Authors :
Presenting Author: Michelle Kim, PhD – University of Washington
Hyun Jin Kang, BS – City University of New York
Abigail Hayden, BS – Seattle Pacific University
Marium Khan, BS – University of Washington
Steven Tobochnik, MD – Dana-Farber Cancer Institute
Andrew Ko, MD – University of Washington
Behnaz Esmaeili, MD – University of Washington
Rationale:
To assess cognitive outcomes following laser interstitial thermal therapy (LITT) for drug-resistant temporal lobe epilepsy in older adults.Methods:
This was a retrospective case-control study of all patients aged 59 years and older who underwent LITT at two epilepsy centers between 2013 and 2022 who had both pre and postoperative neuropsychological evaluation. The control group included patients aged < 40 years, matched 1:1 based on seizure outcome, laterality of surgery (dominant vs. non-dominant hemisphere), interval between pre- and post-LITT neuropsychological testing, and sex. The primary outcome was the change in cognitive performance from pre- to post-LITT across four domains: verbal memory, visual memory, language, and executive function. All scores were standardized using z-scores.Results:
Ten patients aged ≥59 years were matched with 10 control patients aged 20–40 years, all of whom underwent mesial temporal LITT. Mean change scores (post- minus pre-LITT z-scores) in older vs. younger adults were as follows: verbal memory (-0.33 vs. -0.25), visual memory (0.14 vs. -0.14), language (-0.07 vs. -0.02), and executive function (0.52 vs. 0.67). There were no statistically significant differences in cognitive outcomes between groups across any domain.Conclusions:
Cognitive outcomes in older adults with temporal lobe epilepsy following LITT are comparable to those in younger adults. While prior studies have raised concerns about cognitive decline after resective surgery in older patients, LITT may offer more favorable cognitive outcomes, particularly for surgeries involving the dominant temporal lobe. Additional prospective studies are needed to better characterize cognitive trajectories in older adults undergoing LITT.
Funding: None.