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Orhan Varoglu A, Avarisli A, Keskin H, Garipbas N. Comparing neuropsychological functioning in Turkish patients with right and left temporal lobe epilepsy. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 38015648 DOI: 10.1080/23279095.2023.2286504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/30/2023]
Abstract
We compared neuropsychiatric evaluations in temporal lobe epilepsy according to the lateralized hemisphere. Forty-one (68.3%) left-sided temporal lobe epilepsy (LTLE) were compared to 19 right-sided temporal lobe epilepsy (RTLE) (31.7%) (p < 0.001). RTLE mean age was 37 (22-46) years, and LTLE mean age 38 was (30-42). RTLE disease duration was 10 (6-20) years, and LTLE was 22 (10-33) (p < 0.013). Gender (man/woman) for RTLE was 7/12, and for LTLE was 18/23. LTLE scored poorer on the Wechsler Memory Scale (WMS)-III's Mental Control Months-error, WMS-V's "Forward Number Range" and "Backward Number Range" than RTLE (p < 0.017, p < 0.023, p < 0.004). There were differences between hemispheres for "Number of Items Remembered with a Hint" and "Total number of Recalled Items" (WMS-IV) (p < 0.038, p < 0.045). LTLE had lower scores in the Verbal Fluency -K-A-S letters words and WAIS (Wechsler Adult Intelligence Scale) similarity than RTLE (p < 0.019, p < 0.024, p < 0.033, p < 0.026). Oktem and Boston-number of Self-Named Items Tests were poorer in LTLE than RTLE (p < 0.05, p < 0.043). Mental Control Months-error (WMS-III), "Total Number of Recalled Items", "Number of Items Remembered with Hint" (WMS-IV), forward and backward number range (WMS-V), Oktem, Verbal Fluency -K,-A,-S letters words, WAIS similarity, and Boston-number of Self-Named Items tests, can help identify lateralization, particularly in LTLE.
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Affiliation(s)
- Asuman Orhan Varoglu
- Department of Neurology, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
| | - Aysenur Avarisli
- Department of Neurology, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
| | - Havva Keskin
- Department of Internal Medicine, Istanbul Medeniyet University, Goztepe Training and Research Hospital, Istanbul,Turkey
| | - Nilay Garipbas
- Department of Psychiatry, Istanbul Medeniyet University, Goztepe Training, and Research Hospital, Istanbul,Turkey
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Poprelka K, Patrikelis P, Takousi M, Messinis L, Fasilis T, Margariti S, Ntinopoulou E, Verentzioti A, Stefanatou M, Alexoudi A, Korfias S, Zalonis I, Gatzonis S. Arousal deregulation in the co-shaping of neuropsychological dysfunction in frontal and mesial temporal lobe epilepsy. Epilepsy Res 2023; 194:107189. [PMID: 37421714 DOI: 10.1016/j.eplepsyres.2023.107189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 06/27/2023] [Accepted: 07/03/2023] [Indexed: 07/10/2023]
Abstract
OBJECTIVE Our work aims to investigate the role of physiological arousal in the expression of neuropsychological deficits in frontal lobe epilepsy (FLE) and mesial temporal lobe epilepsy (mTLE), by drawing on the Lurian theory of brain function. METHODS For this study a total of 43 patients with focal onset epilepsy has been taken; twenty-four patients with FLE, 19 patients with mTLE and 26 healthy controls, all matched for age and education. Participants underwent a comprehensive neuropsychological assessment including various cognitive domains, such as attention, episodic memory, speed of information processing, response inhibition and mental flexibility, working memory, verbal fluency (phonological & semantic). RESULTS There were no significant differences between FLE and mTLE patients in terms of neuropsychological performance. However, both FLE and mTLE patients showed significantly worse performance in several cognitive domains than HCs. The results seem to support our hypothesis that aberrant physiological arousal, as reflected in patients' worse performance in vigilance and attention, response inhibition, and processing speed, along with other disease-specific variables, may co-determine neuropsychological dysfunction and/or impairment in both FLE and mTLE. CONCLUSION Identifying a differential arousal-related neuropsychological affection in FLE and mTLE, among the known deleterious effects of the functional deficit zone and other disease-related variables, may further our understanding of the underlying cognitive-pathophysiological mechanisms in focal epilepsy syndromes.
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Affiliation(s)
- Katerina Poprelka
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece.
| | - Panayiotis Patrikelis
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece; Laboratory of Cognitive Neuroscience, Department of Psychology, Aristotle University of Thessaloniki, Greece
| | - Maria Takousi
- School of Health Sciences, Metropolitan College, Athens, Greece
| | - Lambros Messinis
- Laboratory of Cognitive Neuroscience, Department of Psychology, Aristotle University of Thessaloniki, Greece
| | - Theodoros Fasilis
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Sofia Margariti
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Evniki Ntinopoulou
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Anastasia Verentzioti
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Maria Stefanatou
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Athanasia Alexoudi
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Stefanos Korfias
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
| | - Ioannis Zalonis
- Aeginition Hospital, Medical School, National & Kapodistrian University of Athens, Neuropsychological Laboratory, 1st Department of Neurology, Greece
| | - Stylianos Gatzonis
- 1st Department of Neurosurgery, National & Kapodistrian University of Athens, Greece
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Catalán-Aguilar J, González-Bono E, Lozano-García A, Tormos-Pons P, Hampel KG, Villanueva V, Cano-López I. Stress phenotypes in epilepsy: impact on cognitive functioning and quality of life. Front Psychol 2023; 14:1100101. [PMID: 37388654 PMCID: PMC10300421 DOI: 10.3389/fpsyg.2023.1100101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 05/22/2023] [Indexed: 07/01/2023] Open
Abstract
Introduction Drug-resistant epilepsy has been proposed as a chronic stress model. Stress can be measured in terms of chronicity (epilepsy duration) and intensity (comorbidities), with depression and anxiety among the most important comorbidities in epilepsy due to its prevalence and its relationship with cognitive functioning and quality of life. This study aims to establish phenotypes according to how patients face a stressful condition (epilepsy) and examine differences in cognition and quality of life depending on these phenotypes. We hypothesize that there will be an interrelationship between epilepsy duration and negative affectivity, and these variables will influence cognition and quality of life. Methods 170 patients (82 men and 88 women) underwent a neuropsychological evaluation in which trait anxiety, depression, attention and executive function, verbal and visual memory, language, emotional recognition, and quality of life were assessed. Hierarchical clustering was performed using z-scores for three variables: trait anxiety; depression; and epilepsy duration. Results Three clusters were found: vulnerable (high negative affectivity and short duration); resilient (moderate negative affectivity and long duration); and low-impact group (low negative affectivity and short duration). Results show that the vulnerable group had poorer cognitive functioning and quality of life than the other groups. Specifically, the vulnerable group had poorer scores than the low-impact group on verbal memory, visual confrontation naming, and quality of life (except seizure worry). Furthermore, resilient patients had better scores than the low-impact group on cognitive flexibility variables, but lower scores on some quality-of-life subscales (i.e., overall quality of life, emotional well-being, and energy). Finally, the vulnerable group had poorer scores than the resilient group in executive functioning, naming, and quality of life. Discussion These results suggest that dealing with stress in patients with epilepsy is related to cognitive performance and quality of life. These findings underline the relevance of considering comorbidities in epilepsy and may be useful for detecting vulnerable or resilient profiles as risk or protective factors for cognitive and quality of life decline.
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Affiliation(s)
- Judit Catalán-Aguilar
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Esperanza González-Bono
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Alejandro Lozano-García
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Paula Tormos-Pons
- Institut d’Investigació en Psicologia dels Recursos Humans, del Desenvolupament Organitzacional i de la Qualitat de Vida Laboral (Idocal)/Department of Psychobiology, Psychology Center, Universitat de València, Valencia, Spain
| | - Kevin G. Hampel
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Vicente Villanueva
- Refractory Epilepsy Unit, Neurology Service Member of ERN EPICARE, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - Irene Cano-López
- Faculty of Health Sciences, Valencian International University, Valencia, Spain
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Yang F, Jia W, Kukun H, Ding S, Zhang H, Wang Y. A Study of Spontaneous Brain Activity on Resting-State Functional Magnetic Resonance Imaging in Adults with MRI-Negative Temporal Lobe Epilepsy. Neuropsychiatr Dis Treat 2022; 18:1107-1116. [PMID: 35677937 PMCID: PMC9170234 DOI: 10.2147/ndt.s366189] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Accepted: 05/18/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE-N) represent an important subgroup of temporal lobe epilepsy (TLE). Here, we aimed to combine three voxel-based local brain area analysis methods of resting-state functional MRI (rs-fMRI), to examine the TLE-N patients' resting brain function based on neural synchronization and intensity of local brain areas. Methods The study included 47 patients with TLE, including 28 cases of drug-controlled TLE (cTLE-N) and 19 cases of drug-resistant TLE-N (rTLE-N), as well as 30 participants in the healthy control (HC) group. To comprehensively assess the altered brain function associated with TLE-N patients, we analyzed three data-driven rs-fMRI algorithms for amplitude of low-frequency fluctuations (ALFF), fractional ALFF (fALFF) and regional homogeneity (ReHo). Results Compared to the HC group, the distribution of abnormal functional brain areas in cTLE-N patients was dominated by occipital lobe activation, as measured by increased fALFF values in the superior occipital gyrus (SOG) and increased ReHo values in the lingual gyrus (Lin), fusiform gyrus, and middle occipital gyrus. Patients with rTLE-N exhibited a diffuse distribution of abnormal functional brain areas, showing increased fALFF values in the SOG, Lin, superior temporal gyrus, and postcentral gyrus, and decreased fALFF values in the inferior frontal gyrus orbital, parahippocampal gyrus, and superior frontal gyrus orbital. The ReHo values were reduced in the orbital region of the middle frontal gyrus, the precuneus, and the parietal inferior angular gyrus; while ReHo values were elevated values in several frontal, temporal, occipital, and subcortical brain areas. Conclusion Patients with rTLE-N have local brain activity changes in the prefrontal limbic system and default model network dysfunction, while cTLE-N patients have local brain activity changes in the visual functional areas. Different epilepsy networks exist between cTLE-N and rTLE-N.
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Affiliation(s)
- Fan Yang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Wenxiao Jia
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Hanjiaerbieke Kukun
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Shuang Ding
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Haotian Zhang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
| | - Yunling Wang
- Department of Radiology, The First Affiliated Hospital of Xinjiang Medical University, Ürümqi, Xinjiang, People’s Republic of China
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Jaimes-Bautista A, Rodríguez-Camacho M, Martínez-Juárez I, Rodríguez-Agudelo Y. Quantitative and qualitative analysis of semantic verbal fluency in patients with temporal lobe epilepsy. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2019.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Elverman KH, Resch ZJ, Quasney EE, Sabsevitz DS, Binder JR, Swanson SJ. Temporal lobe epilepsy is associated with distinct cognitive phenotypes. Epilepsy Behav 2019; 96:61-68. [PMID: 31077942 DOI: 10.1016/j.yebeh.2019.04.015] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 04/09/2019] [Accepted: 04/10/2019] [Indexed: 10/26/2022]
Abstract
Neuropsychological assessment is critical for understanding the impact of seizures on cognition and informing treatment decisions. While focus is often placed on examining groups based on seizure type/epilepsy syndrome, an alternate approach emphasizes empirically derived groups based solely on cognitive performance. This approach has been used to identify cognitive phenotypes in temporal lobe epilepsy (TLE). The current study sought to replicate prior work by Hermann and colleagues (2007) and identify cognitive phenotypes in a separate, larger cohort of 185 patients with TLE (92 left TLE, 93 right TLE). Cluster analysis revealed 3- and 4-cluster solutions, with clusters differentiated primarily by overall level of performance in the 3-cluster solution (Low, Middle, and High performance) and by more varying cognitive phenotypes in the 4-cluster solution (Globally Low, Low Executive Functioning/Speed, Low Language/Memory, and Globally High). Differences in cognitive performance as well as demographic and clinical seizure variables are presented. A greater proportion of the patients with left TLE were captured by Cluster 3 (Low Language/Memory) than by the other 3 clusters, though this cluster captured only approximately one-third of the overall group with left TLE. Consistent with prior findings, executive functioning and speed emerged as additional domains of interest in this sample of patients with TLE. The current results extend prior work examining cognitive phenotypes in TLE and highlight the importance of identifying the comprehensive range of potential cognitive profiles in TLE.
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Affiliation(s)
- Kathleen H Elverman
- Medical College of Wisconsin, Department of Neurology, United States of America
| | - Zachary J Resch
- Rosalind Franklin University of Medicine and Science, United States of America
| | - Erin E Quasney
- Medical College of Wisconsin, Department of Neurology, United States of America
| | - David S Sabsevitz
- Medical College of Wisconsin, Department of Neurology, United States of America
| | - Jeffrey R Binder
- Medical College of Wisconsin, Department of Neurology, United States of America
| | - Sara J Swanson
- Medical College of Wisconsin, Department of Neurology, United States of America.
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Zhang C, Zhang H, Xu K, Yang H, Liu C, Yu T, Chen N, Li K. Impaired prefrontal cortex-thalamus pathway in intractable temporal lobe epilepsy with aberrant executive control function: MRI evidence. Clin Neurophysiol 2019; 130:484-490. [DOI: 10.1016/j.clinph.2018.12.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2018] [Revised: 11/19/2018] [Accepted: 12/16/2018] [Indexed: 01/03/2023]
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Celiker Uslu S, Yuksel B, Tekin B, Sariahmetoglu H, Atakli D. Cognitive impairment and drug responsiveness in mesial temporal lobe epilepsy. Epilepsy Behav 2019; 90:162-167. [PMID: 30576963 DOI: 10.1016/j.yebeh.2018.10.034] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 10/27/2022]
Abstract
OBJECTIVES Mesial temporal lobe epilepsy (MTLE) is the most common form of partial epilepsies. Seizures of MTLE with hippocampal sclerosis (MTLE-HS) are typically resistant to antiepileptic drug (AED) therapy. Although memory disturbances in patients with MTLE-HS are expected, verbal attention and frontal lobe functions may also be impaired. We aimed to examine the relationship between the clinical features and cognitive functions of patients by comparing cognitive test scores of patients with MTLE with few seizures (drug-responsive group) and those with frequent seizures (pharmacoresistant group). METHODS Seventy-nine patients with MTLE-HS and 30 healthy controls were enrolled. Thirty-four patients were accepted as the drug-responsive group (DrG), and 45 patients were included in the pharmacoresistant group (PRG). Tests evaluating attention, memory, and executive functions were performed on all participants. RESULTS Forty-nine (62%) female and 30 (38%) male patients with MTLE-HS, and 14 (46.7%) female and 16 (53.3%) male controls participated in the study. The mean age of the patients and controls was 33.53 ± 9.60 (range, 18-57) years and 35.90 ± 7.98 (range, 18-56) years, respectively. Both the DrG and PRG showed poorer performances in tests evaluating memory and frontal lobe functions when compared with the control group (CG). Additionally, attention test results were significantly worse in the PRG than in the DrG. CONCLUSION It is reasonable to say that increased seizure frequency is the main causative factor of verbal attention deficit due to the poorer attention test results in the PRG. Poor performances in memory and frontal lobe function tests of all patients with MTLE-HS emphasized the importance of the mutual connection between the temporal lobe and prefrontal cortices.
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Affiliation(s)
- Sibel Celiker Uslu
- Samsun Training and Research Hospital Neurology Department, İlkadım, 55090 Samsun, Turkey
| | - Burcu Yuksel
- Antalya Training and Research Hospital, Neurology Department, Muratpasa, 07050 Antalya, Turkey.
| | - Betul Tekin
- Rumeli Hospital Neurology Department, Kucukcekmece, 34295 Istanbul, Turkey
| | - Hande Sariahmetoglu
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Bakirkoy, 34147 Istanbul, Turkey
| | - Dilek Atakli
- Bakirkoy Training and Research Hospital for Psychiatry, Neurology and Neurosurgery, Neurology Department, Bakirkoy, 34147 Istanbul, Turkey
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Dutta M, Murray L, Miller W, Groves D. Effects of Epilepsy on Language Functions: Scoping Review and Data Mining Findings. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2018; 27:350-378. [PMID: 29497749 DOI: 10.1044/2017_ajslp-16-0195] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Accepted: 08/29/2017] [Indexed: 06/08/2023]
Abstract
PURPOSE This study involved a scoping review to identify possible gaps in the empirical description of language functioning in epilepsy in adults. With access to social network data, data mining was used to determine if individuals with epilepsy are expressing language-related concerns. METHOD For the scoping review, scientific databases were explored to identify pertinent articles. Findings regarding the nature of epilepsy etiologies, patient characteristics, tested language modalities, and language measures were compiled. Data mining focused on social network databases to obtain a set of relevant language-related posts. RESULTS The search yielded 66 articles. Epilepsy etiologies except temporal lobe epilepsy and older adults were underrepresented. Most studies utilized aphasia tests and primarily assessed single-word productions; few studies included healthy control groups. Data mining revealed several posts regarding epilepsy-related language problems, including word retrieval, reading, writing, verbal memory difficulties, and negative effects of epilepsy treatment on language. CONCLUSION Our findings underscore the need for future specification of the integrity of language in epilepsy, particularly with respect to discourse and high-level language abilities. Increased awareness of epilepsy-related language issues and understanding the patients' perspectives about their language concerns will allow researchers and speech-language pathologists to utilize appropriate assessments and improve quality of care.
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Affiliation(s)
- Manaswita Dutta
- Department of Speech and Hearing Sciences, Indiana University, Bloomington
| | - Laura Murray
- School of Communication Sciences and Disorders, Western University, London, Ontario, Canada
| | - Wendy Miller
- School of Nursing, Indiana University, Bloomington
| | - Doyle Groves
- School of Nursing, Indiana University, Bloomington
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Zhang C, Yang H, Qin W, Liu C, Qi Z, Chen N, Li K. Characteristics of Resting-State Functional Connectivity in Intractable Unilateral Temporal Lobe Epilepsy Patients with Impaired Executive Control Function. Front Hum Neurosci 2017; 11:609. [PMID: 29375338 PMCID: PMC5770650 DOI: 10.3389/fnhum.2017.00609] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2017] [Accepted: 11/28/2017] [Indexed: 11/13/2022] Open
Abstract
Executive control function (ECF) deficit is a common complication of temporal lobe epilepsy (TLE). Characteristics of brain network connectivity in TLE with ECF dysfunction are still unknown. The aim of this study was to investigate resting-state functional connectivity (FC) changes in patients with unilateral intractable TLE with impaired ECF. Forty right-handed patients with left TLE confirmed by comprehensive preoperative evaluation and postoperative pathological findings were enrolled. The patients were divided into normal ECF (G1) and decreased ECF (G2) groups according to whether they showed ECF impairment on the Wisconsin Card Sorting Test (WCST). Twenty-three healthy volunteers were recruited as the healthy control (HC) group. All subjects underwent resting-state functional magnetic resonance imaging (rs-fMRI). Group-information-guided independent component analysis (GIG-ICA) was performed to estimate resting-state networks (RSNs) for all subjects. General linear model (GLM) was employed to analyze intra-network FC (p < 0.05, false discovery rate, FDR correction) and inter-network FC (p < 0.05, Bonferroni correction) of RSN among three groups. Pearson correlations between FC and neuropsychological tests were also determined through partial correlation analysis (p < 0.05). Eleven meaningful RSNs were identified from 40 left TLE and 23 HC subjects. Comparison of intra-network FC of all 11 meaningful RSNs did not reveal significant difference among the three groups (p > 0.05, FDR correction). For inter-network analysis, G2 exhibited decreased FC between the executive control network (ECN) and default-mode network (DMN) when compared with G1 (p = 0.000, Bonferroni correction) and HC (p = 0.000, Bonferroni correction). G1 showed no significant difference of FC between ECN and DMN when compared with HC. Furthermore, FC between ECN and DMN had significant negative correlation with perseverative responses (RP), response errors (RE) and perseverative errors (RPE) and had significant positive correlation categories completed (CC) in both G1 and G2 (p < 0.05). No significant difference of Montreal Cognitive Assessment (MoCA) was found between G1 and G2, while intelligence quotient (IQ) testing showed significant difference between G1and G2.There was no correlation between FC and either MoCA or IQ performance. Our findings suggest that ECF impairment in unilateral TLE is not confined to the diseased temporal lobe. Decreased FC between DMN and ECN may be an important characteristic of RSN in intractable unilateral TLE.
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Affiliation(s)
- Chao Zhang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Hongyu Yang
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Wen Qin
- Department of Radiology and Tianjin Key Laboratory of Functional Imaging, Tianjin Medical University General Hospital, Tianjin, China
| | - Chang Liu
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Zhigang Qi
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Nan Chen
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
| | - Kuncheng Li
- Department of Radiology, Xuanwu Hospital, Capital Medical University, Beijing, China.,Beijing Key Laboratory of Magnetic Resonance Imaging and Brain Informatics, Capital Medical University, Beijing, China
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Jaimes-Bautista AG, Rodríguez-Camacho M, Martínez-Juárez IE, Rodríguez-Agudelo Y. Quantitative and qualitative analysis of semantic verbal fluency in patients with temporal lobe epilepsy. Neurologia 2017; 35:1-9. [PMID: 28863828 DOI: 10.1016/j.nrl.2017.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 07/05/2017] [Accepted: 07/06/2017] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Patients with temporal lobe epilepsy (TLE) perform poorly on semantic verbal fluency (SVF) tasks. Completing these tasks successfully involves multiple cognitive processes simultaneously. Therefore, quantitative analysis of SVF (number of correct words in one minute), conducted in most studies, has been found to be insufficient to identify cognitive dysfunction underlying SVF difficulties in TLE. OBJECTIVES To determine whether a sample of patients with TLE had SVF difficulties compared with a control group (CG), and to identify the cognitive components associated with SVF difficulties using quantitative and qualitative analysis. METHODS SVF was evaluated in 25 patients with TLE and 24 healthy controls; the semantic verbal fluency test included 5 semantic categories: animals, fruits, occupations, countries, and verbs. All 5 categories were analysed quantitatively (number of correct words per minute and interval of execution: 0-15, 16-30, 31-45, and 46-60seconds); the categories animals and fruits were also analysed qualitatively (clusters, cluster size, switches, perseverations, and intrusions). RESULTS Patients generated fewer words for all categories and intervals and fewer clusters and switches for animals and fruits than the CG (P<.01). Differences between groups were not significant in terms of cluster size and number of intrusions and perseverations (P>.05). CONCLUSIONS Our results suggest an association between SVF difficulties in TLE and difficulty activating semantic networks, impaired strategic search, and poor cognitive flexibility. Attention, inhibition, and working memory are preserved in these patients.
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Affiliation(s)
- A G Jaimes-Bautista
- Proyecto de Neurociencias, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Ciudad de México, México; Departamento de Neuropsicología, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - M Rodríguez-Camacho
- Proyecto de Neurociencias, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Ciudad de México, México
| | - I E Martínez-Juárez
- Clínica de Epilepsia, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México
| | - Y Rodríguez-Agudelo
- Departamento de Neuropsicología, Instituto Nacional de Neurología y Neurocirugía, Ciudad de México, México.
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Rzezak P, Lima EM, Pereira F, Gargaro AC, Coimbra E, de Vincentiis S, Velasco TR, Leite JP, Busatto GF, Valente KD. Decision-making in patients with temporal lobe epilepsy: Delay gratification ability is not impaired in patients with hippocampal sclerosis. Epilepsy Behav 2016; 60:158-164. [PMID: 27206236 DOI: 10.1016/j.yebeh.2016.04.042] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 04/18/2016] [Accepted: 04/19/2016] [Indexed: 01/06/2023]
Abstract
BACKGROUND Decision-making abilities have rarely been examined in patients with temporal lobe epilepsy related to hippocampal sclerosis (TLE-HS). We aimed to investigate the ability to delay gratification, a decision-making subdomain, in patients with intractable TLE-HS and to verify the association of delay gratification performance and cool executive function tests. METHODS We evaluated 27 patients with TLE-HS (mean age: 35.46 [±13.31] years; 7 males) and their cognitive performance was compared with that of 27 age- and gender-matched healthy controls (mean age: 35.33 [±12.05] years; 7 males), without epilepsy and psychiatric disorders. Patients were assessed using the delay discounting task (DDT) and tests of attention, shifting, inhibitory control, and concept formation. Results were correlated with clinical epilepsy variables such as age of onset, epilepsy duration, AED use, history of status epilepticus, febrile seizures, and the presence of generalized seizures. Statistical analysis was performed using one-way ANCOVA with years of education as a confounding factor. RESULTS Patients and controls demonstrated similar performance on DDT, showing similar discount rate (p=0.935) and probability rate (p=0.585). Delay gratification was not related to cool executive function tests (Digit Span, Stroop Color Test, Trail Making Test, Wisconsin Card Sorting Test, and Connors' CPT). History of status epilepticus, presence of generalized seizures and higher seizure frequency, age at onset, and epilepsy duration had a significant impact on DDT. CONCLUSION Patients with intractable TLE-HS showed unimpaired delay gratification abilities, being able to accept a higher delay and a lower amount of chance for receiving a higher reward in the future. Clinical variables related to the epilepsy severity impacted the performance on delay gratification. Impairment on cool aspects of executive function was unrelated to this decision-making domain.
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Affiliation(s)
- Patricia Rzezak
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil.
| | - Ellen Marise Lima
- Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil
| | - Fabricio Pereira
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil
| | - Ana Carolina Gargaro
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Erica Coimbra
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Silvia de Vincentiis
- Laboratory of Clinical Neurophysiology,Psychiatry Department,University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil
| | - Tonicarlo Rodrigues Velasco
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - João Pereira Leite
- Ribeirao Preto School of Medicine,Department of Neurosciences and Behavior,University of Sao Paulo (USP),Brazil
| | - Geraldo F Busatto
- Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil
| | - Kette D Valente
- Laboratory of Clinical Neurophysiology,Psychiatry Department,University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Laboratory of Neuroimaging in Psychiatry (LIM 21),University of São Paulo (USP) School of Medicine,São Paulo, SP, Brazil; Group for the Study of Cognitive and Psychiatric Disorders in Epilepsy - Clinics Hospital,University of Sao Paulo (USP),Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA),University of Sao Paulo (USP),Brazil
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Gül G, Yandim Kuşcu D, Özerden M, Kandemir M, Eren F, Tuğcu B, Keskinkiliç C, Kayrak N, Kirbaş D. Cognitive Outcome after Surgery in Patients with Mesial Temporal Lobe Epilepsy. Noro Psikiyatr Ars 2016; 54:43-48. [PMID: 28566958 DOI: 10.5152/npa.2016.13802] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 01/28/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION The aim of the present study was to evaluate the neuropsychological outcomes of patients with medically intractable unilateral mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS) treated either by anterior temporal lobectomy (ATL) or selective amygdalohippocampectomy (SAH). METHODS This was a retrospective study where 67 patients who had undergone surgery for MTLE were evaluated. Thirty-two patients underwent ATL and 35 underwent SAH. All patients underwent a detailed neuropsychological evaluation before and 1 year after surgery. RESULTS The verbal memory outcome was unchanged after left-sided surgery, whereas learning capacity increased after right-sided surgery (p=0.038). The visual memory outcome improved after right-sided surgery. Improvement of executive functions, particularly in the resistance of interference pattern in the Stroop Test, shortened 5th card time (p=0.000), and decreased corrections (p=0.003), after right-sided surgery and increased attention (p=0.027) after left-sided surgery were observed. After both surgery types, although statistically insignificant, there was a marked decrease in incorrect answers in the Stroop Test, which also showed an improvement in the resistance of interference pattern. Moreover, there was a significant decrease in switching errors with word pairs in the Verbal Fluency Test (p=0.008) after right-sided surgery. When the two sides were compared, we observed that the recall phase of the verbal memory worsened (p=0.018); however, the recognition phase improved (p=0.015) after left-sided surgery. Additionally, the short-term visual memory was better for both sides (p=0.035). CONCLUSION Our results showed that patients with left MTLE were not worsened in verbal memory, but despite improved recognition, they have some problems in recalling information and only a minor improvement in attention. Patients with right MTLE improved in their verbal learning capacity, visual memory, and resistance of interference pattern 1 year after surgery. It was thus shown that while epilepsy surgery is associated with some negative cognitive changes, it may also improve some cognitive functions.
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Affiliation(s)
- Günay Gül
- Clinic of 3 Neurology, Bakırköy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | | | - Mesude Özerden
- Clinic of 3 Neurology, Bakırköy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | - Melek Kandemir
- Clinic of of Neurology, Bayındır Hospital, İstanbul, Turkey
| | - Fulya Eren
- Clinic of 3 Neurology, Bakırköy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | - Bekir Tuğcu
- Clinic of Neurosurgery, Bakırköy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | - Cahit Keskinkiliç
- Neuropsychology Laboratory, Bakırköy Psychiatric and Neurological Diseases Training and Research Hospital, İstanbul, Turkey
| | - Nalan Kayrak
- Department of Neurology, Private Practice, İstanbul, Turkey
| | - Dursun Kirbaş
- Department of Neurology, İstanbul University Institute of Forensic Medicine, İstanbul, Turkey
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15
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Santangelo G, Trojano L, Vitale C, Improta I, Alineri I, Meo R, Bilo L. Cognitive dysfunctions in occipital lobe epilepsy compared to temporal lobe epilepsy. J Neuropsychol 2015; 11:277-290. [DOI: 10.1111/jnp.12085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 07/24/2015] [Indexed: 12/15/2022]
Affiliation(s)
- Gabriella Santangelo
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
- Institute for Diagnosis and Care; ‘Hermitage-Capodimonte’; Naples Italy
| | - Luigi Trojano
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
- Salvatore Maugeri Foundation; IRCCS; Scientific Institute of Telese Terme (BN); Italy
| | - Carmine Vitale
- Institute for Diagnosis and Care; ‘Hermitage-Capodimonte’; Naples Italy
- Deptartment of Motor Sciences and Wellbeing; University of Naples ‘Parthenope’; Naples Italy
| | - Ilaria Improta
- Neuropsychology Laboratory; Department of Psychology; Second University of Naples; Caserta Italy
| | - Irma Alineri
- Department of Psychology; Columbia University; New York New York USA
| | - Roberta Meo
- Neurology Outpatients Service; Naples Local Health Unit; Italy
| | - Leonilda Bilo
- Epilepsy Center; Department of Neuroscience, Reproductive and Odontostomatologic Sciences; University of Naples Federico II; Italy
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16
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Semantic Processing Impairment in Patients with Temporal Lobe Epilepsy. EPILEPSY RESEARCH AND TREATMENT 2015; 2015:746745. [PMID: 26257956 PMCID: PMC4519536 DOI: 10.1155/2015/746745] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/21/2015] [Accepted: 07/02/2015] [Indexed: 11/17/2022]
Abstract
The impairment in episodic memory system is the best-known cognitive deficit in patients with temporal lobe epilepsy (TLE). Recent studies have shown evidence of semantic disorders, but they have been less studied than episodic memory. The semantic dysfunction in TLE has various cognitive manifestations, such as the presence of language disorders characterized by defects in naming, verbal fluency, or remote semantic information retrieval, which affects the ability of patients to interact with their surroundings. This paper is a review of recent research about the consequences of TLE on semantic processing, considering neuropsychological, electrophysiological, and neuroimaging findings, as well as the functional role of the hippocampus in semantic processing. The evidence from these studies shows disturbance of semantic memory in patients with TLE and supports the theory of declarative memory of the hippocampus. Functional neuroimaging studies show an inefficient compensatory functional reorganization of semantic networks and electrophysiological studies show a lack of N400 effect that could indicate that the deficit in semantic processing in patients with TLE could be due to a failure in the mechanisms of automatic access to lexicon.
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17
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Mazur-Mosiewicz A, Carlson HL, Hartwick C, Dykeman J, Lenders T, Brooks BL, Wiebe S. Effectiveness of cognitive rehabilitation following epilepsy surgery: Current state of knowledge. Epilepsia 2015; 56:735-44. [DOI: 10.1111/epi.12963] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/10/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Anya Mazur-Mosiewicz
- The Chicago School of Professional Psychology; Chicago Illinois U.S.A
- Alberta Children's Hospital; Calgary Alberta Canada
| | - Helen L. Carlson
- Alberta Children's Hospital; Calgary Alberta Canada
- Alberta Children's Hospital Research Institute; Calgary Alberta Canada
| | | | | | | | - Brian L. Brooks
- Alberta Children's Hospital; Calgary Alberta Canada
- Alberta Children's Hospital Research Institute; Calgary Alberta Canada
- University of Calgary; Calgary Alberta Canada
| | - Samuel Wiebe
- Foothills Medical Centre; Calgary Alberta Canada
- University of Calgary; Calgary Alberta Canada
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Zhao F, Kang H, You L, Rastogi P, Venkatesh D, Chandra M. Neuropsychological deficits in temporal lobe epilepsy: A comprehensive review. Ann Indian Acad Neurol 2015; 17:374-82. [PMID: 25506156 PMCID: PMC4251008 DOI: 10.4103/0972-2327.144003] [Citation(s) in RCA: 76] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Revised: 03/24/2014] [Accepted: 03/24/2014] [Indexed: 11/23/2022] Open
Abstract
Temporal lobe epilepsy (TLE) is the most prevalent form of complex partial seizures with temporal lobe origin of electrical abnormality. Studies have shown that recurrent seizures affect all aspects of cognitive functioning, including memory, language, praxis, executive functions, and social judgment, among several others. In this article, we will review these cognitive impairments along with their neuropathological correlates in a comprehensive manner. We will see that neuropsychological deficits are prevalent in TLE. Much of the effort has been laid on memory due to the notion that temporal lobe brain structures involved in TLE play a central role in consolidating information into memory. It seems that damage to the mesial structure of the temporal lobe, particularly the amygdale and hippocampus, has the main role in these memory difficulties and the neurobiological plausibility of the role of the temporal lobe in different aspects of memory. Here, we will cover the sub-domains of working memory and episodic memory deficits. This is we will further proceed to evaluate the evidences of executive function deficits in TLE and will see that set-shifting among other EFs is specifically affected in TLE as is social cognition. Finally, critical components of language related deficits are also found in the form of word-finding difficulties. To conclude, TLE affects several of cognitive function domains, but the etiopathogenesis of all these dysfunctions remain elusive. Further well-designed studies are needed for a better understanding of these disorders.
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Affiliation(s)
- Fengqing Zhao
- Department of Emergency, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
| | - Hai Kang
- Department of Emergency, Yantai Yuhuangding Hospital, Yantai 264000, Shandong Province, China
| | - Libo You
- Operating RoomYantaishan Hospital, Yantai 264000, Shandong Province, China
| | - Priyanka Rastogi
- Department of Clinical Psychology, Ranchi Institute of Neuropsychiatry and Allied Sciences, Kanke, Ranchi, Jharkhand, India
| | - D Venkatesh
- Department of Physiology, M. S. Ramaiah Medical College, Mathikere, Bengaluru, Karnataka, India
| | - Mina Chandra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research and Dr. Ram Manohar Lohia Hospital, Formerly Willingdon Hospital, New Delhi, India
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19
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Rzezak P, Valente KD, Duchowny MS. Temporal lobe epilepsy in children: executive and mnestic impairments. Epilepsy Behav 2014; 31:117-22. [PMID: 24397914 DOI: 10.1016/j.yebeh.2013.12.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 11/29/2013] [Accepted: 12/02/2013] [Indexed: 02/02/2023]
Abstract
The current definition of epilepsy emphasizes the importance of cognitive impairment for a complete understanding of the disorder. Cognitive deficits have distinct functional manifestations that differentially impact the daily life experiences of children and adolescents with epilepsy and are a particular concern as they frequently impair academic performance. In particular, memory impairment and executive dysfunction are common disabilities in adults with temporal lobe epilepsy but are less easily recognized and studied in the pediatric population. This review focuses on the consequences of early-onset temporal lobe epilepsy for the development of memory and executive function and discusses current theories to explain these deficits.
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Affiliation(s)
- Patricia Rzezak
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Center for Interdisciplinary Research on Applied Neurosciences (NAPNA), University of São Paulo, São Paulo, SP, Brazil.
| | - Kette D Valente
- Laboratory of Psychiatric Neuroimaging (LIM-21), Department and Institute of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil; Laboratory of Clinical Neurophysiology, Department of Psychiatry, Faculty of Medicine, University of São Paulo, São Paulo, SP, Brazil.
| | - Michael S Duchowny
- Brain Institute and Department of Neurology, Miami Children's Hospital, Miami, FL, USA; Department of Neurology, Wertheim College of Medicine, Florida International University, Miami, FL, USA.
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20
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[Advances in research on cognitive function related to temporal lobe epilepsy: focus on social cognitive function]. J UOEH 2012; 34:245-58. [PMID: 23035344 DOI: 10.7888/juoeh.34.245] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Research on cognitive function related to temporal lobe epilepsy has thus far focused on memory, language, and general intelligence. Recently, however, the concept of social cognitive function has been proposed in the field of neuropsychology. Social cognitive function refers collectively to the higher cognitive functions that are essential in our social lives, and its representative aspects are facial expression recognition and decision-making. Emotional processing centered around the amygdala is thought to play a key role in the neural mechanism of this function. We conducted a study on the social cognitive function (decision-making) of patients with temporal lobe epilepsy, and found that this function is reduced in these patients, and that the right amygdalo-hippocampal complexes play an important role. In order to ensure the best possible treatment for epilepsy patients, it is necessary not only to make an accurate diagnosis and provide appropriate treatment, but also to provide support for enabling a smoother social life from the perspective of social cognitive function. Future research developments in this field are expected to contribute to total management in medical care for epilepsy patients.
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21
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Role of frontotemporal fiber tract integrity in task-switching performance of healthy controls and patients with temporal lobe epilepsy. J Int Neuropsychol Soc 2012; 18:57-67. [PMID: 22014246 PMCID: PMC3482626 DOI: 10.1017/s1355617711001391] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
The objective of this study is to investigate the relationships among frontotemporal fiber tract compromise and task-switching performance in healthy controls and patients with temporal lobe epilepsy (TLE). We performed diffusion tensor imaging (DTI) on 30 controls and 32 patients with TLE (15 left TLE). Fractional anisotropy (FA) was calculated for four fiber tracts [uncinate fasciculus (UncF), arcuate fasciculus (ArcF), dorsal cingulum (CING), and inferior fronto-occipital fasciculus (IFOF)]. Participants completed the Trail Making Test-B (TMT-B) and Verbal Fluency Category Switching (VFCS) test. Multivariate analyses of variances (MANOVAs) were performed to investigate group differences in fiber FA and set-shifting performances. Canonical correlations were used to examine the overall patterns of structural-cognitive relationships and were followed by within-group bivariate correlations. We found a significant canonical correlation between fiber FA and task-switching performance. In controls, TMT-B correlated with left IFOF, whereas VFCS correlated with FA of left ArcF and left UncF. These correlations were not significant in patients with TLE. We report significant correlations between frontotemporal fiber tract integrity and set-shifting performance in healthy controls that appear to be absent or attenuated in patients with TLE. These findings suggest a breakdown of typical structure-function relationships in TLE that may reflect aberrant developmental or degenerative processes.
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22
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Wisniewski I, Staack AM, Bilic S, Steinhoff BJ, Manning L. Visuoperceptual and visuospatial abilities prior to and after anterior temporal lobectomy: a case study. Epilepsy Behav 2012; 23:74-8. [PMID: 22112306 DOI: 10.1016/j.yebeh.2011.10.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2011] [Revised: 10/08/2011] [Accepted: 10/10/2011] [Indexed: 11/18/2022]
Abstract
We describe a patient who presented with temporal lobe epilepsy and a seizure onset pattern in the right temporo-occipital area. Structural MRI revealed sclerosis in the right hippocampus. A comprehensive presurgical neuropsychological assessment allowed us to disentangle deficits in visual object recognition and visual imagery from well-preserved spatial capacities. Following a right temporal lobectomy, the patient remained seizure free, and 1 year postsurgery, the patient's scores on object recognition and imagery were in the normal range. Our findings suggest that visual object recognition and visual imagery are sustained by cortical areas located in proximity to the temporo-occipital ventral pathway and that perceptual and imagery spatial processing is subserved as well by anatomically close mechanisms. Furthermore, the results seem to indicate that nonlesional paroxysmal activity in the posterior temporal lobe can cause chronic dysfunctions of the visual system and that it may be reversible with effective seizure control.
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23
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Stretton J, Thompson PJ. Frontal lobe function in temporal lobe epilepsy. Epilepsy Res 2011; 98:1-13. [PMID: 22100147 PMCID: PMC3398387 DOI: 10.1016/j.eplepsyres.2011.10.009] [Citation(s) in RCA: 131] [Impact Index Per Article: 10.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2011] [Revised: 09/02/2011] [Accepted: 10/09/2011] [Indexed: 10/25/2022]
Abstract
Temporal lobe epilepsy (TLE) is typically associated with long-term memory dysfunction. The frontal lobes support high-level cognition comprising executive skills and working memory that is vital for daily life functioning. Deficits in these functions have been increasingly reported in TLE. Evidence from both the neuropsychological and neuroimaging literature suggests both executive function and working memory are compromised in the presence of TLE. In relation to executive impairment, particular focus has been paid to set shifting as measured by the Wisconsin Card Sorting Task. Other discrete executive functions such as decision-making and theory of mind also appear vulnerable but have received little attention. With regard to working memory, the medial temporal lobe structures appear have a more critical role, but with emerging evidence of hippocampal dependent and independent processes. The relative role of underlying pathology and seizure spread is likely to have considerable bearing upon the cognitive phenotype and trajectory in TLE. The identification of the nature of frontal lobe dysfunction in TLE thus has important clinical implications for prognosis and surgical management. Longitudinal neuropsychological and neuroimaging studies assessing frontal lobe function in TLE patients pre- and postoperatively will improve our understanding further.
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Affiliation(s)
- J Stretton
- Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, London, UK.
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24
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Jodzio K, Biechowska D. Wisconsin card sorting test as a measure of executive function impairments in stroke patients. ACTA ACUST UNITED AC 2011; 17:267-77. [PMID: 21154040 DOI: 10.1080/09084282.2010.525104] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The Wisconsin Card Sorting Test (WCST) is among the most frequently administered neuropsychological tests. It is assumed that successful completion of this test requires engagement of executive functions (EF). One of the most common origins of EF impairments is ischemic stroke. The present study intends to evaluate the diagnostic use of the WCST as a measure of these impairments in poststroke patients. Forty-four patients (8 women and 36 men) who had recent unilateral stroke (22 left hemisphere, 22 right hemisphere) participated in the study. The overall accuracy of the WCST in classifying stroke survivors as having executive disorders was poor. Nevertheless, statistical analysis revealed its negative predictive power to be greater than positive predictive power (i.e., normal scores on the WCST reliably indicated the absence of executive disorders in 8 or more out of 10). Performance on the WCST is clearly influenced by severity of the executive disorders. Namely, patients with severe impairment of EF (as measured by go/no-go, fluency, and other EF tests) performed more poorly on the WCST than patients with lesser impairment or those with no impairment at all, the latter group's results being indistinguishable. In addition, this study highlights a three-factor solution to the WCST, which accounted for 90.3% of the variance. The scores that most strongly loaded on Factors 1 to 3 were, in order: percentage of conceptual-level responses, number of trials to complete the first category, and failures to maintain the set of responses. Finally, an analysis using multivariate analysis of variance, with the anterior versus posterior site and left versus right side of the lesion as independent variables, revealed a relatively weak effect of lesion location on the WCST performance. In particular, with respect to all test scores, there is only one significant interaction between the site and side of lesion was obtained (F(₁(,)₂₄) = 4.12; p < .05; i.e., the number of categories achieved was significantly smaller after damage to the frontal lobe on the left than on the right side, whereas the laterality effect was not significant after nonfrontal lesions). In conclusion, to ascertain the cerebral substrates of poststroke executive dysfunction, there is a need to apply more accurate tests than the WCST. The study highlights the importance of a multicomponent approach to executive functioning in stroke patients.
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Sherman EMS, Wiebe S, Fay-McClymont TB, Tellez-Zenteno J, Metcalfe A, Hernandez-Ronquillo L, Hader WJ, Jetté N. Neuropsychological outcomes after epilepsy surgery: Systematic review and pooled estimates. Epilepsia 2011; 52:857-69. [PMID: 21426331 DOI: 10.1111/j.1528-1167.2011.03022.x] [Citation(s) in RCA: 328] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE Epilepsy surgery is a safe surgical procedure, but it may be associated with cognitive changes. Estimates of the risk of decline in specific neuropsychological domains after epilepsy surgery would assist surgical decision making in clinical practice. The goal of this study was to conduct a systematic review to derive pooled estimates of the rate of losses and gains in neuropsychological functions after epilepsy surgery, using empirically based methods for quantifying cognitive change. METHODS An extensive literature search using PubMed, EmBase, and the Cochrane database was conducted, yielding 5,061 articles on epilepsy surgery, with 193 on neuropsychological outcomes (IQ, memory, language, executive functioning, attention, and subjective cognitive changes). KEY FINDINGS Of these, 23 met final eligibility criteria, with 22 studies involving temporal surgery only. Key aspects of inclusion criteria were N ≥ 20 and use of reliable change index or standardized regression-based change estimates. In addition to the proportion of patients experiencing losses and gains in each individual test, a single pooled estimate of gains and losses for each cognitive domain was derived using a random effects model. Weighted estimates indicated a risk to verbal memory with left-sided temporal surgery of 44%, twice as high as the rate for right-sided surgery (20%). Naming was reduced in 34% of left-sided temporal patients, with almost no patients with gains (4%). Pooled data on IQ, executive functioning, and attention indicated few patients show declines post surgery, but a substantial rate of improvement in verbal fluency with left-sided temporal surgery (27%) was found. Self-reported cognitive declines after epilepsy surgery were uncommon, and gains were reported in some domains where losses were found on objective tests (i.e., verbal memory and language). Variations in surgical techniques did not appear to have a large effect on cognitive outcomes, except for naming outcomes, which appeared better with more conservative resections. Sensitivity to postoperative changes differed across visual memory tests, but not verbal memory tests. Few conclusions could be made regarding cognitive risks and benefits of extratemporal epilepsy surgery, or of epilepsy surgery in children. SIGNIFICANCE In sum, epilepsy surgery is associated with specific cognitive changes, but may also improve cognition in some patients. The results provide base rate estimates of expected cognitive gains and losses associated with epilepsy surgery that may prove useful in clinical settings.
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Affiliation(s)
- Elisabeth M S Sherman
- Department of Clinical Neurosciences, University of Calgary, Calgary, Alberta, Canada.
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Zamarian L, Trinka E, Bonatti E, Kuchukhidze G, Bodner T, Benke T, Koppelstaetter F, Delazer M. Executive functions in chronic mesial temporal lobe epilepsy. EPILEPSY RESEARCH AND TREATMENT 2011; 2011:596174. [PMID: 22937233 PMCID: PMC3428608 DOI: 10.1155/2011/596174] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2010] [Revised: 12/06/2010] [Accepted: 01/11/2011] [Indexed: 12/02/2022]
Abstract
There is no consensus as to whether mesial temporal lobe epilepsy (MTLE) leads to executive function deficits. In this study, we adopted an extensive neuropsychological test battery and assessed different executive functions in chronic, unilateral MTLE. Performance of MTLE patients was compared with that of healthy peers and with normative data. Several MTLE patients had scores below cut-off or below the 10th percentile of normative data. Scores of the whole patient group were overall in the average range of normative data. Relative to controls, MTLE patients performed poorly in tests of working memory, cognitive flexibility, categorical verbal fluency, set-shifting, categorization, and planning. These findings raise an important methodological issue as they suggest that executive function deficits in chronic MTLE may be individually variable and that their assessment should include different tests. Deficits in chronic MTLE are not limited to temporal lobe functions, such as memory, but may extend to extra temporal cognitive domains, such as executive functions.
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Affiliation(s)
- Laura Zamarian
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Eugen Trinka
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
- Department of Neurology, Christian Doppler Clinic, Paracelsus Medical University, Ignaz Herrer Strasse 79, 5020 Salzburg, Austria
| | - Elisabeth Bonatti
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Giorgi Kuchukhidze
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Thomas Bodner
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Thomas Benke
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Florian Koppelstaetter
- Clinical Department of Radiology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
| | - Margarete Delazer
- Clinical Department of Neurology, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria
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27
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Specht K, Lie CH, Shah NJ, Fink GR. Disentangling the prefrontal network for rule selection by means of a non-verbal variant of the Wisconsin Card Sorting Test. Hum Brain Mapp 2009; 30:1734-43. [PMID: 18729079 DOI: 10.1002/hbm.20637] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
This study disentangles the prefrontal network underlying executive functions involved in the Wisconsin Card Sorting Test (WCST). During the WCST, subjects have to perform two key processes: first, they have to derive the correct sorting rule for each trial by trial-and-error, and, second, they have to detect when this sorting rule is changed by the investigator. Both cognitive processes constitute key components of the executive system, which is subserved by the prefrontal cortex. For the current fMRI experiment, we developed a non-verbal variant of the WCST. Subjects were instructed either to respond according to a given sorting rule or to detect the correct sorting rule, like in the original version of the WCST. Data were obtained from 14 healthy male volunteers and analysed using SPM and a random effects model. All conditions activated a fronto-parietal network, which was generally more active when subjects had to search for the correct sorting rule than when the rule was announced beforehand. Significant differences between these two conditions were seen in the dorsolateral prefrontal cortex (PFC) and the parietal lobe. In addition, the data provided new evidence for the assumption of differentiated roles of the left and right prefrontal cortex. Although the right PFC showed a general involvement in response selection and the execution of goal directed responses, based on given rules, the left PFC was only activated when inductive reasoning and feedback integration was required.
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Affiliation(s)
- Karsten Specht
- Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, Bergen, Norway.
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28
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Shin MS, Lee S, Seol SH, Lim YJ, Park EH, Sergeant JA, Chung C. Changes in neuropsychological functioning following temporal lobectomy in patients with temporal lobe epilepsy. Neurol Res 2009; 31:692-701. [PMID: 19309541 DOI: 10.1179/174313209x389848] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
PURPOSE This study was conducted to evaluate the changes in neuropsychological functioning in patients with temporal lobe epilepsy (TLE) after temporal lobe resection. METHODS Fifty-four TLE patients were evaluated before and after surgery using comprehensive neuropsychological tests to assess general intelligence, executive functioning, language, verbal and visual memory, working memory, visuo-spatial ability, attention and motor function. RESULTS The patients with left TLE showed no impairment of neuropsychological functioning after surgery, with the exception of auditory immediate memory. Furthermore, they showed significant improvement in performance IQ, executive function, working memory, visual memory, attention and psychomotor speed. The patients with right TLE did not show any significant impairment in post-operative neuropsychological functioning. They showed improvements in intellectual and executive functions, language, visual memory, visuo-spatial ability, attention and motor function post-operatively. The patients with hippocampal sclerosis showed greater post-operative improvements than the patients without hippocampal sclerosis regardless of the side. Patients with better pre-operative neuropsychological function had a higher chance of successfully discontinuing all seizure medications after surgery. DISCUSSION The results of this study suggest that temporal lobectomy does not harm the neuropsychological functioning of patients with intractable TLE and that it improves cognitive functions of the contralateral hemisphere.
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Affiliation(s)
- Min-Sup Shin
- Department of Psychiatry and Behavioral Science, Seoul National University College of Medicine, Seoul, Korea
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29
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Labudda K, Frigge K, Horstmann S, Aengenendt J, Woermann FG, Ebner A, Markowitsch HJ, Brand M. Decision making in patients with temporal lobe epilepsy. Neuropsychologia 2009; 47:50-8. [DOI: 10.1016/j.neuropsychologia.2008.08.014] [Citation(s) in RCA: 65] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2008] [Revised: 07/08/2008] [Accepted: 08/17/2008] [Indexed: 11/30/2022]
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30
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Krull KR, Gioia G, Ness KK, Ellenberg L, Recklitis C, Leisenring W, Huang S, Stovall M, Robison LL, Zeltzer L. Reliability and validity of the Childhood Cancer Survivor Study Neurocognitive Questionnaire. Cancer 2008; 113:2188-97. [PMID: 18792068 DOI: 10.1002/cncr.23809] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
BACKGROUND Up to 40% of childhood cancer survivors may experience neurocognitive impairment in 1 or more specific domains. As such, regular monitoring has been recommended for patients exposed to cranial irradiation and/or antimetabolite chemotherapy. This study reports the results of a questionnaire developed to identify those survivors who may be experiencing neurocognitive problems. METHODS Participants for this study were 7121 members of the Childhood Cancer Survivor Study cohort (6739 survivors and 382 siblings). These participants completed a new neurocognitive questionnaire designed to assess functions commonly affected by cancer therapy, as well as a standard measure of emotional functioning. A measure of cognitive and emotional functioning was also completed on a subset of the patients roughly 7 years before the current questionnaire. Responses to the questionnaires among subgroups of survivors were then analyzed to examine the reliability and validity of the new neurocognitive questionnaire. RESULTS Four reliable factors were identified that assessed task efficiency, emotional regulation, organization, and memory skills. These neurocognitive factors accurately discriminated survivors who were at "high risk" for neurocognitive dysfunction, because of neurologic abnormalities or a history of intensive focal cranial irradiation, from healthy "low-risk" survivors and siblings. CONCLUSIONS The questionnaire demonstrated excellent reliability, as well as construct and discriminative validity. It appears to be a practical and efficient tool for monitoring neurocognitive outcomes in adult survivors of pediatric cancer.
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Affiliation(s)
- Kevin R Krull
- Department of Epidemiology and Cancer Control, St. Jude Children's Research Hospital, Memphis, Tennessee 38105-2794, USA.
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31
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Tisser L, Palmini A, Paglioli E, Portuguez M, Azambuja N, da Costa JC, Paglioli E, Torres C, Martinez JV. Pre- and post-operative Wisconsin card sorting test performance in patients with temporal lobe epilepsy due to hippocampal sclerosis. Dement Neuropsychol 2007; 1:173-180. [PMID: 29213385 PMCID: PMC5619566 DOI: 10.1590/s1980-57642008dn10200010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Patients with temporal lobe epilepsy due to hippocampal sclerosis (TLE/HS) have a
distinct neuropsychological profile, but there is still debate on whether
executive dysfunction is part of this profile and also whether temporal lobe
surgery can modify this dysfunction.
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Affiliation(s)
- Luciana Tisser
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS)
| | - Andre Palmini
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,MD, PhD, Division of Neurology, Department of Internal Medicine and
| | - Eliseu Paglioli
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,Division of Neurosurgery, Department of Surgery, Faculty of Medicine, PUCRS, Porto Alegre, Brazil
| | - Mirna Portuguez
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,MD, PhD, Division of Neurology, Department of Internal Medicine and
| | - Ney Azambuja
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,Division of Neurosurgery, Department of Surgery, Faculty of Medicine, PUCRS, Porto Alegre, Brazil
| | - Jaderson Costa da Costa
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,MD, PhD, Division of Neurology, Department of Internal Medicine and
| | - Eduardo Paglioli
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS).,Division of Neurosurgery, Department of Surgery, Faculty of Medicine, PUCRS, Porto Alegre, Brazil
| | - Carolina Torres
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS)
| | - Jose Victor Martinez
- MSc, Porto Alegre Epilepsy Surgery Program, Services of Neurology and Neurosurgery, Hospital São Lucas da Pontificia Universidade Católica do Rio Grande do Sul (PUCRS)
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