Estimating risk of word-finding problems in adults undergoing epilepsy surgery.

Objective: This retrospective, observational study examined the frequency and magnitude of change in naming ability as a function of side/site of epilepsy surgery and identified predictive factors to assist clinicians in identifying patients at low, moderate, or high risk of postoperative naming decline.

Methods: A total of 875 adults with pharmacoresistant epilepsy (454 left/421 right; 763 temporal/87 frontal/25 posterior quadrant) met inclusion criteria and completed the Boston Naming Test before and after surgery. Clinically meaningful change in naming ability was assessed using reliable change indices for epilepsy.

Memory performance in older adults before and after temporal lobectomy for pharmacoresistant epilepsy.

Little is known about the effects of epilepsy surgery on memory in older adults. The purpose of this study was to determine if older adults exhibit greater memory decline than younger adults after anterior temporal lobectomy (ATL). Patients 55 years and older at time of surgery (23 left, 14 right ATL, range 55-66 years) were compared to patients age 25-35 years (44 left, 33 right ATL) to assess differences in preoperative to postoperative change in WMS-III index scores.

Cognitive characteristics of PTEN hamartoma tumor syndromes.

Purpose: We sought to characterize cognition in individuals with germline PTEN mutations (n = 23) as well as in PTEN mutation-negative individuals with classic Cowden syndrome or Bannayan-Riley-Ruvalcaba syndrome (n = 2).

Methods: Twenty-five individuals completed a comprehensive neuropsychological evaluation. One sample t-tests and effect sizes were used to examine differences in participant test scores compared with normal controls.

Word-finding difficulties confound performance on verbal cognitive measures in adults with intractable left temporal lobe epilepsy.

This study sought to determine if word-finding difficulties (WFDs), which are common in adults with dominant temporal lobe epilepsy (TLE), are related to performance on verbal cognitive measures, including memory. One hundred six individuals with left TLE and pathologically confirmed mesial temporal sclerosis completed comprehensive preoperative neuropsychological evaluations. Patients were divided into two groups based on the degree of benefit received from phonemic cueing on a confrontation naming task.

Working memory and intelligence are associated with victoria symptom validity test hard item performance in patients with intractable epilepsy.

Loring et al. (Journal of clinical and experimental neuropsychology, 2005:27;610–617) observed relationships between VSVT hard item performance and IQ and memory indices in epilepsy surgical candidates, with a potential confound of low FSIQ on VSVT performance. The present study replicated the Loring et al.

Executive functioning and depressed mood before and after unilateral frontal lobe resection for intractable epilepsy.

Executive dysfunction occurs in a variety of patients who have sustained damage to the frontal lobes. In individuals with frontal lobe epilepsy (FLE) or after unilateral frontal lobe resection (FLR), a unique neuropsychological profile linking executive functions (EF) with the frontal lobe has been elusive, with conflicting findings in the literature. Some studies show greater risk of executive impairment with left-sided FLE or FLR, while others report greater risk for right-sided patients.

Pre-surgical mood predicts memory decline after anterior temporal lobe resection for epilepsy.

This study examined pre-surgical depressed mood as a predictor of post-surgical memory change in adults who underwent temporal lobe resections (TLRs; n = 211). Patients completed the Wechsler Memory Scale-III and Beck Depression Inventory-Second Edition (BDI-II) before and after TLR (left = 110, right = 101) and were divided into two groups (clinically elevated depressive symptoms or not depressed) based on BDI-II score. Left-TLR patients with poorer pre-surgical mood had greater verbal memory declines after surgery compared with nondepressed left- or right-TLR patients and right-TLR patients with poor mood.

Effect of apolipoprotein ε4 allele on hippocampal and brain volume in intractable temporal lobe epilepsy.

This study investigated the relationship between the apolipoprotein (APOE) ε4 allele and brain volumes in patients with medically intractable temporal lobe epilepsy (TLE). MRI-based volumetric analyses of the hippocampi, cerebral hemispheres, and whole brain were conducted in 59 patients with TLE (31 with left TLE, 28 with right TLE) with hippocampal sclerosis (HS). There were no differences in hippocampal, hemispheric, or whole brain volumes as a function of ε4 status even after correcting for hemispheric and total brain volumes.

Comparison of personality traits in patients with frontal and temporal lobe epilepsies.

The current study sought to characterize and compare personality traits of patients with temporal lobe epilepsy (TLE) and frontal lobe epilepsy (FLE). Ninety-seven adults with medically intractable epilepsy (TLE n=58, FLE n=39) completed the Personality Assessment Inventory (PAI) as part of routine preoperative investigations. Not surprisingly, both epilepsy groups endorsed significantly more symptoms across PAI clinical scales than the normative sample, most notably on scales assessing Depression and Somatic Complaints.

Clinical utility of the Boston Naming Test in predicting ultimate side of surgery in patients with medically intractable temporal lobe epilepsy: A double cross-validation study.

The Boston Naming Test (BNT) is often used in the evaluation of surgical epilepsy patients to assess left temporal lobe function. In 2005, Busch et al. demonstrated the diagnostic utility of the BNT in predicting ultimate side of surgery in patients with temporal lobe epilepsy.

Poor presurgical performance on both verbal and visual memory measures is associated with low risk for memory decline following left temporal lobectomy for intractable epilepsy.

Studies have shown a lower risk for verbal memory decline following dominant anterior temporal lobectomy (ATL) among patients with poor, presurgical verbal memory scores. It is unclear however, if the risk of decline is increased in patients who also have reduced visual memory. Objective and subjective memory outcome following left ATL was examined in twelve patients with reduced presurgical visual and verbal memory scores.

The Family Pictures subtest of the WMS-III: relationship to verbal and visual memory following temporal lobectomy for intractable epilepsy.

This study examined the extent to which the Family Pictures (FP) subtest of the Wechsler Memory Scale-Third Edition (WMS-III) is related to verbal memory measures and right mesial temporal integrity. Epilepsy patients who underwent temporal lobectomy did not differ in the extent to which FP scores changed from before to after surgery, although postoperative FP performance was worse in those who underwent right temporal lobectomy than in those who underwent left temporal lobectomy. FP was most strongly related to the Logical Memory subtest from the WMS-III.

APOE epsilon4 is associated with postictal confusion in patients with medically refractory temporal lobe epilepsy.

This study examined the relationship between the APOE epsilon4 allele and postictal confusion in patients with medically intractable temporal lobe epilepsy (TLE). Patients with at least one epsilon4 allele (n=22) were three times more likely to exhibit postictal confusion (68%) than the 63 patients without epsilon4 (43%). These preliminary results demonstrate that APOE epsilon4 is associated with an increased risk of postictal confusion in patients with medically intractable TLE, suggesting possible dysfunction in neuronal recovery mechanisms.

Relationship between presurgical memory performance on the Wechsler Memory Scale-III and memory change following temporal resection for treatment of intractable epilepsy.

Previous research demonstrated a relationship between preoperative memory measured by the Wechsler Memory Scale-Revised (WMS-R) and postsurgical memory change in patients who underwent left (LATL), but not right (RATL) anterior temporal lobectomy. The current study replicated previous efforts using the Wechsler Memory Scale-Third Edition (WMS-III) in a larger sample. The WMS-III was administered to 161 patients with medically intractable epilepsy prior to and approximately 6 months following LATL or RATL.

Review of normative data for common screening measures used to evaluate cognitive functioning in elderly individuals.

When conducting neuropsychological evaluations of the elderly, it is important to compare patients' test scores to appropriate normative data to maximize diagnostic and descriptive accuracy. Many sets of normative data are now available for screening measures that assess cognitive functioning in the elderly. This article systematically reviewed available norms for 6 widely used screening measures of cognitive functioning in elderly patients.