Declines in Socio-Emotional Functioning Occur in a Subset of Patients with Medial Temporal Lobe Epilepsy Following Surgical Intervention
Abstract number :
2.251
Submission category :
9. Surgery / 9A. Adult
Year :
2021
Submission ID :
1826386
Source :
www.aesnet.org
Presentation date :
12/5/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:53 AM
Authors :
Daniel Drane, PhD - Emory University School of Medicine; Edward Valentin - Neurology - Emory University School of Medicine; Taylor Shade - Neurology - Emory University School of Medicine; Nigel Pedersen - Neurology - Emory University School of Medicine; Kelsey Hewitt - Neurology - Emory University School of Medicine; Sean Wickham - Neurology - Emory University School of Medicine; Scott Millis - Physical Medicine and Rehabilitation - Wayne State University School of Medicine; G. James - Psychiatric Research Institute - University of Arkansas for Medical Sciences; Cady Block - Neurology - Emory University School of Medicine; Ekaterina Staikova - Neurology - Emory University School of Medicine; Michele Price - Neurology - Emory University School of Medicine; Noah Okado - Neurology - Emory University School of Medicine; David Loring - Neurology - Emory University School of Medicine; Sanne van Rooij - Psychiatry and Behavioral Sciences - Emory University School of Medicine; Stephan Hamann - Psychology - Emory University School of Medicine; Jon Willie - Neurological Surgery - Washington University School of Medicine and Barnes-Jewish Hospital; Robert Gross - Neurosurgery - Emory University School of Medicine
Rationale: In recent years, minimally invasive procedures have led to better cognitive outcomes in our medial temporal lobe epilepsy (mTLE) patients requiring surgery for seizure control. However, we have noticed an increase in complaints related to socio-emotional function in these same patients. This has included problems with loss of emotional control, altered reactivity (e.g., flattened emotional response), and diminished awareness of emotions conveyed by human interaction. We explore this area with pre-/post-surgical data related to gauging emotional tone from facial expression and self-report of post-surgical changes in socio-emotional processing.
Methods: We examined the pre/post-surgical data of 51 consecutive mTLE patients completing the Reading the Mind Through the Eyes Test (Eyes Test) prior to undergoing a surgical procedure that involved medial TL structures; either open resection (OR: n=12) or stereotactic laser amygdalohippocamptomy (SLAH: n=39). All patients underwent presurgical evaluation, including video-EEG monitoring, neuropsychological testing, and neuroimaging. We determined the proportion of patients to experience a significant decline based on normative standards (e.g., those with >1.5 SD decline) and used a binary logistic analysis to determine if outcome was predicted by side of surgery, type of surgery, baseline performance level, or mood status as defined by the 2nd edition of the Beck Depression Inventory.
Results: A significant decline on the Eyes Test was observed in 35.3% of all post-surgical mTLE patients. Binary logistic regression analysis revealed intact baseline performance (p< .01) was the only examined factor that predicted a poor outcome. Surgical type (OR vs. SLAH: p=0.83)) and side (left vs. right: p=0.30) did not contribute independently to rates of decline on the Eyes Test nor did mood status at the time of evaluation (p=0.34). Post-surgical patients with socio-emotional complaints performed significantly worse on the Eyes Test than those without (t=14.7, p< .001).
Surgery