Effects of dual pathology on cognitive outcome following left anterior temporal lobectomy for treatment of epilepsy |
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| Institution: | 1. Wellesley College, Wellesley, MA 02481, USA;2. Department of Anatomic Pathology, Cleveland Clinic, Cleveland, OH 44195, USA;3. Department of Psychology and Psychiatry, Cleveland Clinic, Cleveland, OH 44195, USA;4. Epilepsy Center, Cleveland Clinic, Cleveland, OH 44195, USA;1. Division of Health Sciences, Warwick Medical School, University of Warwick, Coventry, UK;2. Department of Population Health, Luxembourg Institute of Health, Strassen, , Luxembourg;3. Department of Medicine, Duke Clinical Research Institute, Duke University, North Carolina, USA;4. Duke Global Health Institute, Duke University, North Carolina, USA;5. Department of Internal Medicine, Benue State University Teaching Hospital, Makurdi, Nigeria;6. Warwick Centre for Applied Health Research and Delivery (WCAHRD), Warwick Medical School, University of Warwick, Coventry, UK;7. Department of Public Health (IHCAR), Karolinska Institutet, Stockholm, Sweden;8. Centre for Evidence-Based Health Care, Stellenbosch University, Tygerberg 7505, South Africa;1. Dept. of Neurosurgery, Oslo University Hospital-Rikshospitalet, Oslo, Norway;2. Faculty of Medicine, University of Oslo, Oslo, Norway;3. Oslo Centre of Biostatistics and Epidemiology, Oslo University Hospital, Oslo, Norway;4. Dept. of Radiology and Nuclear Medicine, Oslo University Hospital-Rikshospitalet, Oslo, Norway;1. Center for Neurosciences, Department of Pharmaceutical Chemistry, Drug Analysis and Drug Information, Vrije Universiteit Brussel, Laarbeeklaan 103, Brussels 1090, Belgium;2. Department of Neurology, UZ Gent, De Pintelaan 185, Ghent 9000, Belgium |
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| Abstract: | The objective of this retrospective study was to determine if dual pathology DUAL — focal cortical dysplasia (FCD) and mesial temporal sclerosis (MTS)] in patients with left temporal lobe epilepsy is associated with greater risk for cognitive decline following temporal lobectomy than single pathology (MTS only). Sixty-three adults (Mage = 36.5 years, female: 52.4%) who underwent left anterior temporal lobectomy for treatment of epilepsy (MTS = 28; DUAL = 35) completed preoperative and postoperative neuropsychological evaluations. The base rate of dual pathology was 55.5%. Repeated measures ANOVAs yielded significant 2-way interactions (group × time) on most measures of language and memory with generally moderate effect sizes. Specifically, patients with MTS only demonstrated postoperative declines, while those with dual pathology remained unchanged or improved. Results suggest that dual pathology may be associated with better cognitive outcome following epilepsy surgery than MTS alone, possibly reflecting limited functionality of the resected tissue or intrahemispheric reorganization of function in the context of a developmental lesion. |
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