title: Memory outcome 2 years after anterior temporal lobectomy in patients with drug-resistant epilepsy.
abstract: 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.
authors.affiliation: Epilepsy Surgery Unit, Department of Neurological Sciences, IRCCS Neuromed, 86077 Pozzilli (IS), Italy.
authors.forename: Liliana G
authors.initials: LG
authors.lastname: Grammaldo
authors.forename: Giancarlo
authors.initials: G
authors.lastname: Di Gennaro
authors.forename: Teresa
authors.initials: T
authors.lastname: Giampà
authors.forename: Marco
authors.initials: M
authors.lastname: De Risi
authors.forename: Giulio N
authors.initials: GN
authors.lastname: Meldolesi
authors.forename: Addolorata
authors.initials: A
authors.lastname: Mascia
authors.forename: Antonio
authors.initials: A
authors.lastname: Sparano
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Esposito
authors.forename: Pier Paolo
authors.initials: PP
authors.lastname: Quarato
authors.forename: Angelo
authors.initials: A
authors.lastname: Picardi
mesh_terms: 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