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Paradigm Shifts in the Neuropsychology of Epilepsy

机译：范式在癫痫神经心理学中转移

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This article reviews the major paradigm shifts that have occurred in the area of the application of clinical and experimental neuropsychology to epilepsy and epilepsy surgery since the founding of the International Neuropsychological Society. The five paradigm shifts discussed include: 1) The neurobiology of cognitive disorders in epilepsy – expanding the landscape of syndrome-specific neuropsychological impairment; 2) pathways to comorbidities: bidirectional relationships and their clinical implications; 3) discovering quality of life: The concept, its quantification and applicability; 4) outcomes of epilepsy surgery: challenging conventional wisdom; and 5) Iatrogenic effects of treatment: cognitive and behavioral effects of antiepilepsy drugs. For each area we characterize the status of knowledge, the key developments that have occurred, and how they have altered our understanding of the epilepsies and their management. We conclude with a brief overview of where we believe the field will be headed in the next decade which includes changes in assessment paradigms, moving from characterization of comorbidities to interventions; increasing development of new measures, terminology and classification; increasing interest in neurodegenerative proteins; transitioning from clinical seizure features to modifiable risk factors; and neurobehavioral phenotypes. Overall, enormous progress has been made over the lifespan of the INS with promise of ongoing improvements in understanding of the cognitive and behavioral complications of the epilepsies and their treatment. (JINS, 2017, 23, 791–805)
机译：本文综述了自国际神经心理学会成立以来，临床和实验神经心理学应用于癫痫和癫痫手术的应用领域的主要范式转变。讨论的五个范式转变包括：1）癫痫中的认知障碍的神经生物学 - 扩大综合征特异性神经心理学障碍的景观; 2）合并症的途径：双向关系及其临床意义; 3）发现生活质量：概念，量化和适用性; 4）癫痫手术的结果：挑战常规智慧; 5）治疗的理性作用：抗癫痫药物的认知和行为作用。对于每个区域，我们描述了知识状况，发生了关键的发展，以及如何改变我们对癫痫和他们的管理的理解。我们的结论是简要概述了我们认为该领域将在未来十年中领导的领域，其中包括评估范例的变化，从合并症的表征转变为干预措施;增加新措施，术语和分类的发展;增加对神经变性蛋白质的兴趣;从临床癫痫发作功能转换到可修改的危险因素;和神经兽性表型。总体而言，在理解癫痫和治疗的认知和行为并发症的情况下，对终身造成了巨大进展。 （济恩，2017,23,791-805）

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