Memory outcome after hippocampus sparing resections in the temporal lobe

Wagner, Kathrin; Uherek, Martin; Horstmann, Simone; Kadish, Navah Ester; Wisniewski, Ilona; Mayer, H.; Buschmann, F.; Metternich, Birgitta; Zentner, Josef; Schulze‐Bonhage, Andreas

doi:10.1136/jnnp-2012-304052

Cited by 30 publications

(23 citation statements)

References 22 publications

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“…Laterality of the resected focus is a determinant of postoperative OM impairment [33] and possibly of self-awareness of SM [34]. Consistent with previous studies [10], [25], our data did not support a difference in SM performance between right and left TLE after surgery.…”

Section: Discussionsupporting

confidence: 88%

Subjective Memory Evaluation before and after Temporal Lobe Epilepsy Surgery

et al. 2014

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Subjective memory (SM), a self-evaluation of memory, in contrast to objective memory (OM) measured by neuropsychological testing, is less well studied in patients with epilepsy. We assessed SM before and after temporal lobectomy. The Frequency of Forgetting 10 scale (FOF-10), developed to evaluate SM in dementia, was given before and one year after temporal lobectomy. Reliability and validity for use in epilepsy were first assessed. Measures of depression (CES-D) and neuroticism (PANAS) were done before and after surgery as well as complete neuropsychological assessment of OM. Correlation analysis between FOF-10 results and all the other variables was implemented. In 48 patients the FOF-10 was reliable and valid showing high internal consistency in all items (Cronbach's alpha >0.82) and high reproducibility (p<0.01). The FOF-10 also correlated with the memory assessment clinics self rating scale (MAC-S) (p<0.01). FOF-10 scores improved or were unchanged postoperatively in 28 patients (58%) and worsened in 20 (42%). The FOF-10 did not significantly correlate with memory scores from neuropsychological testing but did correlate with perceived word finding difficulty (p<0.001) and postoperative depression (p<0.05). A reduction in number of antiepileptic drugs (AEDs) after surgery distinguished those with improved postoperative SM. No correlation was found between SM and neuroticism, side of surgery or number of seizures. The FOF-10 is a brief and reliable measure of subjective memory in patients with epilepsy. Perceived memory impairment reflects more emotional state, language problems and quantity of AEDs than actual defects in memory function. These results would potentially be useful in presurgical counselling and management of memory issues after temporal lobe surgery.

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Section: Discussionsupporting

confidence: 88%

Subjective Memory Evaluation before and after Temporal Lobe Epilepsy Surgery

et al. 2014

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“…Another study showed that parahippocampal connections measured by diffusion MRI were reduced in patients with left TLE and were also associated with impaired memory performance. In our previous study, we were able to show that in a sample of patients without hippocampectomy, resection of the PHG was associated with lower memory performance compared to patients whose PHG was preserved …”

Section: Discussionmentioning

confidence: 91%

“…Because the HC is an integral part of a distributed memory network comprising different structures within and beyond the TL (eg), it can be assumed that disruption of this network by any resection within the TL might lead to secondary hippocampal atrophy and subsequent memory disturbances. In particular, resections of temporal structures that are directly connected to the HC, for example, the parahippocampal gyrus (PHG), which serves as its major afferent projection, can thus cause secondary HC atrophy . In addition, secondary HV loss disrupts the memory network functionally and therefore—as a major hub for memory functions—results in decreased memory performance.…”

Section: Discussionmentioning

confidence: 99%

“…To preserve functionally intact brain tissue, surgical procedures have become more tailored, and memory‐associated structures, such as the hippocampus (HC), are preserved whenever possible. However, in a previous study in TL‐resected patients with and without hippocampectomy, we found significant memory deterioration after surgery in both groups, although a stronger decrease was observed after HC resection . In the present study, we therefore wished to further elucidate the potential causes behind memory decline in patients with HC‐sparing resections.…”

Section: Introductionmentioning

confidence: 85%

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Effects of hippocampus‐sparing resections in the temporal lobe: Hippocampal atrophy is associated with a decline in memory performance

et al. 2020

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Objective:In patients with temporal lobe epilepsy (TLE) with a nonlesional and nonepileptogenic hippocampus (HC), in order to preserve functionally intact brain tissue, the HC is not resected. However, some patients experience postoperative memory decline, possibly due to disruption of the extrahippocampal memory network and secondary hippocampal volume (HV) loss. The purpose of this study was to determine the extent of hippocampal atrophy ipsilateral and contralateral to the side of the surgery and its relation to memory outcomes. Methods: Hippocampal volume and verbal as well as visual memory performance were retrospectively examined in 55 patients (mean age ± standard deviation [SD] 30 ± 15 years, 25 female, 31 left) before and 5 months after surgery within the temporal lobe that spared the entire HC. HV was extracted based on prespecified templates, and resection volumes were also determined. Results: HV loss was found both ipsilateral and contralateral to the side of surgery (P < .001). Postoperative left HV loss was a significant predictor of postoperative verbal memory deterioration after left-sided surgery (P < .01). Together with the preoperative verbal memory performance, postoperative left HV explained almost 60% of the variance (P < .0001). However, right HV was not a clear predictor of visual memory performance. Larger resection volumes were associated with smaller postoperative HV, irrespective of side of surgery (left: P < .05, right: P < .01). Significance: A disruption of the memory network by any resection within the TL, especially within the language-dominant hemisphere, may lead to HC atrophy and memory decline. These findings may further improve the counseling of patients concerning their postoperative memory outcome before TL resections sparing the entire HC. |WAGNER Et Al.

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“…Portanto, a assistência da endoscopia pode prevenir a ressecção de parênquima cerebral quando acesso ST está sendo utilizado.A preservação de parênquima cerebral é particularmente importante no lobo temporal. Estudos de tratamento cirúrgico de epilepsia do lobo temporal refratária a tratamento medicamentoso evidenciaram que pacientes submetidos a ressecção do hipocampo, giro parahipocampal e córtex entorinal apresentam pior aprendizado verbal e alterações na memória[55][56][57][58] .Benefícios adicionais da assistência da endoscopia incluem maior exposição da superfície lateral do pedúnculo cerebral (área anterior) através dos acessos TC e OI (P<0.05). As vantagens da assistência de endoscopia incluem a habilidade de visão "ao virar da esquina", visualização de pontos cegos, e fornecimento de uma outra perspectiva da anatomia.…”

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Avaliação qualitativa e quantitativa de acessos cirúrgicos com microscopia e assistido por endoscopia à cisterna ambiens: estudo em cadáveres

Furlan¹,

Luíz²

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Memory outcome after hippocampus sparing resections in the temporal lobe

Cited by 30 publications

References 22 publications

Subjective Memory Evaluation before and after Temporal Lobe Epilepsy Surgery

Subjective Memory Evaluation before and after Temporal Lobe Epilepsy Surgery

Effects of hippocampus‐sparing resections in the temporal lobe: Hippocampal atrophy is associated with a decline in memory performance

Avaliação qualitativa e quantitativa de acessos cirúrgicos com microscopia e assistido por endoscopia à cisterna ambiens: estudo em cadáveres

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