title: Preoperative neuropsychological presentation of patients with refractory frontal lobe epilepsy.
abstract: This study investigated whether certain cognitive deficits are associated with frontal lobe epilepsy (FLE) aiming to contribute with localization data to the preoperative assessment of epilepsy surgery candidates.
  
  
  
  We evaluated 34 patients with refractory FLE, 37 patients with refractory medial temporal lobe epilepsy (MTLE), and 22 healthy individuals in attention, psychomotor speed, motor function, verbal memory span, verbal fluency, response inhibition/interference, concept formation and set shifting, anticipation and planning, global memory.
  
  
  
  Neuropsychological performances of FLE and MTLE were similar, with the only exception the WCST-number of categories index, measuring mental flexibility, in which MTLE patients performed significantly worse than FLE patients. Left-FLE patients presented more perseverative responding compared to both other patient groups and healthy controls (HCs), while left-MTLE patients showed worse sorting abilities than the other epilepsy groups.
  
  
  
  Our findings suggest a weak cognitive differentiation between FLE and MTLE, probably attributed to the intricate nature of fronto-temporal connectivity frequently resulting in overlapping deficits as well as the confounding effects of seizure-related variables. In clinical practice, a highly individualized (idiographic) neuropsychological approach along with the inclusion of concurrent EEG recordings (e.g., interictal coupling) may be of help for neuropsychologists in identifying FLE patients from those with medial temporal pathology presenting frontal dysfunction as a secondary cognitive symptom.
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Unit, School of Medicine, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676, Athens, Greece. ppatrik@cc.uoi.gr.
authors.forename: Panayiotis
authors.initials: P
authors.lastname: Patrikelis
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Unit, School of Medicine, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676, Athens, Greece.
authors.forename: Stylianos
authors.initials: S
authors.lastname: Gatzonis
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Unit, School of Medicine, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676, Athens, Greece.
authors.forename: Anna
authors.initials: A
authors.lastname: Siatouni
authors.affiliation: First Department of Psychiatry, School of Medicine, University of Athens, Eginition Hospital, 11528, Athens, Greece.
authors.forename: Elias
authors.initials: E
authors.lastname: Angelopoulos
authors.affiliation: First Department of Psychiatry, School of Medicine, University of Athens, Eginition Hospital, 11528, Athens, Greece.|Section of Cognitive Neuropsychiatry, Institute of Psychiatry, King's College London, SE58AF, London, UK.
authors.forename: George
authors.initials: G
authors.lastname: Konstantakopoulos
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Unit, School of Medicine, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Takousi
authors.affiliation: Department of Neurosurgery, Epilepsy Surgery Unit, School of Medicine, University of Athens, Evangelismos Hospital, 45-47 Ipsilantou Str., 10676, Athens, Greece.
authors.forename: Damianos E
authors.initials: DE
authors.lastname: Sakas
authors.affiliation: Department of Neurology, School of Medicine, University of Athens, Eginition Hospital, 11528, Athens, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Zalonis
mesh_terms: D000293:Adolescent; D000328:Adult; D001288:Attention; D016022:Case-Control Studies; D003071:Cognition; D000069279:Drug Resistant Epilepsy / Q000175:diagnosis* / Q000601:surgery; D017034:Epilepsy, Frontal Lobe / Q000175:diagnosis* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D019635:Neurosurgical Procedures / Q000379:methods; D018579:Patient Selection; D057234:Preoperative Period
keywords: Frontal seizures; Neuropsychological profile; Preoperative assessment