Early and late cognitive changes following temporal lobe surgery for epilepsy

Rausch, Rebecca; Kraemer, S.; Pietras, C.J.; Le, Minh‐An Thuy; Vickrey, Barbara G.; Passaro, Erasmo A.

doi:10.1212/01.wnl.0000048203.23766.a1

Cited by 165 publications

(120 citation statements)

References 30 publications

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“…Patients with right resection had a tendency for visual memory and FSIQ decline but the results did not reach statistical significance. Similar findings had been published previously [16,17,19]. Our findings are consistent with already reported verbal memory deterioration following dominant temporal lobe surgery [7,18,19,20].…”

Section: Discussionsupporting

confidence: 93%

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Mihaylova¹,

Khan²,

Buchtel³

et al. 2015

MRAJ

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Purpose-Resective epilepsy surgery for temporal lobe epilepsy (TLE) remains underutilized in elderly patients and only few studies report postsurgical seizure and neurocognitive outcomes in this group. The aim of this study was to investigate the tolerability and efficacy of surgery in older epileptics.Methods-We conducted a retrospective analysis of 18 patients aged 55 or older to assess the efficacy and tolerability of the procedure. Mean disease duration was 34 years.Results-Fourteen patients (78%) achieved Engel class I outcome over a mean follow-up period of 4.2 years. Thirteen patients had neuroimaging and histopathology consistent with mesial temporal sclerosis (MTS). We did not find a measurable effect of disease duration on postsurgical outcome. We confirmed Medical Research Archives 2015Issue 2Copyright © 2015, Knowledge Enterprises Incorporated. All rights reserved. 2 that the MRI evidence of MTS can be used as a predictor for postsurgical outcome. Postsurgical neuropsychological evaluation completed in 13 patients between three months and two and a half years post resection showed decline in verbal abilities most significantly in those who had undergone dominant temporal lobe surgery.Discussion/Conclusion-Our results indicate that epilepsy surgery is well tolerated, safe and effective in older patients with refractory TLE. Postsurgical neuropsychological evaluation showed expected decline in verbal abilities in patients who had undergone dominant resection.

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Section: Discussionsupporting

confidence: 93%

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Mihaylova¹,

Khan²,

Buchtel³

et al. 2015

MRAJ

View full text Add to dashboard Cite

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“…Despite extensive non-invasive and invasive pre-operative hemispheric language and memory testing, subtle problems may arise in post-operative language functioning after left ATL (Hermann et al, 1994;Davies et al, 1998;Langfitt and Rausch, 1996;Clusmann et al, 2002). More frequently difficulties in verbal memory are found post-operatively (Rausch et al, 2003;Lee et al, 2002;Bell and Davies, 1998). When a hippocampal sclerosis is diagnosed less post-operative difficulties are found, presumably caused by reorganization of function during the transformation of healthy brain tissue into a sclerosis.…”

Section: Introductionmentioning

confidence: 99%

Language activation distributions revealed by fMRI in post-operative epilepsy patients: Differences between left- and right-sided resections

et al. 2005

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Objective: To reveal differences of cerebral activation related to language functions in post-operative temporal lobe epilepsy (TLE) patients. Methods: Right (RTL) and left temporal lobe (LTL) resected patients, and healthy controls were studied using functional magnetic resonance imaging (fMRI). Only patients with complete left-hemispheric language dominance according to the intracarotid amytal procedure (IAP) were included. Language-related activations were evoked by performing word generation and text reading language tasks. Activation lateralization and temporo-frontal distribution effects were analysed. Results: For word generation, only LTL patients showed reduced left lateralized activation compared to controls, due to a decrease in activation in the left prefrontal cortex and an increase in the right prefrontal cortex. For reading, the left-hemispheric lateralization in RTL patients increased because of enhanced activity in the left prefrontal cortex, whereas for LTL patients the activation became bilaterally distributed over the temporal lobes. Lateralization results between pre-operative IAP and postoperative fMRI were highly discordant. Significant temporo-frontal distribution changes manifested from the reading but not from the word generation task. * Corresponding author. Backes et al. / Epilepsy Research 66 (2005) [1][2][3][4][5][6][7][8][9][10][11][12] Conclusion: The cerebral language representation in post-operative LTL epilepsy patients is more bi-hemispherically lateralized than in controls and RTL patients. Post-operative temporo-frontal and interhemispheric redistribution effects, involving contralateral homologuous brain areas, are suggested to contribute to the cerebral reorganisation of language function.

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“…Epileptic patients are often suffering from memory and cognitive problems [57-59]. Preliminary studies established that the treatment with crude extract and with the alcoholic extract of Bacopa monnieri plant [60] enhanced learning ability in rats.…”

Section: Discussionmentioning

confidence: 99%

Decreased GABA receptor in the cerebral cortex of epileptic rats: effect of Bacopa monnieri and Bacoside-A

et al. 2012

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AbstactBackgroundGamma amino butyric acid (GABA), the principal inhibitory neurotransmitter in the cerebral cortex, maintains the inhibitory tones that counter balances neuronal excitation. When this balance is perturbed, seizures may ensue.MethodsIn the present study, alterations of the general GABA, GABAA and GABAB receptors in the cerebral cortex of the epileptic rat and the therapeutic application of Bacopa monnieri were investigated.ResultsScatchard analysis of [3H]GABA, [3H]bicuculline and [3H]baclofen in the cerebral cortex of the epileptic rat showed significant decrease in Bmax (P < 0.001) compared to control. Real Time PCR amplification of GABA receptor subunits such as GABAAά1, GABAAγ, GABAAδ, GABAB and GAD where down regulated (P < 0.001) in epileptic rats. GABAAά5 subunit and Cyclic AMP responsible element binding protein were up regulated. Confocal imaging study confirmed the decreased GABA receptors in epileptic rats. Epileptic rats have deficit in radial arm and Y maze performance.ConclusionsBacopa monnieri and Bacoside-A treatment reverses epilepsy associated changes to near control suggesting that decreased GABA receptors in the cerebral cortex have an important role in epileptic occurrence; Bacopa monnieri and Bacoside-A have therapeutic application in epilepsy management.

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Early and late cognitive changes following temporal lobe surgery for epilepsy

Cited by 165 publications

References 30 publications

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Outcomes of epilepsy surgery for medically refractory temporal lobe epilepsy in older patients

Language activation distributions revealed by fMRI in post-operative epilepsy patients: Differences between left- and right-sided resections

Decreased GABA receptor in the cerebral cortex of epileptic rats: effect of Bacopa monnieri and Bacoside-A

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