The role of the intracarotid amobarbital procedure in predicting verbal memory decline after temporal lobe resection.
OBJECTIVE
The aim of this study was to compare the utility of baseline neuropsychological measures and scores from the intracarotid amobarbital procedure (IAP) in the prediction of postoperative memory decline in temporal lobe epilepsy surgery patients.


METHODS
Logistic regression analyses were used to determine the relation between demographic variables, baseline neuropsychological scores, and scores from the IAP (using mixed verbal and nonverbal stimuli) and postoperative deterioration in verbal learning and verbal recall in 91 patients (48 right, RTL; 43 left, LTL) who had undergone a standard anterior temporal lobe resection for the relief of medically intractable epilepsy and who had been followed up 1 year postoperatively.


RESULTS
In the RTL group, the IAP scores were not significant predictors of a postoperative decline in verbal learning or recall. In the LTL group, postoperative decline in verbal learning was associated with good preoperative baseline scores, an older age at the time of surgery, and an unexpected asymmetry on the IAP. Baseline neuropsychological scores and scores from the IAP were associated with a significant postoperative decline in verbal recall in the LTL group.


CONCLUSIONS
Scores from the IAP using mixed stimuli were not helpful in the prediction of postoperative verbal memory decline in RTL patients. The significance of IAP scores in predicting verbal memory deficits in LTL patients may be task specific.
Baxendale
Sallie
S
Department of Clinical and Experimental Epilepsy, Institute of Neurology, Queen Square, London, United Kingdom. sallieb@ion.ucl.ac.uk
Thompson
Pamela
P
Harkness
William
W
Duncan
John
J
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000654:Amobarbital / Q000494:pharmacology; D038481:Anterior Temporal Lobectomy; D002343:Carotid Artery, Internal; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D006801:Humans; D007269:Injections, Intra-Arterial; D016015:Logistic Models; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis* / Q000209:etiology; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology; D011379:Prognosis; D014705:Verbal Behavior / Q000502:physiology; D014706:Verbal Learning / Q000502:physiology*
D000654:Amobarbital