OBJECTIVES: To investigate the effects of the resection of hippocampus and temporal neocortex on postsurgical seizure and memory outcomes in mesial temporal lobe epilepsy (mTLE) patients. METHODS: Sixty-eight mTLE patients underwent pre- and postsurgical brain magnetic resonance imaging (MRI). The patients were divided into seizure-free group (SF, N=54) and non-seizure-free group (NSF, N=14). The resection length of hippocampus was determined by the difference between presurgical and postsurgical hippocampus lengths in MRIs. The lengths of resected temporal gyri were measured on three-dimensional MRI reconstruction. Among SF group, 37 patients performed pre- and postsurgical neuropsychological tests. The postsurgical memory decline (PMD) was calculated by subtracting postsurgical memory score from presurgical one in verbal and visual memory tests. RESULTS: The resection length of hippocampus in SF was significantly longer than in NSF (32.7 +/- 7.7 mm versus 25.1 +/- 7.3 mm, t-test, p=0.002), regardless of intersubject difference in the extent of hippocampal sclerosis (logistic regression, p=0.003) while the resection lengths of the lateral temporal gyri were not different between SF and NSF. Overall postsurgical change of verbal or visual memory was not significant. However, regression analysis showed a significant correlation between the resection length of inferior or basal temporal gyrus and verbal PMD (p<0.001) in left TLE patients with seizure-free outcome. CONCLUSION: More resection of hippocampus may predict a better postsurgical seizure-free outcome. The larger resection of inferior or basal temporal gyrus seems to be related to a postsurgical verbal memory decline in left TLE patients.
OBJECTIVES: To investigate the effects of the resection of hippocampus and temporal neocortex on postsurgical seizure and memory outcomes in mesial temporal lobe epilepsy (mTLE) patients. METHODS: Sixty-eight mTLE patients underwent pre- and postsurgical brain magnetic resonance imaging (MRI). The patients were divided into seizure-free group (SF, N=54) and non-seizure-free group (NSF, N=14). The resection length of hippocampus was determined by the difference between presurgical and postsurgical hippocampus lengths in MRIs. The lengths of resected temporal gyri were measured on three-dimensional MRI reconstruction. Among SF group, 37 patients performed pre- and postsurgical neuropsychological tests. The postsurgical memory decline (PMD) was calculated by subtracting postsurgical memory score from presurgical one in verbal and visual memory tests. RESULTS: The resection length of hippocampus in SF was significantly longer than in NSF (32.7 +/- 7.7 mm versus 25.1 +/- 7.3 mm, t-test, p=0.002), regardless of intersubject difference in the extent of hippocampal sclerosis (logistic regression, p=0.003) while the resection lengths of the lateral temporal gyri were not different between SF and NSF. Overall postsurgical change of verbal or visual memory was not significant. However, regression analysis showed a significant correlation between the resection length of inferior or basal temporal gyrus and verbal PMD (p<0.001) in left TLEpatients with seizure-free outcome. CONCLUSION: More resection of hippocampus may predict a better postsurgical seizure-free outcome. The larger resection of inferior or basal temporal gyrus seems to be related to a postsurgical verbal memory decline in left TLEpatients.
Authors: Chengyuan Wu; Walter J Jermakowicz; Srijata Chakravorti; Iahn Cajigas; Ashwini D Sharan; Jonathan R Jagid; Caio M Matias; Michael R Sperling; Robert Buckley; Andrew Ko; Jeffrey G Ojemann; John W Miller; Brett Youngerman; Sameer A Sheth; Guy M McKhann; Adrian W Laxton; Daniel E Couture; Gautam S Popli; Alexander Smith; Ashesh D Mehta; Allen L Ho; Casey H Halpern; Dario J Englot; Joseph S Neimat; Peter E Konrad; Elliot Neal; Fernando L Vale; Kathryn L Holloway; Ellen L Air; Jason Schwalb; Benoit M Dawant; Pierre-Francois D'Haese Journal: Epilepsia Date: 2019-05-21 Impact factor: 5.864
Authors: Simon S Keller; G Russell Glenn; Bernd Weber; Barbara A K Kreilkamp; Jens H Jensen; Joseph A Helpern; Jan Wagner; Gareth J Barker; Mark P Richardson; Leonardo Bonilha Journal: Brain Date: 2016-11-15 Impact factor: 13.501
Authors: Samia Elkommos; Bernd Weber; Pitt Niehusmann; Elisa Volmering; Mark P Richardson; Yen Y Goh; Anthony G Marson; Christian Elger; Simon S Keller Journal: Seizure Date: 2016-01-08 Impact factor: 3.184