title: The selective amobarbital test in the anterior choroidal artery: perfusion pattern assessed by intraarterial SPECT and prediction of postoperative verbal memory.
abstract: To screen for patients at risk for memory decline after temporal lobe epilepsy (TLE) surgery, selective amobarbital procedures, such as injection into the anterior choroidal artery (ACA-IAT), are sometimes used. We investigated the extent of the territory affected during ACA-IAT and its predictive value with respect to postoperative memory. Seventeen patients with TLE underwent ACA-IAT. In 9 of 17 patients, intraarterial SPECT co-registrated to MRI allowed delineation of amobarbital-perfused structures. Another subgroup of 9 of 17 patients underwent anterior temporal lobectomy. Verbal memory was tested pre- and postoperatively and during ACA-IAT. Major variations in the ACA-IAT perfusion pattern occurred and were not correlated with the verbal memory scores during ACA-IAT. Postoperatively, no patient experienced a severe verbal memory decline, but individual postoperative performance was not correlated with results during ACA-IAT. Our study suggests that ACA-IAT can be used to screen for severe postoperative amnesia in inconclusive cases, but cannot predict individual outcome, even when the perfusion pattern is taken into account.
authors.affiliation: Department of Neurology, University Hospital of Geneva, Geneva, Switzerland. serge.vulliemoz@hcuge.ch <serge.vulliemoz@hcuge.ch>
authors.forename: S
authors.initials: S
authors.lastname: Vulliemoz
authors.forename: A J
authors.initials: AJ
authors.lastname: Pegna
authors.forename: J-M
authors.initials: JM
authors.lastname: Annoni
authors.forename: H
authors.initials: H
authors.lastname: Yilmaz
authors.forename: J P
authors.initials: JP
authors.lastname: Willi
authors.forename: L
authors.initials: L
authors.lastname: Spinelli
authors.forename: T
authors.initials: T
authors.lastname: Landis
authors.forename: M
authors.initials: M
authors.lastname: Seeck
mesh_terms: D000293:Adolescent; D000328:Adult; D000654:Amobarbital / Q000008:administration & dosage*; D038481:Anterior Temporal Lobectomy / Q000379:methods*; D002343:Carotid Artery, Internal; D004569:Electroencephalography; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery; D005069:Evaluation Studies as Topic; D005260:Female; D007839:Functional Laterality / Q000187:drug effects / Q000502:physiology; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000187:drug effects* / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011184:Postoperative Period; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D015899:Tomography, Emission-Computed, Single-Photon; D014706:Verbal Learning / Q000187:drug effects* / Q000502:physiology
chemical_list: D006993:Hypnotics and Sedatives; D000654:Amobarbital