A methodological perspective on the cognitive outcome of epilepsy surgery in children and adolescents

Jakobsen, Anne Vagner; Müller, Elisabeth; Uldall, Peter

doi:10.1016/j.yebeh.2020.107330

Cited by 6 publications

(12 citation statements)

References 34 publications

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“…Two studies 32,33 with a two-year follow-up period reported no significant post-operative IQ changes. On the other hand, three studies 22,28,29 reported an overall significant improvement. Finally, in the long follow-up group, two studies 26,27 reported that the effect of surgery was not significant in the post-surgical IQ values whereas two studies 13,24 reported a significant improvement and one study 23 reported a modest improvement.…”

Section: Results Of Individual Studiesmentioning

confidence: 94%

“…At an individual level, in Jakobsen AV, 22 35% of the sample had their FSIQ improved more than 10 points, 56% were unchanged and 9% underwent a decrease of more than 10 points.…”

Section: Results Of Individual Studiesmentioning

confidence: 97%

“…27,29 Lee YJ, 2015 27 also reported that shorter epilepsy duration was a good predictor of PIQ after surgery (a gain over five points). In three different studies (Jakobsen AV; 22 Faramand AM 25 and Skirrow C, 2011 13 ) no correlation between postoperative FSIQ and duration of epilepsy was found. In Skirrow C, 2019, 23 it was reported that post-operative FSIQ was inversely correlated with a longer duration of epilepsy but there was no correlation with FSIQ change between pre-and post-surgery.…”

Section: Hemispherotomymentioning

confidence: 92%

“…Considering all the studies with curative surgeries, only three 13,22,24 reported an overall significant improvement in IQ after surgery. Two of them 13,24 were also the ones with a longer follow-up period.…”

Section: Skirrow C 2019 23 ----------Improvementmentioning

confidence: 98%

“…Jakobsen AV, 2020 22 Significant improvement ---------- 24 Significant improvement ----------Faramand AM, 2017 25 No significant effect ----------Shurleff HA, 2015 26 No significant effect ----------Lee YJ, 2015 27 No significant effect ----------Liang S, 2014 28 -----Significant Improvement -----Lee YJ, 2013 29 Not analyzed Not analyzed Not analyzed…”

Section: Hemispherotomymentioning

confidence: 99%

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Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

AR¹,

Oliveiros²,

Pereira³

2021

jpsychiatrymentaldisord

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There is a deep-rooted correlation between refractory epilepsy in pediatric age and intelligence development. However, little is known about whether surgical procedures used in pediatric epilepsy treatment can affect Intelligence Quotient (IQ) or not. Factors that might influence postoperative IQ are also a matter of study in several articles. To tackle these issues, a systematic review with meta-analysis was conducted with the terms “epilepsy”, “epileptic”, “surgery”, “surgical”, “Wechsler Scale” and “intelligence tests” in PubMed, the Cochrane Library, EMBASE and Clinical Trials.gov. A descriptive data synthesis was carried out to address each of the objectives and then a metaanalysis using a random effects model was conducted. A meta-regression was performed to ascertain possible factors that could influence postoperative IQ. The meta-analysis of the studies included found a mean difference between postoperative and preoperative full-scale IQ values of 1.014 standardized points (p < 0.001). Among all the articles regarding curative surgeries, only three reported an overall significant improvement in IQ after surgery. Regarding palliative procedures, both studies with anterior corpus callosotomy reported a significant improvement in full-scale IQ values two years after surgery. The meta-regression performed did not find any predictors of change in full-scale IQ.

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Section: Results Of Individual Studiesmentioning

confidence: 94%

“…At an individual level, in Jakobsen AV, 22 35% of the sample had their FSIQ improved more than 10 points, 56% were unchanged and 9% underwent a decrease of more than 10 points.…”

Section: Results Of Individual Studiesmentioning

confidence: 97%

Section: Hemispherotomymentioning

confidence: 92%

Section: Skirrow C 2019 23 ----------Improvementmentioning

confidence: 98%

Section: Hemispherotomymentioning

confidence: 99%

See 3 more Smart Citations

Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

AR¹,

Oliveiros²,

Pereira³

2021

jpsychiatrymentaldisord

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IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis

Schmidlechner,

Zaddach,

Heinen

et al. 2023

J Neurol

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Objective This systematic review aimed to assess the intellectual outcome of children who underwent surgery for epilepsy. Methods A systematic review of electronic databases was conducted on December 3, 2021, for PubMed and January 11, 2022, for Web of Science. The review was conducted according to the PRISMA guidelines. The included studies reported on intelligence quotient (IQ) or developmental quotient (DQ) before and after epilepsy surgery in children. Studies were included, if the patients had medically intractable epilepsy and if the study reported mainly on curative surgical procedures. We conducted a random-effects meta-analysis to determine the mean change of IQ/DQ. Results Fifty-seven studies reporting on a total of 2593 patients met the inclusion criteria. The mean age at surgery was 9.2 years (± 3.44; range 2.4 months–19.81 years). Thirty-eight studies showed IQ/DQ improvement on a group level, 8 yielded stable IQ/DQ, and 19 showed deterioration. Pooled analysis revealed a significant mean gain in FSIQ of + 2.52 FSIQ points (95% CI 1.12–3.91). The pooled mean difference in DQ was + 1.47 (95% CI − 6.5 to 9.5). The pooled mean difference in IQ/DQ was 0.73 (95% CI − 4.8 to 6.2). Mean FSIQ gain was significantly higher in patients who reached seizure freedom (+ 5.58 ± 8.27) than in patients who did not (+ 0.23 ± 5.65). It was also significantly higher in patients who stopped ASM after surgery (+ 6.37 ± 3.80) than in patients who did not (+ 2.01 ± 2.41). Controlled studies showed a better outcome in the surgery group compared to the non-surgery group. There was no correlation between FSIQ change and age at surgery, epilepsy duration to surgery, and preoperative FSIQ. Significance The present review indicates that there is a mean gain in FSIQ and DQ in children with medically intractable epilepsy after surgery. The mean gain of 2.52 FSIQ points reflects more likely sustainability of intellectual function rather than improvement after surgery. Seizure-free and ASM-free patients reach higher FSIQ gains. More research is needed to evaluate individual changes after specific surgery types and their effect on long-term follow-up.

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Current state of hemispherectomy and callosotomy for pediatric refractory epilepsy in Denmark

De Knegt,

Børresen,

Knudsen

et al. 2024

Brain and Development

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A methodological perspective on the cognitive outcome of epilepsy surgery in children and adolescents

Cited by 6 publications

References 34 publications

Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

Intelligence Quotient Outcome Following Epilepsy Surgery in Pediatric Age – A Systematic Review and Meta-Analysis

IQ changes after pediatric epilepsy surgery: a systematic review and meta-analysis

Current state of hemispherectomy and callosotomy for pediatric refractory epilepsy in Denmark

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