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

被引:21
作者
Alpherts, W. C. J. [3 ]
Vermeulen, J. [3 ]
van Rijen, P. C. [2 ]
da Silva, F. H. Lopes [1 ]
van Veelen, C. W. M. [2 ]
机构
[1] Univ Amsterdam, Inst Neurobiol, NL-1012 WX Amsterdam, Netherlands
[2] Univ Utrecht, Rudolf Magnus Inst Neurosci, NL-3508 TC Utrecht, Netherlands
[3] SEIN, Epilepsy Ctr Netherlands Fdn, Dept Psychol, Heemstede, Netherlands
关键词
epilepsy surgery; anterior temporal lobectomy; Penfield procedure; neuropsychology; anaesthesia;
D O I
10.1016/j.neuropsychologia.2007.08.022
中图分类号
B84 [心理学]; C [社会科学总论]; Q98 [人类学];
学科分类号
03 ; 0303 ; 030303 ; 04 ; 0402 ;
摘要
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. (C) 2007 Elsevier Ltd. All rights reserved.
引用
收藏
页码:455 / 460
页数:6
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