Cognitive development from two to ten years after pediatric epilepsy surgery

Viggedal, Gerd; Kristjánsdóttir, Ragnhildur; Olssøn, Ingrid; Rydenhag, Bertil; Uvebrant, Paul

doi:10.1016/j.yebeh.2012.06.010

Cited by 20 publications

(27 citation statements)

References 35 publications

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“…The contrast in findings may suggest that effortful retrieval demanded in recall is impaired in these patients, and that their performance is facilitated with specific retrieval cues and meaning. Of the two previous longterm outcome studies that have examined word list recall, Skirrow et al 18 reported no significant change following temporal lobectomy (consistent with our results), whereas Viggedal et al, 16 with a heterogenous sample of 12 surgical The number of patients who have shown an improvement or deterioration of 1 standard deviation (3 points) from baseline to long-term follow-up. 31 Lower scores on word list recall at follow-up were not associated with seizure control or surgical status, which suggests that this course of development may be related to an underlying abnormal neural substrate rather than to the effects of seizures or surgical resection.…”

Section: Discussionsupporting

confidence: 89%

“…[16][17][18] Higher scores among seizure-free patients may also reflect improvements in attentional networks, 32 which may then improve the ability to acquire material in a single presentation. Higher word pair recall scores were also marginally associated with seizure freedom.…”

Section: Discussionmentioning

confidence: 99%

“…Similarly, most studies in children do not find any effects of laterality of seizure focus, [5][6][7][8] although some do report side-specific improvements, where verbal and visual memory improve following right 12,13 and left 14 hemisphere resections, respectively. Viggedal et al, 16 examining surgical patients only, found improvements in verbal learning capacity and declines in visual memory. 15 The long-term neuropsychological outcomes of pediatric epilepsy surgery, particularly memory functioning, have been scarcely investigated.…”

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confidence: 99%

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Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Puka

Smith

2016

Epilepsia

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Section: Discussionsupporting

confidence: 89%

Section: Discussionmentioning

confidence: 99%

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confidence: 99%

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Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Puka

Smith

2016

Epilepsia

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“…The present results represent the cognitive outcome two years after surgery, and it is possible that the cognitive outcome may improve in a longer perspective, as found by Skirrow et al [11], but not supported by our previously reported findings ten years after surgery [34].…”

Section: Discussioncontrasting

confidence: 56%

Intelligence two years after epilepsy surgery in children

Viggedal

Olssøn

Carlsson

et al. 2013

Epilepsy & Behavior

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Intelligence before and two years after epilepsy surgery was assessed in 94 children and adolescents and related to preoperative IQ and seizure outcome. The median full-scale IQ was 70 before and two years after surgery. The proportion with a higher or unchanged postoperative IQ was 24 of 49 (49%) of those with an IQ of 70 and more before surgery, nine of 17 (53%) of those with an IQ of 50-69, and ten of 28 (36%) of those with an IQ of less than 50. A significant difference was found between the 47 individuals who became seizure-free and the 47 with persisting seizures, as 60% of the seizure-free children had a higher or unchanged IQ compared with 32% of the 47 who were not seizure-free. The cognitive outcome of children with intellectual disabilities was as good as that of children with average IQ. Thus, they should not be excluded from epilepsy surgery on the basis of low intellectual level.

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“…1 Around 60% of children are free from seizures at 5 or more years after temporal or extratemporal surgery. 2 Research indicates that in children epilepsy surgery overall has either little impact, [3][4][5][6][7] or possibly a positive effect [8][9][10][11][12] on cognitive function, as measured by intelligence quotient (IQ). However, embedded in these group effects is significant interindividual variation.…”

Section: Introductionmentioning

confidence: 99%

Determinants of IQ outcome after focal epilepsy surgery in childhood: A longitudinal case‐control neuroimaging study

et al. 2019

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Summary Objective Intelligence quotient (IQ) outcomes after pediatric epilepsy surgery show significant individual variation. Clinical factors such as seizure cessation or antiepileptic medication discontinuation have been implicated, but do not fully account for the heterogeneity seen. Less is known about the impact of neurobiological factors, such as brain development and resection location. This study examines clinical and neuroimaging factors associated with cognitive outcome after epilepsy surgery in childhood. Methods Fifty‐two children (28 boys, 24 girls) were evaluated for epilepsy surgery and reassessed on average 7.7 years later. In the intervening time, 13 were treated pharmacologically and 39 underwent focal surgery (17 temporal, 16 extratemporal, six multilobar; mean age at surgery = 14.0 years). Pre‐ and postsurgical assessments included IQ tests and T1‐weighted brain images. Predictors of IQ change were investigated, including voxel‐based analyses of resection location, and gray and white matter volume change. Results Overall modest IQ improvement was seen in children treated surgically, but not in those treated pharmacologically only. Applying a ≥10‐point change threshold, 39% of the surgically treated children improved, whereas 10% declined. Clinical factors associated with IQ increases were lower preoperative IQ and longer follow‐up duration, whereas seizure and antiepileptic medication cessation were not predictive. Among neuroimaging factors, we observed that left anterior temporal resections impacted negatively on verbal reasoning, linked to full‐scale IQ decline. In contrast, gray matter volume change in ipsi‐ and contralesional hemispheres was positively correlated with IQ change. Voxel‐based morphometry identified the gray matter volume change in the contralesional dorsolateral frontal cortex as most strongly associated with IQ improvement. Significance We show that a variety of factors are likely to contribute to patterns of postsurgical change in IQ. Neuroimaging results indicate that left anterior temporal resections constrain development of verbal cognition, whereas simultaneously cortical growth after surgical treatment can support improvements in IQ.

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Cognitive development from two to ten years after pediatric epilepsy surgery

Cited by 20 publications

References 35 publications

Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Remembrance and time passed: Memory outcomes 4–11 years after pediatric epilepsy surgery

Intelligence two years after epilepsy surgery in children

Determinants of IQ outcome after focal epilepsy surgery in childhood: A longitudinal case‐control neuroimaging study

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