Verbal memory decline after temporal epilepsy surgery?

Alpherts, W.C.J.; Vermeulen, Jan; Rijen, Peter C. van; Silva, F. H. Lopes da; Veelen, C.W.M. van

doi:10.1212/01.wnl.0000230139.45304.eb

Cited by 120 publications

(81 citation statements)

References 37 publications

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“…Previous studies have consistently shown that verbal memory is likely to decrease following resection of the language-dominant left temporal lobe [24][25][26] . Alpherts et al 24 found that L-TLE patients showed an ongoing decline in the acquisition and consolidation of verbal memory for up to 2 years after surgery, while R-TLE patients initially showed a slight improvement in verbal memory, which vanished 2 years after surgery. However, the main limitation of that study was that they only examined the postoperative changes in general intelligence, memory, language and visual-motor functions and did not examine the changes in executive functioning after surgery.…”

Section: Discussionmentioning

confidence: 95%

Changes in neuropsychological functioning following temporal lobectomy in patients with temporal lobe epilepsy

Shin

Lee

Seol

et al. 2009

Neurological Research

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Purpose: This study was conducted to evaluate the changes in neuropsychological functioning in patients with temporal lobe epilepsy (TLE) after temporal lobe resection. Methods: Fifty-four TLE patients were evaluated before and after surgery using comprehensive neuropsychological tests to assess general intelligence, executive functioning, language, verbal and visual memory, working memory, visuo-spatial ability, attention and motor function. Results: The patients with left TLE showed no impairment of neuropsychological functioning after surgery, with the exception of auditory immediate memory. Furthermore, they showed significant improvement in performance IQ, executive function, working memory, visual memory, attention and psychomotor speed. The patients with right TLE did not show any significant impairment in post-operative neuropsychological functioning. They showed improvements in intellectual and executive functions, language, visual memory, visuo-spatial ability, attention and motor function post-operatively. The patients with hippocampal sclerosis showed greater post-operative improvements than the patients without hippocampal sclerosis regardless of the side. Patients with better pre-operative neuropsychological function had a higher chance of successfully discontinuing all seizure medications after surgery. Discussion: The results of this study suggest that temporal lobectomy does not harm the neuropsychological functioning of patients with intractable TLE and that it improves cognitive functions of the contralateral hemisphere. [Neurol Res 2009; 31: 692-701]

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Section: Discussionmentioning

confidence: 95%

Changes in neuropsychological functioning following temporal lobectomy in patients with temporal lobe epilepsy

Shin

Lee

Seol

et al. 2009

Neurological Research

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“…Longitudinal results in nonsurgical patients with focal symptomatic epilepsies indicate rather stable performance over time, although a decline depending on the seizure situation seems possible. 1,11,21,31,47 In surgical patients with epilepsy, it has been observed that after an initial postsurgical decline, cognitive functions are stable, 2,3 and in cases of seizure freedom, even tend to improve. 21 Another difference between the groups was the fact that surgery was not offered to the medical patients.…”

Section: Limitations Of the Studymentioning

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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“…Although many follow-up studies span up to 2 years after surgery, showing little or no group changes in IQ, [5][6][7][8] long-term follow-up studies commonly extrapolate outcome from only a few individuals because of considerable within-study variation in follow-up duration, [9][10][11] ranging from 6 months to 10 years. Previous studies have suggested that seizure frequency, 12 memory function, 13 and intelligence 11 may show late changes after temporal lobe surgery. Long-term follow-up studies are therefore required to determine the more stable levels of cognitive functioning, allowing for postsurgical recovery and functional reorganization.…”

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confidence: 96%

Long-term intellectual outcome after temporal lobe surgery in childhood

Skirrow¹,

Cross²,

Cormack³

et al. 2011

Neurology

215

199

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Objective: Temporal lobe resection is an established treatment for medication-resistant temporal lobe epilepsy, which in recent years has increasingly been performed in children. However, little is known about the long-term outcome in these children. The aim of this study was to characterize intellectual and psychosocial functioning of children after temporal lobe resection as they progress into late adolescence and adulthood. Methods:We report the long-term follow-up of 42 children who underwent temporal lobe surgery after an average postoperative period of 9 years. Longitudinal change in IQ was documented, psychosocial outcome including quality of life was assessed, and preoperative and postoperative T1-weighted MRI brain scans were evaluated quantitatively. A well-matched nonsurgical comparison group of 11 children with similar clinical characteristics was also assessed.Results: At follow-up, 86% of the surgical group were seizure-free, and 57% were no longer taking antiepileptic medication. A significant increase in IQ was found in the surgical group after an extended follow-up period of Ͼ5 years. This IQ change was not found in the nonsurgical comparison group. IQ increases were associated with cessation of antiepileptic medication and changes in MRI-derived gray matter volume. The surgical group also reported better psychosocial outcome including quality of life, which was more strongly associated with seizure freedom rather than surgery per se. Conclusions:Surgery for temporal lobe epilepsy performed in childhood results in excellent long-term seizure control and favorable cognitive outcome along with positive effects on brain development. Classification of evidence:This study provides Class III evidence that temporal lobectomy in children with temporal lobe epilepsy is associated with improved long-term intellectual outcomes compared with those undergoing standard medical treatment. Neurology Medication-resistant temporal lobe epilepsy (TLE) is often caused by brain abnormalities such as tumors or hippocampal sclerosis. Surgical removal of such lesions results in excellent seizure control.1 When surgical treatment for TLE in children is considered, factors such as the impact of seizures and medication on brain development and function have to be taken into account.2 Because children with poor seizure control show a decrease in intellectual functioning over time, 3 it is thought that early surgical intervention could reduce the severity of cognitive impairment.

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Verbal memory decline after temporal epilepsy surgery?

Abstract: The results provide evidence for a dynamic decline of verbal memory functions up to 2 years after left temporal lobectomy, which then levels off.

Cited by 120 publications

References 37 publications

Changes in neuropsychological functioning following temporal lobectomy in patients with temporal lobe epilepsy

Changes in neuropsychological functioning following temporal lobectomy in patients with temporal lobe epilepsy

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

Long-term intellectual outcome after temporal lobe surgery in childhood

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