Predicting Memory Decline After Temporal Lobe Resection for Epilepsy: Utility of a WMS-III Model as Applied to the WMS-IV
Abstract number :
2.285
Submission category :
11. Behavior/Neuropsychology/Language / 11A. Adult
Year :
2021
Submission ID :
1825981
Source :
www.aesnet.org
Presentation date :
12/9/2021 12:00:00 PM
Published date :
Nov 22, 2021, 06:51 AM
Authors :
Lisa Ferguson, MS - Neurological Institute; Robyn Busch – Neurological Institute; Olivia Hogue – Lerner Research Institute
Rationale: A recently published nomogram uses baseline WMS-III Logical Memory Delay scaled score, surgical side, and education to predict the probability a patient will experience verbal memory decline after temporal lobe resection (TLR). This model correctly classifies patients 76% of the time. With increasing use of WMS-IV in clinical practice, the goal of this study was to examine the utility of this nomogram when applied to the WMS-IV Logical Memory Delayed subtest.
Methods: Forty-two adults underwent TLR (60% female; 69% dominant-sided) and completed pre- and post-operative neuropsychological evaluations that included the WMS-IV Logical Memory (LM) subtest. First, change scores were calculated for LM Delay, and patients were classified as declined or not declined using published, epilepsy-specific reliable change indices (RCIs) with an 80% confidence interval. Next, the model developed for predicting decline in LM Delay on the WMS-III was applied to this cohort of patients who completed the WMS-IV, and performance was assessed. The discriminatory ability of the model was evaluated using the concordance (c) statistic, and calibration was assessed by plotting predicted probabilities against observed outcomes and deriving a confidence band.
Results: Thirty-three percent of the sample experienced a clinically relevant postoperative decline using RCIs developed for the WMS-III. The WMS-III LM Delay model applied to our sample of patients who completed the WMS-IV LM Delayed subtest achieved a c-statistic of 0.70. This suggests that when two patients are presented, one with postoperative memory decline and one without, the model correctly classifies patients 70% of the time. Calibration analyses suggest that the WMS-III model underestimates risk when applied to the WMS-IV.
Conclusions: This study suggests that the nomogram developed using the WMS-III LM Delay subtest may show promise when applied to the WMS-IV LM Delay subtest, as there was only a marginal loss of discrimination. However, future research with larger samples will be required to validate this model for clinical use in patients whose verbal memory is assessed with the WMS-IV LM Delay subtest. Development of RCIs specifically for WMS-IV is also a consideration.
Funding: Please list any funding that was received in support of this abstract.: Charles Shor Epilepsy Center at the Cleveland Clinic.
Behavior