Marla J Hamberger1, Catherine A Schevon1, William T Seidel2, Guy M McKhann3, Chris Morrison4. 1. Department of Neurology, Columbia University Medical Center, New York, New York. 2. Tris Pharma, Inc., Monmouth Junction, New Jersey. 3. Department of Neurological Surgery, Columbia University Medical Center, New York, New York. 4. Department of Neurology, New York University Medical, New York, New York.
Abstract
OBJECTIVE: Critical decisions regarding resection boundaries for epilepsy surgery are often based on results of electrical stimulation mapping (ESM). Despite the potentially serious implications for postoperative functioning, age-referenced data that might facilitate the procedure are lacking. Age might be particularly relevant, as pediatric ESM studies have shown a paucity of language sites in young children followed by a rapid increase at approximately 8-10 years. Beyond adolescence, it has generally been assumed that the language system remains stable, and therefore, potential age-related changes across the adult age span have not been examined. However, increasing age during adulthood is associated with both positive and negative language-related changes, such as a broadening vocabulary and increased word finding difficulty. Because most patients who undergo ESM are adults, we aimed to determine the potential impact of age on the incidence of ESM-identified naming sites across the adult age span in patients with refractory epilepsy. METHODS: We analyzed clinical language ESM results from 47 patients, ages 17-64 years, with refractory dominant-hemisphere epilepsy. Patients had comparable location and number of cortical sites tested. The incidence of naming sites was examined as a function of age, and compared between younger and older adults. RESULTS: Significantly more naming sites were found in older than younger adults, and age was found to be a significant predictor of number of naming sites identified. SIGNIFICANCE: Unlike the developmental changes that coincide with increased naming sites in children, increased naming sites in older adults might signify greater vulnerability of the language system to disruption. Because preservation of language sites can limit the extent of the resection, and thereby reduce the likelihood of seizure freedom, further work should aim to determine the clinical relevance of increased naming sites in older adults. Wiley Periodicals, Inc.
OBJECTIVE: Critical decisions regarding resection boundaries for epilepsy surgery are often based on results of electrical stimulation mapping (ESM). Despite the potentially serious implications for postoperative functioning, age-referenced data that might facilitate the procedure are lacking. Age might be particularly relevant, as pediatric ESM studies have shown a paucity of language sites in young children followed by a rapid increase at approximately 8-10 years. Beyond adolescence, it has generally been assumed that the language system remains stable, and therefore, potential age-related changes across the adult age span have not been examined. However, increasing age during adulthood is associated with both positive and negative language-related changes, such as a broadening vocabulary and increased word finding difficulty. Because most patients who undergo ESM are adults, we aimed to determine the potential impact of age on the incidence of ESM-identified naming sites across the adult age span in patients with refractory epilepsy. METHODS: We analyzed clinical language ESM results from 47 patients, ages 17-64 years, with refractory dominant-hemisphere epilepsy. Patients had comparable location and number of cortical sites tested. The incidence of naming sites was examined as a function of age, and compared between younger and older adults. RESULTS: Significantly more naming sites were found in older than younger adults, and age was found to be a significant predictor of number of naming sites identified. SIGNIFICANCE: Unlike the developmental changes that coincide with increased naming sites in children, increased naming sites in older adults might signify greater vulnerability of the language system to disruption. Because preservation of language sites can limit the extent of the resection, and thereby reduce the likelihood of seizure freedom, further work should aim to determine the clinical relevance of increased naming sites in older adults. Wiley Periodicals, Inc.
Authors: Catherine A Schevon; Chad Carlson; Charles M Zaroff; Howard J Weiner; Werner K Doyle; Daniel Miles; Josiane Lajoie; Ruben Kuzniecky; Steven Pacia; Blanca Vazquez; Daniel Luciano; Souhel Najjar; Orrin Devinsky Journal: Epilepsia Date: 2007-02-05 Impact factor: 5.864
Authors: Marla J Hamberger; William T Seidel; Robert R Goodman; Alicia Williams; Kenneth Perrine; Orrin Devinsky; Guy M McKhann Journal: Brain Date: 2007-08-17 Impact factor: 13.501
Authors: S S Spencer; A T Berg; B G Vickrey; M R Sperling; C W Bazil; S Shinnar; J T Langfitt; T S Walczak; S V Pacia; N Ebrahimi; D Frobish Journal: Neurology Date: 2003-12-23 Impact factor: 9.910
Authors: Meredith A Shafto; Deborah M Burke; Emmanuel A Stamatakis; Phyllis P Tam; Lorraine K Tyler Journal: J Cogn Neurosci Date: 2007-12 Impact factor: 3.225