Literature DB >> 17920084

Standard versus tailored left temporal lobe resections: differences in cognitive outcome?

W C J Alpherts1, J Vermeulen, P C van Rijen, F H Lopes da Silva, C W M van Veelen.   

Abstract

UNLABELLED: This study explores differences in cognitive outcome after a standard resection (SR) or tailored (TR) in 100 patients with left temporal lobe epilepsy, controlling for extent in the three lateral gyri. Comparing preoperative to 6-month postoperative performance on a battery of intelligence, language and verbal memory tests revealed the following: a differential effect of the procedure was found for digit span, a short-term memory and attention task, the SR group showing a gain and the TR group a loss postoperatively. This could be explained by a rather large improvement of the SR group with below average resection sizes in the superior temporal gyrus (STG) (<2.8 cm), which small resections are nearly absent in TR resections. Effect of larger extent on the STG in the SR group was related to a decrease in verbal intelligence and a tendency in auditory comprehension which poses a risk in 'large' standard resections. Differences in extent of resection on the other gyri did not cause differences in effects on language functioning or verbal memory.
CONCLUSIONS: In standard anterior temporal lobe resections only (without intraoperative language mapping) up to a limit of 4.5 cm, large resections on the STG pose a risk for declining on verbal IQ and auditory comprehension. In general, tailored resections (with language mapping) result in decline on a task measuring short-term memory and attention.

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Year:  2007        PMID: 17920084     DOI: 10.1016/j.neuropsychologia.2007.08.022

Source DB:  PubMed          Journal:  Neuropsychologia        ISSN: 0028-3932            Impact factor:   3.139


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