title: Short-term neurocognitive outcomes following anterior temporal lobectomy.
abstract: Changes in cognitive function are a well established risk of anterior temporal lobectomy (ATL). Deficits in verbal memory are a common postoperative finding, though a small proportion of patients may improve. Postoperative evaluation typically occurs after six to 12months. Patients may benefit from earlier evaluation to identify potential needs; however, the results of a formal neuropsychological assessment at an early postoperative stage are not described in the literature. We compared pre- and postoperative cognitive function for 28 right ATL and 23 left ATL patients using repeated measures ANOVA. Changes in cognitive function were compared to ILAE seizure outcome. The mean time to postoperative neuropsychological testing was 11.1weeks (SD=6.7weeks). There was a side×surgery interaction for the verbal tasks: immediate memory recall (F(1,33)=20.68, p<0.001), short delay recall (F(1,29)=4.99, p=0.03), long delay recall (F(1,33)=10.36, p=0.003), recognition (F(1,33)=5.69, p=0.02), and naming (F(1,37)=15.86, p<0.001). This indicated that the left ATL group had a significant decrement in verbal memory following surgery, while the right ATL group experienced a small but significant improvement. For the right ATL group, there was a positive correlation between ILAE outcome and improvement in immediate recall (r=-0.62, p=0.02) and long delay recall (r=-0.57, p=0.03). There was no similar finding for the left ATL group. This study demonstrates that short-interval follow-up is effective in elucidating postoperative cognitive changes. Right ATL was associated with improvement in verbal memory, while left ATL resulted in a decrement in performance. Improvement in the right ATL group was related to improved seizure outcome. Short-interval follow-up may lend itself to the identification of patients who could benefit from early intervention.
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B400, 200 Lothrop Street, Pittsburgh, PA 15213, USA. Electronic address: leeps@upmc.edu.
authors.forename: Philip S
authors.initials: PS
authors.lastname: Lee
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Jamie
authors.initials: J
authors.lastname: Pardini
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Rick
authors.initials: R
authors.lastname: Hendrickson
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Vincent
authors.initials: V
authors.lastname: Destefino
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Popescu
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Gena
authors.initials: G
authors.lastname: Ghearing
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Arun
authors.initials: A
authors.lastname: Antony
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Jullie
authors.initials: J
authors.lastname: Pan
authors.affiliation: Department of Neurology, University of Pittsburgh Medical Center, 8111 Kaufmann Medical Building, 3471 Fifth Avenue, Pittsburgh, PA 15213, USA.
authors.forename: Anto
authors.initials: A
authors.lastname: Bagic
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: Danielle
authors.initials: D
authors.lastname: Wagner
authors.affiliation: Department of Neurological Surgery, University of Pittsburgh Medical Center, UPMC Presbyterian, Suite B400, 200 Lothrop Street, Pittsburgh, PA 15213, USA.
authors.forename: R Mark
authors.initials: RM
authors.lastname: Richardson
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D003071:Cognition / Q000502:physiology; D060825:Cognitive Dysfunction / Q000209:etiology* / Q000523:psychology; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005260:Female; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000209:etiology* / Q000523:psychology; D011939:Mental Recall; D008875:Middle Aged; D009483:Neuropsychological Tests; D011183:Postoperative Complications / Q000523:psychology; D011184:Postoperative Period; D016896:Treatment Outcome
keywords: Epilepsy; Neuropsychology; Surgery; Verbal memory