Age at surgery as a predictor of cognitive improvements in patients with drug-resistant temporal epilepsy

Autores de IIS La Fe

• Juan Francisco Vázquez Costa

  Autor

• Angel Campos Andreu

  Autor

• Antonio Gutierrez Laso

  Autor

• Mercedes Garcés Sánchez

  Autor

• Asier Gomez Ibañez

  Autor

• Rebeca Conde Sarrión

  Autor

• Esperanza Gonzalez Bono

  Autor

• Vicente Enrique Villanueva Haba

  Autor

Participantes ajenos a IIS La Fe

• Cano-Lopez, I

Grupos

• Patología Neuromuscular y Ataxias

  

  Investigador Principal

  Teresa Sevilla Mantecón

Abstract

Temporal lobe epilepsy (TLE) surgery is an effective procedure that can produce cognitive changes. However, the prognostic factors related with cognitive outcomes need to be better understood. The aim of the present study is to know if age at surgery is a reliable predictor of verbal memory competence and considering factors such as: hemisphere; type of surgery; pre-surgical seizure frequency; and epilepsy duration. Sixty-one typically dominant patients with drug-resistant TLE (34 with left TLE [L-TLE] and 27 with right TLE [R-TLE]) underwent a neuropsychological assessment before and a year after surgery. Results showed that R-TLE patients had better evolution in short- and long-term verbal memory and naming than L-TLE patients (for all, p > .04). L-TLE patients also more frequently showed a strong and reliable decline in these functions than R-TLE patients. No effects for gender or type of surgery were found. From a multivariate approach, patients with improvements in verbal competence underwent surgery at earlier ages and suffered epilepsy for less time (for all, p < 0.4). The relevance of age at surgery was confirmed as a predictor of long-term verbal memory changes, although the frequency of partial seizures also explains, at least partially, these changes. In addition, the frequency of partial seizures explains short-term verbal memory changes. These results emphasize the importance of early intervention, independently of the resected hemisphere, in order to minimize the cognitive side-effects of epilepsy treatment, as well the need to consider cognitive functions as related processes and network dependent. (C) 2017 Elsevier Inc. All rights reserved.

Keywords

• Epilepsy; Temporal lobe; Age at surgery; Verbal memory; Cognitive performance