INTRODUCTION The concept of cognitive phenotypes has been developed to categorize the heterogeneity of neuropsychological profiles in patients with temporal lobe epilepsy (TLE). This study examines the utility of cognitive phenotypes derived from clinical criteria in the prediction of postoperative outcomes. METHODS Scores from 9 standardized neuropsychological tests were used to sample preoperative performance in 4 core domains (intellectual, memory, language, & executive function) in 445 patients with TLE (206 right: 236 left). Patients were grouped into 3 clinical phenotypes using clinical criteria: 1. intact cognition, 2. isolated memory and/or language impairment, and 3. widespread impairment. Patients who did not meet the criteria for these phenotypes were characterized as having a mixed profile phenotype. RESULTS Approximately half of the sample had intact cognitive function, with one-quarter demonstrating isolated impairments in language and memory function. The remainder demonstrated widespread impairment or a mixed pattern of cognitive impairments. The clinically derived cognitive phenotypes were associated with demographic and clinical characteristics. Patients with widespread cognitive impairments had an earlier onset of seizures than those with other cognitive phenotypes. They also reported higher levels of depression. Higher levels of anxiety were reported in those with isolated memory/language impairments. Phenotypes were not associated with postoperative seizure outcome or postoperative declines in verbal memory or language function, but an intact phenotype was associated with a greater risk of decline in visual learning than right-sided surgery. CONCLUSIONS Distinct cognitive phenotypes in TLE can be identified using clinical criteria and may reflect neurodevelopmental influences and mood in addition to progression of the disease. Phenotype may be a more powerful predictor of postoperative decline in visual memory than laterality of surgery.

中文翻译：

---

颞叶癫痫患者癫痫手术后认知表型与术后结局的相关性

引言 认知表型的概念已被开发用于对颞叶癫痫 (TLE) 患者神经心理特征的异质性进行分类。本研究检查了源自临床标准的认知表型在预测术后结果中的效用。方法 9 项标准化神经心理学测试的分数用于对 445 名 TLE 患者（右 206 名：左 236 名）在 4 个核心领域（智力、记忆、语言和执行功能）的术前表现进行抽样。使用临床标准将患者分为 3 种临床表型：1. 完整的认知，2. 孤立的记忆和/或语言障碍，以及 3. 广泛的障碍。不符合这些表型标准的患者被定性为具有混合谱表型。结果 大约一半的样本具有完整的认知功能，四分之一的样本表现出单独的语言和记忆功能障碍。其余的表现出广泛的损害或认知损害的混合模式。临床衍生的认知表型与人口统计学和临床​​特征相关。与其他认知表型的患者相比，具有广泛认知障碍的患者癫痫发作更早。他们还报告了更高程度的抑郁症。有孤立记忆/语言障碍的人报告的焦虑程度更高。表型与术后癫痫发作结果或术后语言记忆或语言功能下降无关，但与右侧手术相比，完整的表型与视觉学习能力下降的风险更大有关。结论 可以使用临床标准确定 TLE 中不同的认知表型，除了疾病的进展外，还可以反映神经发育的影响和情绪。与手术偏侧性相比，表型可能更能预测术后视觉记忆力下降。