title: Neuropsychological outcomes after Gamma Knife radiosurgery for mesial temporal lobe epilepsy: a prospective multicenter study.
abstract: OBJECTIVE
  To assess outcomes of language, verbal memory, cognitive efficiency and mental flexibility, mood, and quality of life (QOL) in a prospective, multicenter pilot study of Gamma Knife radiosurgery (RS) for mesial temporal lobe epilepsy (MTLE).
  
  
  METHODS
  RS, randomized to 20 Gy or 24 Gy comprising 5.5-7.5 ml at the 50% isodose volume, was performed on mesial temporal structures of patients with unilateral MTLE. Neuropsychological evaluations were performed at preoperative baseline, and mean change scores were described at 12 and 24 months postoperatively. QOL data were also available at 36 months.
  
  
  RESULTS
  Thirty patients were treated and 26 were available for the final 24-month neuropsychological evaluation. Language (Boston Naming Test), verbal memory (California Verbal Learning Test and Logical Memory subtest of the Wechsler Memory Scale-Revised), cognitive efficiency and mental flexibility (Trail Making Test), and mood (Beck Depression Inventory) did not differ from baseline. QOL scores improved at 24 and 36 months, with those patients attaining seizure remission by month 24s accounting for the majority of the improvement.
  
  
  CONCLUSIONS
  The serial changes in cognitive outcomes, mood, and QOL are unremarkable following RS for MTLE. RS may provide an alternative to open surgery, especially in those patients at risk of cognitive impairment or who desire a noninvasive alternative to open surgery.
authors.affiliation: Department of Neurology, University of Virginia, Charlottesville, Virginia 22908, USA. quigg@virginia.edu
authors.forename: Mark
authors.initials: M
authors.lastname: Quigg
authors.forename: Donna K
authors.initials: DK
authors.lastname: Broshek
authors.forename: Nicholas M
authors.initials: NM
authors.lastname: Barbaro
authors.forename: Mariann M
authors.initials: MM
authors.lastname: Ward
authors.forename: Kenneth D
authors.initials: KD
authors.lastname: Laxer
authors.forename: Guofen
authors.initials: G
authors.lastname: Yan
authors.forename: Kathleen
authors.initials: K
authors.lastname: Lamborn
mesh_terms: D000328:Adult; D003072:Cognition Disorders / Q000175:diagnosis* / Q000453:epidemiology; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010865:Pilot Projects; D011183:Postoperative Complications / Q000175:diagnosis* / Q000453:epidemiology; D011446:Prospective Studies; D016634:Radiosurgery / Q000379:methods*; D013702:Temporal Lobe / Q000601:surgery; D016896:Treatment Outcome