Word-finding deficits persist after left anterotemporal lobectomy.
OBJECTIVE
To determine the incidence and extent of exacerbation of word-finding difficulty following anterotemporal lobectomy and to identify predictors of change.


METHODS
Case-series study of qualitative and quantitative changes in confrontation naming ability before surgery and 1 year after surgery. Stepwise multiple regression analysis of predictors of postoperative naming change.


METHODS
A university epilepsy surgery program.


METHODS
Fifty-nine consecutive patients.


METHODS
Standard, en bloc anterotemporal lobectomy.


METHODS
Raw scores and types of errors on the 85-item Boston Naming Test.


RESULTS
A significant exacerbation of word-finding difficulty was noted that persisted at least 1 year after surgery in 25% of patients with left, speech-dominant anterotemporal lobectomy (Laterality x Time interaction [F = 24.5; P < .0005]). "Tip-of-the-tongue"-type errors were most frequent (F = 54.66; P < .001), as opposed to paraphasic-type errors seen more frequently among patients with aphasia or dementia. Word-finding decline was worse among patients who underwent a left anterotemporal lobectomy and who were left-hemisphere speech dominant, older, or evaluated earlier in the postoperative course.


CONCLUSIONS
Significant, persisting worsening of word-finding difficulties is not a rare consequence of a left anterotemporal lobectomy, as suggested by previous studies. Differences between these results and those of previous studies may reflect differences in extent of surgical resection and/or differential sensitivity of psychometric measures of naming to word-finding problems. Information regarding extent, frequency, and predictors of word-finding declines may be used in counseling surgical candidates about the potential cognitive side effects of anterotemporal lobectomy.
Langfitt
J T
JT
Department of Neurology, University of Rochester, NY, USA.
Rausch
R
R
D000328:Adult; D018450:Disease Progression; D004833:Epilepsy, Temporal Lobe / Q000150:complications / Q000523:psychology* / Q000601:surgery*; D005260:Female; D005544:Forecasting; D007839:Functional Laterality; D006801:Humans; D007806:Language Disorders / Q000209:etiology* / Q000523:psychology; D008297:Male; D011183:Postoperative Complications; D011184:Postoperative Period; D012044:Regression Analysis