Evaluating the contributions of state-of-the-art assessment techniques to predicting memory outcome after unilateral anterior temporal lobectomy.
OBJECTIVE
Although anterior temporal lobectomy (ATL) is an effective treatment for many patients with medically refractory temporal lobe epilepsy (TLE), one risk associated with this procedure is postsurgical decline in memory. A substantial number of past studies examined factors that predict memory decline after surgery, but few have investigated multiple predictors simultaneously or considered measures that are currently in use.


METHODS
This study compared the relative contributions made by presurgical neuropsychological test scores, MRI-based hippocampal volumetric analysis, and Wada test results to predicting memory outcome after ATL in a group of 87 patients.


RESULTS
Logistic regression analyses indicated that noninvasive procedures (neuropsychological testing and MRI) made significant contributions to improving the prediction of memory outcome in this sample. The results from the Wada procedure did not significantly improve prediction once these other factors were considered. The only exception was in predicting memory for visual information after a delay, in which Wada results improved prediction accuracy from 78% to 81%.


CONCLUSIONS
Current neuropsychological tests and MRI volumetric measures predict changes in verbal and visual memory after ATL. The relatively small change in correct classification rates when Wada memory scores are considered calls into question the benefits of using Wada test results to predict memory outcome when the results of noninvasive procedures are available.
Lineweaver
Tara T
TT
Psychology Department, Butler University, Indianapolis, Indiana 46208, USA. tlinewea@butler.edu
Morris
Harold H
HH
Naugle
Richard I
RI
Najm
Imad M
IM
Diehl
Beate
B
Bingaman
William
W
D038481:Anterior Temporal Lobectomy; D007839:Functional Laterality / Q000502:physiology; D006624:Hippocampus / Q000473:pathology; D006801:Humans; D008279:Magnetic Resonance Imaging; D008568:Memory / Q000187:drug effects; D008569:Memory Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D009483:Neuropsychological Tests; D010424:Pentobarbital; D011300:Preoperative Care; D016896:Treatment Outcome
D010424:Pentobarbital