhahn KJ, Kreamer G, et al. Cognitive-behavioralscreening in elderly patients with new-onset epilepsy before treatment.Acta Neurol Scand, 2014, 130(9):172-177.
9. Velissaris SL, Wilson SJ, Saling MM, et al. The psychological impactof a newly diagnosed seizure:losing and restoring perceived control.Epilepsy Behav, 2007, 10(4):223-233.
10. Velissaris SL, Saling MM, Newton MR, et al. Psychologicaltrajectories in the year after a newly-diagnosed seizure. Epilepsia, 2012, 53(11):1774-1781.
11. Rayner G, Wrench JM, Wilson SJ. Differential contributions ofobjective memory and mood to subjective memory complaints inrefractory focal epilepsy. Epilepsy Behav, 2010, 19(6):359-364.
12. Loughman A, Bowden SC, D'Souza W. Cognitive functioning inidiopathic generalised epilepsies:a systematic review and metaanalysis. Neurosci BiobehavRev, 2014, 43(12):20-34.
13. Caplan R, Siddarth P, Stahl L, et al. Childhood absence epilepsy:behavioral, cognitive, and linguistic comorbidities. Epilepsia, 2008, 49(7):1838-1846.
14. Overvliet GM, Aldenkamp AP, Klinkenberg S, et al. Correlationbetween language impairment and problems in motor developmentin children with rolandic epilepsy. Epilepsy Behav, 2011, 22(8):527-531.
15. Gascoigne MB, Smith ML, Barton B, et al. Accelerated long-termforgetting in children with temporal lobe epilepsy. Neuropsychologia, 2014, 59(3):93-102.
16. Helmstaedter C, Elger CE. Chronic temporal lobe epilepsy:aneurodevelopmental or progressively dementing disease? Brain, 2009, 132(12):2822-2830.
17. Jackson DC, Dabbs K, Walker NM, et al. The neuropsychological andacademic substrate of new/recent-onset epilepsies. J Pediatr, 2013, 162(10):1047-1053.
18. Blume WT. The progression of epilepsy. Epilepsia, 2006, 47(Suppl 1):71-78.
19. Neligan A, Shorvon SD. Prognostic factors morbidity and mortality intonic-clonic status epilepticus:a review. Epilepsy Res, 2011, 93(5):1-10.
20. Helmstaedter C. Cognitive outcome of status epilepticus in adults.Epilepsia, 2007, 48(Suppl 8):85-90.
21. Tinuper P, Cerullo A, Marini C, et al. Epileptic drop attacks in partialepilepsy:clinical features, evolution and prognosis. J NeurolNeurosurg Psychiatry, 1998, 64(10):231-237.
22. Baker GA, Taylor J, Aldenkamp AP. Newly diagnosed epilepsy:cognitive outcome after 12 months. Epilepsia, 2011, 52(6):1084-1091.
23. Butler CR, Zeman A. Recent insights into the impairment of memoryin epilepsy:a systematic review of transient epileptic amnesia accelerated long-term forgetting and remote memory impairment. Brain, 2008, 131(2):2243-2263.
24. Calamia M, Markon K, Tranel D. The robust reliability ofneuropsychological measures:meta-analyses of test-retestcorrelations. Clin Neuropsychol, 2013, 27(2):1077-1105.
25. Loring DW, Lowenstein DH, Barbaro NM, et al. Common dataelements in epilepsy research:development and implementation of theNINDS epilepsy CDE project. Epilepsia, 2011, 52(6):1186-1191.
26. Helmstaedter C, Witt J. Clinical neuropsychology in epilepsy:theoretical and practical issues//Stefan H, Theodore WH, ed.Epilepsy Part I:Basic principles and diagnosis. Handbook of clinicalneurology, 3rd series, Vol. 107. Amsterdam:Elsevier, 2012:437-459.
27. Giovagnoli AR. Theory of mind in epilepsy patients and implicationsfor behaviour//Helmstaedter C, Hermann B, Lassonde M, ed. Neuropsychology in the care of people withepilepsy. Progress in epileptic disorders. Montrouge, France:John Libbey Eurotext, 2011:263-271.
28. Hermann BP, Seidenberg M, Schoenfeld J, et al. Empirical techniquesfor determining the reliability, magnitude, and pattern ofneuropsychological change after epilepsy surgery. Epilepsia, 1996, 37(4):942-950.
29. Hermann B, Seidenberg M, Sager M, et al. Growing old with epilepsy:the neglected issue of cognitive and brain health in aging and elderpersons with chronic epilepsy. Epilepsia, 2008, 49(1):731-740.
30. Wiebe S, Matijevic S, Eliasziw M, et al. Clinically important changein quality of life in epilepsy. J Neurol Neurosurg Psychiatry, 2002, 73(3):2116-2120.
31. Hesdorffer DC, French JA, Posner K, et al. Suicidal ideation andbehavior screening in intractable focal epilepsy eligible for drug trials. Epilepsia, 2013, 54(2):879-887.
32. Jones JE, Siddarth P, Gurbani S, et al. Screening for suicidal ideationin children with epilepsy. Epilepsy Behav, 2013, 29(6):521-526.
33. Gorske TT, Smith SR. Collaborative therapeutic neuropsychologicalassessment. New York, NY:Springer Publications, 2009.
34. Kleim JA, Jones TA. Principles of experience-dependent neuralplasticity:implications for rehabilitation after brain damage. J SpeechLang Hear Res, 2008, 51(Suppl 1):225-239.
35. Engelberts NHJ, Klein M, Ader HJ, et al. The effectiveness ofcognitive rehabilitation for attention deficits in focal seizures:arandomized controlled study. Epilepsia, 2002, 43(10):587-595.
36. Helmstaedter C, Loer B, Wohlfahrt R, et al. The effects of cognitiverehabilitation on memory outcome after temporal lobe epilepsysurgery. Epilepsy Behav, 2008, 12(6):402-409.
37. Kerr EN, Alavie N, Blackwell M. The impact of intervention onworking memory in children with intractable epilepsy:preliminary results from a repeated measure study. Epilepsia, 2013, 54(3):27.
38. Thorbecke R, May TW, Koch-Stoecker S, et al. Effects of an inpatientrehabilitation program after temporal lobe epilepsy surgery and otherfactors on employment 2 years after epilepsy surgery. Epilepsia, 2014, 55(4):725-733.
39. Blocher JB, Fujikawa M, Sung C, et al. Computer-assisted cognitivebehavioral therapy for children with epilepsy and anxiety:a pilotstudy. Epilepsy Behav, 2013, 27(9):70-76.
40. Wagner JL, Smith G, Ferguson P, et al. Feasibility of a pediatriccognitive-behavioral self-management intervention:Coping Openlyand Personally with Epilepsy (COPE). Seizure, 2011, 20(6):462-467.
41. Walker ER, Obolensky N, Dini S, et al. Formative and processevaluations of a cognitive-behavioral therapy and mindfulnessintervention for people with epilepsy and depression. Epilepsy Behav, 2010, 19(11):239-246.

Journal of Epilepsy

国际抗癫痫联盟诊断方法委员会神经精神协作组报告——常规癫痫治疗中进行神经心理评估的适应证及重要性

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