Cognition in Surgically Naïve and Post-surgical Epilepsy Associated with Bottom of Sulcus Dysplasia
Abstract number :
3.358
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2022
Submission ID :
2204918
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:27 AM
Authors :
Chris Tailby, MPsych(Clin Neuro), PhD – Florey Institute of Neuroscience and Mental Health; Carmen Zheng, MPsych(Clin Neuro) – Florey Institute of Neuroscience and Mental Health; David Weintrob, MPsych(Clin Neuro), PhD – Austin Health; Marie O'Shea, MPsych(Clin Neuro), PhD – Austin Health; Graeme Jackson, Professor – Florey Institute of Neuroscience and Mental Health
Rationale: Bottom-of-sulcus dysplasia (BOSD) is a localised form of cortical malformation and a common cause of intractable focal epilepsy. Cognition in individuals with BOSD is yet to be examined in detail. This study aims to 1) characterise baseline cognition in surgically naïve patients with BOSD, and 2) assess longitudinally for cognitive change following surgery.
Methods: This retrospective study analysed clinically acquired neuropsychological data from 38 adult patients with BOSD treated at Austin Health between 1992 and 2022. Baseline cognition was evaluated relative to normative expectations using one-sample t-tests. Post-surgical change was measured using within-subjects t-tests. Wilcoxon signed rank tests were used for comparisons involving non-normally distributed variables.
Results: BOSDs were observed predominantly in the frontal (n = 20; 9 left hemisphere) and parietal (n = 14; 3 left hemisphere) lobes. Mean age of epilepsy onset was 9.5 years (SD = 6.5) and mean age at baseline assessment was 30.9 years (SD = 11.2). The mean interval between pre- and post-surgery assessments was 1.5 years (SD = 1.8; min = 147 days), with a median interval between surgery and post-surgical assessment of 96 days (SD = 293 days; min = 62 days). At baseline, group-level analysis revealed reduced performances (p < .01) on measures of processing speed (median z = -0.66), attention/working memory (mean z = -0.72), divided attention (mean z = -1.53), letter fluency (mean z = -1.45), confrontation naming (median z = -1.66), and estimated intellect (mean z = -0.62). Verbal learning (but not delayed recall) was also reduced in the presence of frontal (mean z = -0.96), but not parietal (mean z = 0.30), BOSD. Verbal reasoning, visuoconstructive and non-verbal memory abilities were not significantly affected. Focal cognitive findings referable to the location of the BOSD were occasionally seen in individual cases. Processing speed significantly improved (p < .01) following surgery; no significant post-operative declines were observed in any cognitive domain.
Behavior