Prediction of neuropsychological outcome after resection of temporal and extratemporal seizure foci

Dulay, Mario F.; Busch, Robyn M.

doi:10.3171/2012.1.focus11340

Cited by 46 publications

(34 citation statements)

References 59 publications

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“…Quantitative measurement revealed smaller presurgical CC area in patients with treatment‐resistant epilepsy (TRE), relative to controls, after controlling for overall brain volume. Variation in CC area was associated with pre‐ to postsurgical change in working memory, after controlling for established predictors of cognitive outcome, such as age and level of cognitive functioning . This was not the case for longer‐term retention of verbal information; there was no relationship between CC area and pre‐ to postsurgical change in delayed verbal memory.…”

Section: Discussionsupporting

confidence: 89%

“…Conversely, postsurgical gains in executive domains such as attention and working memory can be observed . Clinical (e.g., epilepsy duration, presurgical cognitive level) and demographic (e.g., age) factors predict postsurgical cognitive outcomes . Yet, little is known about the degree to which cross‐hemispheric white matter pathways promote recovery of cognitive functions following epilepsy surgery.…”

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confidence: 99%

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The corpus callosum and recovery of working memory after epilepsy surgery

et al. 2015

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SUMMARYObjective: For patients with medically intractable focal epilepsy, the benefit of epilepsy surgery must be weighed against the risk of cognitive decline. Clinical factors such as age and presurgical cognitive level partially predict cognitive outcome; yet, little is known about the role of cross-hemispheric white matter pathways in supporting postsurgical recovery of cognitive function. The purpose of this study is to determine whether the presurgical corpus callosum (CC) midsagittal area is associated with pre-to postsurgical change following epilepsy surgery. Methods: In this observational study, we retrospectively identified 24 adult patients from an epilepsy resection series who completed preoperative high-resolution T 1 -weighted magnetic resonance imaging (MRI) scans, as well as pre-and postsurgical neuropsychological testing. The total area and seven subregional areas of the CC were measured on the midsagittal MRI slice using an automated method. Standardized indices of auditory-verbal working memory and delayed memory were used to probe cognitive change from pre-to postsurgery. CC total and subregional areas were regressed on memory-change scores, after controlling for overall brain volume, age, presurgical memory scores, and duration of epilepsy. Results: Patients had significantly reduced CC area relative to healthy controls. We found a positive relationship between CC area and change in working memory, but not delayed memory; specifically, the larger the CC, the greater the postsurgical improvement in working memory (b = 0.523; p = 0.009). Effects were strongest in posterior CC subregions. There was no relationship between CC area and presurgical memory scores. Significance: Findings indicate that larger CC area, measured presurgically, is related to improvement in working memory abilities following epilepsy surgery. This suggests that transcallosal pathways may play an important, yet little understood, role in postsurgical recovery of cognitive functions.

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Section: Discussionsupporting

confidence: 89%

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confidence: 99%

The corpus callosum and recovery of working memory after epilepsy surgery

et al. 2015

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“…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: 82%

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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“…3). Functional connectivity studies of the language deficits known to be present in TLE have emerged (for review of language deficits see [39,40]). Pravata et al [35] showed that for both left 2.5 R 4 FIGURE 2.…”

Section: Anticorrelated Activity Correlated Activitymentioning

confidence: 99%

Resting-state functional connectivity in epilepsy

Tracy

Doucet²

2015

Current Opinion in Neurology

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The role of rsFC remains limited in most clinical settings, but shows great promise for identifying epileptic circuits and foci, predicting outcomes following surgery, and explaining cognitive deficits and psychiatric symptoms of epilepsy. RsFC has demonstrated that even focal epilepsies constitute a network and brain systems disorder. By providing a tool to both identify and characterize the brain network impact of epileptiform activity, rsFC can make a strong contribution to presurgical algorithms in epilepsy.

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Prediction of neuropsychological outcome after resection of temporal and extratemporal seizure foci

Cited by 46 publications

References 59 publications

The corpus callosum and recovery of working memory after epilepsy surgery

The corpus callosum and recovery of working memory after epilepsy surgery

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

Resting-state functional connectivity in epilepsy

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