Utility of the Boston naming test in predicting ultimate side of surgery in patients with medically intractable temporal lobe epilepsy.
OBJECTIVE
Confrontation naming tasks have long been presumed to be sensitive to left temporal dysfunction and, consequently, are frequently used in the evaluation of surgical epilepsy patients. Despite wide and frequent use, few studies have examined the utility of confrontation naming tasks in individuals with temporal lobe epilepsy (TLE).


METHODS
The current study examined the presurgical Boston Naming Test (BNT) performance of 217 right-handed adult patients with intractable TLE (left, 108; right, 109) to determine the utility of this measure in predicting ultimate side of surgery.


RESULTS
The results support the clinical utility of the BNT in determining ultimate side of surgery and suggest that the BNT has incremental validity over and above presurgical delayed memory and intelligence scores. This relation was found to be moderated by Full Scale IQ (FSIQ), age at seizure onset, and duration of epilepsy. The use of a logistic regression equation to predict side of surgery revealed that prediction of left temporal surgery was best among patients with low BNT scores, high FSIQs, and late age at seizure onset. In contrast, right temporal surgery was best predicted among patients with high BNT scores, low FSIQs, and short duration of epilepsy.


CONCLUSIONS
This study supports the clinical utility of the BNT in the preoperative evaluation of candidates for TLE surgery and highlights the importance of examining potential moderating variables when making predictions about side of surgery. This study further provides clinicians with a regression equation that can be used to predict side of surgery in patients with temporal lobe epilepsy.
Busch
Robyn M
RM
Department of Psychiatry and Psychology, Section of Neuropsychology, Cleveland Clinic Foundation, Cleveland, Ohio 44195, USA. buschr@ccf.org
Frazier
Thomas W
TW
Haggerty
Kathryn A
KA
Kubu
Cynthia S
CS
D000293:Adolescent; D000328:Adult; D017668:Age of Onset; D000368:Aged; D001931:Brain Mapping / Q000379:methods*; D002540:Cerebral Cortex / Q000502:physiology / Q000503:physiopathology* / Q000601:surgery; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D005240:Feasibility Studies; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007361:Intelligence Tests / Q000706:statistics & numerical data; D007802:Language; D007807:Language Tests / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data*; D011237:Predictive Value of Tests; D011300:Preoperative Care; D012044:Regression Analysis; D015203:Reproducibility of Results; D012660:Semantics