Memory outcome 2 years after anterior temporal lobectomy in patients with drug-resistant epilepsy.
OBJECTIVE
Memory decline is often observed after anterior temporal lobectomy (ATL), particularly in patients with dominant hemisphere resections. However, the follow-up length has been 1 year or less in most studies. Our aims were to examine postoperative memory changes over a longer period and to identify baseline demographic and clinical predictors of memory outcome.


METHODS
We administered material-specific memory tests at baseline, and 1 and 2 years after surgery to 82 consecutive right-handed patients (52% males) who underwent ATL for drug-resistant temporal lobe epilepsy (TLE) (35 left, 47 right) after a non-invasive presurgical protocol. Repeated measures multivariate analysis of variance (RM-MANOVA) was used to examine the relationship between changes in memory tests scores over time and side of TLE and pathology. Also, standardized residual change scores were calculated for each memory test and entered in multiple linear regression models aimed at identifying baseline predictors of better memory outcome.


RESULTS
RM-MANOVA revealed a significant change in memory test scores over time, with an interaction between time and side of surgery, as 2 years after surgery patients with RTLE were improved while patients with LTLE were not worse as compared with baseline. Pathology was not associated with changes in memory scores. In multiple regression analysis, significant associations were found between right TLE and greater improvement in verbal memory, younger age and greater improvement in visuospatial memory, and male gender and greater improvement in both verbal and visuospatial memory.


CONCLUSIONS
Our results suggest that the long-term memory outcome of TLE patients undergoing ATL without invasive presurgical assessment may be good in most cases not only for right-sided but also for left-sided resections.
Grammaldo
Liliana G
LG
Epilepsy Surgery Unit, Department of Neurological Sciences, IRCCS Neuromed, 86077 Pozzilli (IS), Italy.
Di Gennaro
Giancarlo
G
Giampà
Teresa
T
De Risi
Marco
M
Meldolesi
Giulio N
GN
Mascia
Addolorata
A
Sparano
Antonio
A
Esposito
Vincenzo
V
Quarato
Pier Paolo
PP
Picardi
Angelo
A
D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000453:epidemiology* / Q000209:etiology*; D013702:Temporal Lobe / Q000601:surgery*; D016896:Treatment Outcome