title: Predictors of decline in verbal fluency after frontal lobe epilepsy surgery.
abstract: Few studies have focused on language changes following frontal lobe epilepsy (FLE) surgery. The aim of the current study is to quantify the role of resection location and size in verbal fluency decline after FLE surgery and to examine its predictors. A retrospective chart review identified 36 adult patients who underwent FLE surgery. Verbal fluency was assessed using the Controlled Oral Word Association Test (COWAT). Nine (25%) of the patients had significant decline. Binary logistic regression incorporating side of resection and preoperative COWAT score significantly predicted decline and accounted for 25% of the variance. A trend was also noted for decliners to have higher postoperative seizure recurrence (p=0.067). There was no effect of size of resection. Patients undergoing FLE surgery are at risk of verbal fluency decline, especially if they have a high presurgical verbal fluency score, undergo a frontal lobe resection in the language dominant hemisphere, and have poor seizure outcome.
authors.affiliation: Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, OH, USA. rani_sa@yahoo.com
authors.forename: R A
authors.initials: RA
authors.lastname: Sarkis
authors.forename: R M
authors.initials: RM
authors.lastname: Busch
authors.forename: D
authors.initials: D
authors.lastname: Floden
authors.forename: J S
authors.initials: JS
authors.lastname: Chapin
authors.forename: C
authors.initials: C
authors.lastname: Kalman Kenney
authors.forename: L
authors.initials: L
authors.lastname: Jehi
authors.forename: P
authors.initials: P
authors.lastname: Ruggieri
authors.forename: I
authors.initials: I
authors.lastname: Najm
mesh_terms: D000328:Adult; D001245:Association Learning; D017034:Epilepsy, Frontal Lobe / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D019635:Neurosurgical Procedures / Q000009:adverse effects*; D011183:Postoperative Complications / Q000175:diagnosis* / Q000209:etiology*; D012044:Regression Analysis; D012189:Retrospective Studies; D013064:Speech Disorders / Q000175:diagnosis* / Q000209:etiology*; D014057:Tomography, X-Ray Computed; D014706:Verbal Learning; D055815:Young Adult