Hanna Ljung1,2,3, Arto Nordlund4, Maria Strandberg1,3, Johan Bengzon5,6, Kristina Källén1,2,3. 1. Department of Neurology and Rehabilitation Medicine, Lund University Hospital, Lund, Sweden. 2. Division of Clinical Sciences Helsingborg, Department of Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden. 3. Division of Neurology, Department of Clinical Neurosciences Lund, Faculty of Medicine, Lund University, Lund, Sweden. 4. Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden. 5. Division of Neurosurgery, Department of Clinical Neurosciences Lund, Faculty of Medicine, Lund University, Lund, Sweden. 6. Department of Neurosurgery, Skåne University Hospital, Lund, Sweden.
Abstract
OBJECTIVE: To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language-dominant hemisphere. METHODS: A long-term neuropsychological follow-up (mean 61.5 months, range 22-111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24). The groups were equal with respect to education, age at seizure onset, epilepsy duration, and prevalence of pharmacoresistant temporal lobe epilepsy (TLE; 75%) versus seizure freedom (25%). Retrospective neuropsychological data from preoperative surgical workup (T1) and prospective follow-up neuropsychological data (T2) were compared. A ≥1 SD intrapatient decline was considered as clinically relevant deterioration of verbal memory. RESULTS: Significant decline in verbal memory was seen in 56% of the patients in the study group compared to 21% in the reference group. At T1, there were no statistical between-group differences in memory performance. At T2, between-group comparison showed significantly greater verbal memory decline for the study group (Claeson Dahl Learning and Retention Test, Verbal Learning: p = 0.05; Rey Auditory Verbal Learning Test, Total Learning: p = 0.04; Claeson Dahl Learning and Retention Test, Verbal Retention: p = 0.04). An odds ratio (OR) of 7.1 (90% confidence interval [CI] 1.3-37.7) for verbal memory decline was seen if right temporal lobe resection (R TLR) had been performed between T1 and T2. The difference between groups remained unchanged when patients who had undergone R TLR were excluded from the analysis, with a remaining aggravated significant decline in verbal memory performance for the study group compared to the reference group. SIGNIFICANCE: Our results suggest a risk of verbal memory deterioration after the use of depth electrodes along the longitudinal axis of the hippocampus. Until this issue is further investigated, caution regarding depth electrodes in the language-dominant hemisphere hippocampus seems advisable. Wiley Periodicals, Inc.
OBJECTIVE: To explore whether patients with refractory mesial temporal lobe epilepsy risk aggravated verbal memory loss from intracranial electroencephalography (EEG) recording with longitudinal hippocampal electrodes in the language-dominant hemisphere. METHODS: A long-term neuropsychological follow-up (mean 61.5 months, range 22-111 months) was performed in 40 patients after ictal registration with left hippocampal depth electrodes (study group, n = 16) or no invasive EEG, only extracranial registration (reference group, n = 24). The groups were equal with respect to education, age at seizure onset, epilepsy duration, and prevalence of pharmacoresistant temporal lobe epilepsy (TLE; 75%) versus seizure freedom (25%). Retrospective neuropsychological data from preoperative surgical workup (T1) and prospective follow-up neuropsychological data (T2) were compared. A ≥1 SD intrapatient decline was considered as clinically relevant deterioration of verbal memory. RESULTS: Significant decline in verbal memory was seen in 56% of the patients in the study group compared to 21% in the reference group. At T1, there were no statistical between-group differences in memory performance. At T2, between-group comparison showed significantly greater verbal memory decline for the study group (Claeson Dahl Learning and Retention Test, Verbal Learning: p = 0.05; Rey Auditory Verbal Learning Test, Total Learning: p = 0.04; Claeson Dahl Learning and Retention Test, Verbal Retention: p = 0.04). An odds ratio (OR) of 7.1 (90% confidence interval [CI] 1.3-37.7) for verbal memory decline was seen if right temporal lobe resection (R TLR) had been performed between T1 and T2. The difference between groups remained unchanged when patients who had undergone R TLR were excluded from the analysis, with a remaining aggravated significant decline in verbal memory performance for the study group compared to the reference group. SIGNIFICANCE: Our results suggest a risk of verbal memory deterioration after the use of depth electrodes along the longitudinal axis of the hippocampus. Until this issue is further investigated, caution regarding depth electrodes in the language-dominant hemisphere hippocampus seems advisable. Wiley Periodicals, Inc.
Authors: Vejay N Vakharia; John S Duncan; Juri-Alexander Witt; Christian E Elger; Richard Staba; Jerome Engel Journal: Ann Neurol Date: 2018-04-10 Impact factor: 10.422
Authors: Daniel L Drane; Nigel P Pedersen; David S Sabsevitz; Cady Block; Adam S Dickey; Abdulrahman Alwaki; Ammar Kheder Journal: Front Neurol Date: 2021-04-12 Impact factor: 4.003
Authors: Daniel L Drane; Jon T Willie; Nigel P Pedersen; Deqiang Qiu; Natalie L Voets; Scott R Millis; Bruno P Soares; Amit M Saindane; Ranliang Hu; Michelle S Kim; Kelsey C Hewitt; Shahin Hakimian; Thomas Grabowski; Jeffrey G Ojemann; David W Loring; Kimford J Meador; Edward Faught; John W Miller; Robert E Gross Journal: Front Neurol Date: 2021-12-09 Impact factor: 4.003