THE AMYGDALA AND SEXUAL OUTCOME AFTER EPILEPSY SURGERY: DOES SIZE MATTER?
Abstract number :
3.198
Submission category :
Year :
2002
Submission ID :
1464
Source :
www.aesnet.org
Presentation date :
12/7/2002 12:00:00 AM
Published date :
Dec 1, 2002, 06:00 AM
Authors :
Amee D. Baird, Sarah J. Wilson, Peter F. Bladin, Michael M. Saling, David C. Reutens. Comprehensive Epilepsy Program (CEP), Epilepsy Research Institute, Austin & Repatriation Medical Centre (A&RMC), Melbourne, Australia; Department of Medicine and Departm
RATIONALE: Previous animal and human studies have shown a specific role in the mediation of sexual function for the temporal lobe, a structure commonly resected for the treatment of intractable epilepsy. Postoperative sexual changes may have important psychosocial consequences, but despite its clinical signficance, there has been little research on such changes and the potential underlying mechanisms. We compared the postoperative sexual outcome of patients undergoing temporal lobe resection (TLR) and extratemporal lobe resection (ELR) and examined the relationship between amygdalar volume and postoperative sexual change.
METHODS: Forty-five TLR and 15 ELR patients who underwent surgery at the A&RMC completed a semi-structured interview and questionnaire at one month to 5 years post-surgery. Manual segmentation of both amygdalae was performed on the preoperative MRI scans of patients and 46 neurologically normal volunteers following image registration into stereotaxic coordinate space.
RESULTS: Postoperative sexual change was significantly more likely in TLR patients (69%) than ELR patients (27%, p=0.01). The amygdalar volume contralateral to the side of resection was larger in TLR patients who reported a sexual increase compared with those who reported a decrease or no change and controls (see Table 1). Analysis of Variance (ANOVA) showed significant differences in right amygdalar volumes between patients with different sexual outcomes who underwent left TLR and controls, ( p=0.00). Post-hoc comparisons revealed that left TLR patients reporting a sexual increase had significantly larger right amygdalar volumes than patients reporting a decrease (p=0.01), or no change (p=0.01) and controls (p=0.00). Similarly, ANOVA showed significant differences in left amygdalar volumes between patients with different sexual outcomes who underwent right TLR and controls, (p=0.00). Right TLR patients reporting a sexual increase had significantly larger left amygdalar volumes than controls (p=0.00). Comparisons with patients reporting a sexual decrease or no change did not reach statistical significance (p=0.07 and p=0.28 respectively).
CONCLUSIONS: The findings show that postoperative sexual change is more common after TLR than ELR. They provide support for a specific role of the temporal lobe, specifically the amygdala, in the mediation of sexual function.[table1]
[Supported by: NH&MRC Australia]