Differential neuropsychological test sensitivity to left temporal lobe epilepsy

Loring, David W.; Strauss, Esther; Hermann, Bruce P.; Barr, William; Perrine, Kenneth; Trenerry, Max R.; Chelune, Gordon J.; Westerveld, Michael; Lee, Gregory P.; Meador, Kimford J.; Bowden, Stephen C.

doi:10.1017/s1355617708080582

Cited by 86 publications

(48 citation statements)

References 20 publications

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“…These measures show different sensitivity and specificity in regard to temporal lobe dysfunction. 26,38 Memory outcome after temporal lobe surgery is usually analyzed separately for verbal and nonverbal memory. A major reason for this approach is that systematic effects of surgery are mostly found only for verbal memory after left temporal lobe surgery.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Vogt¹,

Malter²,

Schoene-Bake³

et al. 2014

JNS

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Object. The purpose of this study was to retrospectively assess the objective and subjective neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis (AHS).Methods. Memory and executive functions were evaluated at baseline and at follow-up in 11 surgically treated patients and compared with 8 pharmacologically treated patients with temporal lobe epilepsy and bilateral AHS. The median follow-up duration was 16 months in the surgically treated patients and 80.5 months in the pharmacologically treated group. Subjective outcome was evaluated by questionnaires and included mood, quality of life, subjective memory, and activities of daily living.Results. At the follow-up assessment, 82% of the surgically treated patients as opposed to 0% of the nonsurgery patients were seizure free. In the surgical group, nonverbal memory performance did not change significantly in any patient after surgery, but there was a floor effect in 55% of the surgical patients. Regarding verbal memory, 9% of the surgical patients improved while 73% declined, despite severe impairments already evident at baseline. In the nonsurgery control group, 13% of the patients declined in nonverbal memory (floor effect in 63%) and 25% declined in verbal memory (floor effect in 25%) at follow-up. None of the controls improved at follow-up. Executive functions remained unchanged on an impaired level in both groups. At follow-up, the patient groups did not differ significantly with respect to mood, quality of life, subjective memory, or activities of daily living. However, in most aspects, surgically treated patients reported a slightly better subjective outcome than pharmacologically treated patients and a significantly improved quality of life.Conclusions. These results suggest that beyond benefits concerning seizure control, surgically treated patients with bilateral AHS, despite already poor baseline performance, are still at risk for severe postoperative decline in memory. In the light of predominantly minor benefits on a subjective level, the findings put the overall outcome of epilepsy surgery in bilateral AHS patients into perspective. (http://thejns.org/doi/abs/10.3171/2014.7.JNS132037) key WordS • neuropsychological outcome • temporal lobe epilepsy surgery • memory • bilateral Ammon's horn sclerosis Abbreviations used in this paper: AHS = Ammon's horn sclerosis; BDI = Beck Depression Inventory; QOLIE = Quality of Life in Epilepsy Inventory; RCI = reliable change index; TLE = temporal lobe epilepsy; VLMT = Verbaler Lern-und Merkfähigkeitstest.

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Section: Discussionmentioning

confidence: 99%

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Vogt¹,

Malter²,

Schoene-Bake³

et al. 2014

JNS

View full text Add to dashboard Cite

show abstract

“…Previous studies often had small and heterogeneous samples, partially with mixed samples of mesial and lateral TLE, and they used memory tests with different sensitivities to mesial temporal lobe pathologies [20,21]. In the current study, we examined postoperative memory change as a function of neuronal cell densities within hippocampal subfields in a large sample of patients with solely mesial temporal lobe epilepsy (mTLE), employing verbal and figural memory tests with proven sensitivity to mesiotemporal pathology.…”

Section: Introductionmentioning

confidence: 99%

Relevance of hippocampal integrity for memory outcome after surgical treatment of mesial temporal lobe epilepsy

et al. 2015

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Surgical treatment of unilateral mesial temporal lobe epilepsy (mTLE) particularly bears the risk of episodic memory decline. The present study investigates the role of the ipsilateral hippocampal integrity for postoperative change in material-specific memory performance. In 104 patients who had undergone epilepsy surgery for unilateral mTLE, we analyzed pre- to postoperative changes of verbal and figural memory as a function of segmental neuronal cell densities of the resected hippocampus (cornu ammonis, CA1-4; internal and external limb of the dentate gyrus, DG). Results were controlled for side of surgery and hemispheric dominance. Surgery caused significant memory decline, especially with regard to verbal memory after left temporal resections. Seizure freedom (65 % Engel Ia) did not affect memory outcome. Higher neuronal cell densities of the resected left hippocampus were associated with greater declines in verbal memory parameters (r = -0.27 to r = -0.39, p < 0.05), especially when excluding patients with atypical hemispheric dominance (r = -0.34 to r = -0.60, p < 0.05; significant correlations across all hippocampal subfields). There were no systematic correlations between neuronal cell densities of the resected right hippocampus and memory changes. The results emphasize the role of the structural and functional integrity of the hippocampus within the left dominant hemisphere for the degree of verbal memory decline after temporal lobe surgery. Presurgical verbal memory performance may be taken as a marker of ipsilateral left hippocampal integrity and may contribute to individual risk-benefit evaluations before epilepsy surgery. Finally, more precise neuropsychological markers of right hippocampal integrity are needed.

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“…The National Association of Epilepsy Centers [2] has recognized neuropsychologists as essential personnel for the surgical treatment of epilepsy and mandated the inclusion of neuropsychological evaluations for all epilepsy surgery centers. Neuropsychological assessment serves two main purposes in the context of epilepsy surgical consultation: the localization and lateralization of functional deficits related to seizure onset and the prediction of postoperative memory and language functioning [3].…”

Section: Introductionmentioning

confidence: 99%

Clinical utility of the Wechsler Memory Scale—Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates

Soble

Eichstaedt

Waseem

et al. 2014

Epilepsy & Behavior

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Differential neuropsychological test sensitivity to left temporal lobe epilepsy

Cited by 86 publications

References 20 publications

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Relevance of hippocampal integrity for memory outcome after surgical treatment of mesial temporal lobe epilepsy

Clinical utility of the Wechsler Memory Scale—Fourth Edition (WMS-IV) in predicting laterality of temporal lobe epilepsy among surgical candidates

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