Presurgical neuropsychological testing predicts cognitive and seizure outcomes after anterior temporal lobectomy

Abstract We sought to determine significant predictors of seizure and cognitive outcome following surgery for epilepsy. Participants included 41 patients who had undergone anterior temporal lobectomy (ATL). Higher presurgical verbal/language scores and lower nonverbal memory scores were predictive o...

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Bibliographic Details
Published in:Epilepsy & behavior 2009-10, Vol.16 (2), p.246-253
Main Authors: Potter, Jennifer Loyden, Schefft, Bruce K, Beebe, Dean W, Howe, Steven R, Yeh, Hwa-shain, Privitera, Michael D
Format: Article
Language:English
Subjects:
Adult
Anterior Temporal Lobectomy
Cognition - physiology
Cognitive outcome
Epilepsy
Epilepsy - physiopathology
Epilepsy - surgery
Female
Humans
Male
Memory
Middle Aged
Neurology
Neuropsychological Tests
Postoperative Complications
Predictive Value of Tests
Preoperative Care
Prospective Studies
Regression Analysis
ROC Curve
Seizure
Severity of Illness Index
Temporal lobe epilepsy
Treatment Outcome
Wada procedure
Young Adult
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Summary:Abstract We sought to determine significant predictors of seizure and cognitive outcome following surgery for epilepsy. Participants included 41 patients who had undergone anterior temporal lobectomy (ATL). Higher presurgical verbal/language scores and lower nonverbal memory scores were predictive of seizure-free status following ATL. Overall, the presurgical predictors were 93% accurate in discriminating between seizure-free and non-seizure-free patients postsurgery. Surgery in the nondominant-for-language hemisphere was predictive of higher postsurgical verbal/language and verbal memory scores. Higher presurgical visual/construction, nonverbal memory, and verbal/language scores were predictive of better postsurgical verbal/language functioning. Better presurgical verbal/language functioning was predictive of the same skills postsurgically as well as visual/construction outcomes. Exploratory analyses in a subset of participants ( n = 25) revealed that dominant and nondominant intracarotid amobarbital (Wada) memory scores added unique variance only for predicting nonverbal memory following ATL. Presurgical neuropsychological testing provides significant and unique information regarding postsurgical seizure freedom and cognitive outcome in patients who have undergone ATL.
ISSN:1525-5050
1525-5069
DOI:10.1016/j.yebeh.2009.07.007