Authors :
Presenting Author: Kathryn Snyder, BE – The University of Texas Health Science Center at Houston
Jaya Thekdi, NA – Undergraduate Research Assistant, Vivian L Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston; Kiefer Forseth, MD/PhD – Vivian L Smith Department of Neurosurgery – The University of Texas Health Science Center at Houston; Oscar Woolnough, PhD – Postdoctoral Research Fellow, Vivian L Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston; Yosefa Modiano, PhD – Clinical Neuropsychologist, Vivian L Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston; Nitin Tandon, MD – Chair ad interim, Vivian L Smith Department of Neurosurgery, The University of Texas Health Science Center at Houston
Rationale:
Temporal lobe epilepsy (TLE) is the most common type of drug-resistant epilepsy in adults and is commonly associated with pervasive naming deficits, particularly when the seizure focus is located within the language-dominant hemisphere. Furthermore, resections within the dominant temporal lobe for epilepsy increase the risk of further naming decline. Thus, naming assessments are a critical component of the presurgical evaluation process. Previous approaches have primarily standardized naming performance using normative data from healthy controls; however, the characterization of naming function in TLE and the development of normative data derived from a large population of epilepsy patients has yet to be explored. Here, we comprehensively evaluate a large database of epilepsy patients who completed a picture naming task during invasive monitoring with intracranial electrodes to characterize naming function in TLE.
Methods:
Data was obtained from 142 patients (18-61 years) with drug-resistant, temporal lobe epilepsy who underwent invasive electrocorticography. Patients completed a picture naming task that consisted of a standardized set of 260 unique black-and-white line drawings of common objects from the Snodgrass and Vanderwart dataset. The start of each trial was marked by a digital pulse triggered by the task paradigm, and response accuracy and articulation onset were manually labeled using continuous audio recordings. Behavioral measures included percent accuracy and average reaction time of correct trials.Results:
Of the 142 patients, 72 patients had seizure onsets located within the language dominant temporal lobe only (accuracy=91.7+/-8.0%;reaction time=1,404+/-376ms), 42 had onsets located within the non-dominant temporal lobe only (accuracy=94.9+/-4.5%;reaction time=1,288+/-354ms), and 26 had bilateral onsets (accuracy=88.7+/-10.8%;reaction time=1,404+/-357ms). Patients with dominant hemisphere onsets had a significantly lower accuracy (t=-2.74,p=0.0071) and a significantly higher mean reaction time (t=2.1;p=0.0397) compared to patients with nondominant hemisphere onsets. Additionally, patients with bilateral onsets had a significantly lower accuracy (t=-2.73,p=0.0106) compared to patients with nondominant onsets.Conclusions:
This work comprehensively characterizes naming function across a large cohort of TLE patients using more sensitive performance scores and contributes to the development of normative data for epilepsy. Future work will incorporate patients with extra-temporal seizure onsets to further characterize naming performance across all epilepsy types. Ultimately, these results contribute crucial information that could improve seizure localization and facilitate a more comprehensive assessment of pre-operative function in order to minimize the risk of postoperative deficits. Funding:
NIH NINDS UH3 NS119832