Differences in Verbal Memory Functioning Following Frontal and Temporal Lobe Epilepsy Surgery
Abstract number :
3.454
Submission category :
11. Behavior/Neuropsychology/Language / 11B. Pediatrics
Year :
2022
Submission ID :
2233033
Source :
www.aesnet.org
Presentation date :
12/5/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:29 AM
Authors :
Alyssa Ailion, PhD – Boston Children's Hospital; Trey Moore, BA – Boston Children's Hospital; Jeffrey Bolton, MD – Boston Children's Hospital; Katrina Boyer, PhD – Boston Children's Hospital; Song Dam, BA – Boston Children's Hospital; Phillip Pearl, MD – Boston Children's Hospital; Scellig Stone, MD, PhD – Boston Children's Hospital; Melissa Tsuboyama, MD – Boston Children's Hospital; Clemente Vega, PhD – Boston Children's Hospital; Brigitte Wilson, BA – Boston Children's Hospital; Alena Hornak, BA – Boston Children's Hospital
This is a Late Breaking abstract
Rationale: Prior research indicates that epilepsy surgery involving the left temporal lobe is associated with an increased risk for verbal memory decline. Epilepsy surgery involving the frontal lobe also places memory at risk due to the executive functioning demands of learning and memory. Given the significant negative consequences that can result from verbal memory deficits, we aim to investigate which factors, if any, may contribute to verbal memory decline following epilepsy surgery in pediatric patients with frontal lobe epilepsy (FLE) or temporal lobe epilepsy (TLE). We hypothesize that, when compared to FLE patients,TLE patients will have greater pre-surgical memory deficits, and will demonstrate less post-operative verbal memory skill decline.
Methods: We completed a retrospective review of patients with either FLE or TLE that had undergone epilepsy surgery at Boston Children’s Hospital between 2002-2021. Of the 632 total patients reviewed, 278 patients had TLE, while 104 patients had FLE. Pre- and post-operative neuropsychological testing of verbal memory (CVLT-C) was available for 31 patients (13 with FLE and 18 with TLE). Mean post-operative follow-up time -8.50 months for FLE patients; 8.19 months for TLE patients.
Results: Pre-operatively, FLE patients showed lower learning for verbal memory consolidation function compared to TLE patients (mean list learning t-score: FLE=39.18, TLE=47.06). FLE patients showed a larger decrease in consolidation function post-operatively compared to TLE patients (mean list learning t-score change: TLE=-2.45, FLE=-0.71; p=.12). Interestingly, our sample suggests patients with FLE show greater reduction in short-term verbal memory function post-operatively as opposed to patients with TLE (mean short delay z-score change: FLE=-1.69, TLE=+0.10; p=.06). Similarly, FLE patients exhibit greater reduction in long-term verbal memory function following surgery compared to patients with TLE (mean long delay z-score change: FLE=-0.88, TLE=-0.05; p=.10).
Conclusions: In our sample, there is a greater chance of learning and subsequent verbal memory decline following epilepsy surgery in patients with FLE as opposed to those with TLE. It is likely that problems with executive skills interfered with verbal memory encoding and thus have a notable impact on the ability to learn and remember verbal information for the frontal lobe epilepsy group. Patients with TLE had, on average, higher pre-surgical verbal memory scores than FLE patients. Interestingly, verbal memory function in TLE patients tends to remain fairly stable post-operatively as compared to FLE patients. This may be due to patients who are surgical candidates already having mesial temporal sclerosis, and thus memory abilities may already be affected or recognized prior to surgery. Further investigation of the underlying intersection between the region and laterality of seizure and verbal memory networks and their impact on verbal memory performance is needed to more accurately determine risk of verbal memory decline following epilepsy surgery.
Funding: Not applicable
Behavior