A-68 Neuropsychological Predictors of Seizure Freedom in Patients Undergoing Stereotactic Laser Ablation of the Hippocampus (SLAH) for Refractory Epilepsy

2021 ◽  
Vol 36 (6) ◽  
pp. 1110-1110
Author(s):  
Sydney E Park ◽  
Tiffany L Cummings ◽  
Joseph Rigdon ◽  
Christian Robles ◽  
Brinda Bhaskar ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Verbal Memory ◽  
Visual Memory ◽  
Postoperative Outcome ◽  
Seizure Freedom ◽  
Psychiatric Status ◽  
Minimally Invasive Surgical ◽  
Significant Difference ◽  
Postoperative Seizure ◽  
Composite Scores

Abstract Objective Presurgical cognitive and psychiatric status can serve as predictors of surgical outcomes; however, there are no studies that assess the predictive nature of cognitive factors and psychiatric illness on seizure freedom following stereotactic laser ablation, a novel, minimally invasive surgical approach, of the hippocampus (SLAH). Therefore, this study aimed to assess whether neuropsychological factors were associated with long-term postoperative outcome, defined as time maintaining continuous postoperative seizure freedom (Engel Class I outcome persistently after surgery), after mesial temporal laser ablation surgery. Method Forty-one patients (Age M = 37.5 ± 12.6; 61% female; 63% left mesial temporal ablation; 37% right mesial temporal ablation) were selected from retrospective data collection of epilepsy surgery outcomes following mesial temporal laser ablation. Patients were assessed with a presurgical neuropsychological battery as part of Phase I work-up. Results Wilcoxon rank-sum tests revealed there were no significant differences between groups (seizure free and non-seizure free) across presurgical intellectual functioning, (seizure free M = 37.6; non-seizure free M = 40.6; p = 0.31), verbal memory (p = 0.59), visual memory (p = 0.39), and language composite scores (p = 0.87). There was also no significant difference in presurgical mean depression scores (p = 0.81). Conclusions There were no significant differences between groups in presurgical cognitive and psychiatric predictors on seizure outcomes; however, sample size is a limitation. Further investigations are needed given that cognitive and psychiatric predictors may be associated with SLAH outcomes. Additionally, these findings add to the absence of literature on cognitive and psychiatric predictors in SLAH.

scholarly journals The maintenance of modified electroconvulsive therapy combined with risperidone is better than risperidone alone in preventing relapse of schizophrenia and improving cognitive function

2016 ◽  
Vol 74 (10) ◽  
pp. 823-828 ◽  
Author(s):  
Ying Yang ◽  
Xiaojing Cheng ◽  
Qingzhi Xu ◽  
Renjun Li ◽  
Zengxun Liu ◽  
...  
Keyword(s):  
Cognitive Function ◽  
Relapse Rate ◽  
Electroconvulsive Therapy ◽  
Verbal Memory ◽  
Visual Memory ◽  
Clinical Symptoms ◽  
Control Group ◽  
Significant Difference ◽  
Modified Electroconvulsive Therapy ◽  
Experimental Group

ABSTRACT Objective To evaluate the effect of maintenance modified electroconvulsive therapy (MECT) on schizophrenic patients. Methods From June 2012 to June 2014, 62 patients with schizophrenia, who had recovered from a successful course of acute MECT, were recruited. Thirty-one patients received maintenance MECT and risperidone, as the experimental group. Another 31 patients were enrolled in the control group, and received risperidone only. The effects on cognitive functions, clinical symptoms and relapse rate were determined. Results Patients in the experimental group had a lower relapse rate and longer relapse-free survival time than the controls. Relative to the baseline evaluation, patients showed statistically significant improvement in verbal memory and visual memory. At the final assessment, the scores of verbal and visual memory were remarkably lower in the experimental group than the controls but there was no significant difference in other tests. Conclusion Maintenance MECT plus medication is superior to medication alone in preventing relapse and improving cognitive function.

Resection of Temporal Neocortex During Multiple Hippocampal Transections for Mesial Temporal Lobe Epilepsy Does not Affect Seizure or Memory Outcome

2017 ◽  
Vol 13 (6) ◽  
pp. 711-717 ◽  
Author(s):  
Fady Girgis ◽  
Madeline E Greil ◽  
Philip S Fastenau ◽  
Jennifer Sweet ◽  
Hans Lüders ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Visual Memory ◽  
Mesial Temporal Lobe Epilepsy ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Visual Spatial ◽  
Mesial Temporal Lobe ◽  
Postoperative Seizure ◽  
Temporal Neocortex

Abstract BACKGROUND Multiple hippocampal transection (MHT) is a surgical treatment for mesial temporal lobe epilepsy associated with improved postoperative neuropsychological outcomes compared with lobectomy. OBJECTIVE To determine whether resection of the amygdala and anterior temporal neocortex during MHT affects postoperative seizure/memory outcome. METHODS Seventeen patients with normal magnetic resonance imaging and stereo-electroencephalogram-proven drug-resistant dominant mesial temporal lobe epilepsy were treated with MHT. Nine patients underwent MHT alone (MHT–) and 8 patients underwent MHT plus removal of the amygdala and anterior 4.5 cm of temporal neocortex lateral to the fusiform gyrus (MHT+). Verbal and visual-spatial memory were assessed in all patients preoperatively and in 14 patients postoperatively using the Wechsler Memory Scale. Postoperative seizure control was assessed at 12 months for all patients. RESULTS Overall, 11 of 17 patients (64.7%) were Engel class 1 at 1 year (6/9 MHT–, 5/8 MHT+, P = .38), and 10 of 14 patients (71.4%) had no significant postoperative decline in either verbal or visual memory (6/8 MHT–, 4/6 MHT+, P = .42). Verbal memory declined in 2 of 8 MHT– and 1 of 6 MHT+ patients, and visual memory declined in 1 of 8 MHT– and 2 of 6 MHT+ patients. Two patients had improved visual memory postoperatively, both in the MHT+ group. CONCLUSION MHT on the dominant side is associated with high rates of seizure freedom and favorable memory preservation outcomes regardless of the extent of neocortical resection. Preservation of the temporal neocortex and amygdala during MHT does not appear to decrease the risk of postoperative memory decline, nor does it alter seizure outcome.

scholarly journals Allium sativumL. Improves Visual Memory and Attention in Healthy Human Volunteers

2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Sara Tasnim ◽  
Parsa Sanjana Haque ◽  
Md. Sazzadul Bari ◽  
Md. Monir Hossain ◽  
Sardar Mohd. Ashraful Islam ◽  
...  
Keyword(s):  
Executive Function ◽  
Verbal Memory ◽  
Visual Memory ◽  
Neuropsychological Test ◽  
Healthy Human ◽  
Beneficial Effects ◽  
Memory And Attention ◽  
Human Volunteers ◽  
Short Period ◽  
Significant Difference

Studies have shown thatAllium sativumL. (AS) protects amyloid-beta peptide-induced apoptosis, prevents oxidative insults to neurons and synapses, and thus prevent Alzheimer’s disease progression in experimental animals. However, there is no experimental evidence in human regarding its putative role in memory and cognition. We have studied the effect of AS consumption by healthy human volunteers on visual memory, verbal memory, attention, and executive function in comparison to control subjects taking placebo. The study was conducted over five weeks and twenty volunteers of both genders were recruited and divided randomly into two groups: A (AS) and B (placebo). Both groups participated in the 6 computerized neuropsychological tests of the Cambridge Neuropsychological Test Automated Battery (CANTAB) twice: at the beginning and after five weeks of the study. We found statistically significant difference (p<0.05) in several parameters of visual memory and attention due to AS ingestion. We also found statistically nonsignificant (p>0.05) beneficial effects on verbal memory and executive function within a short period of time among the volunteers. Study for a longer period of time with patients suffering from neurodegenerative diseases might yield more relevant results regarding the potential therapeutic role of AS.

scholarly journals SPORT TYPE AND BASELINE NEUROCOGNITIVE SCORES AMONG HEALTHY HIGH SCHOOL ATHLETES

2021 ◽  
Vol 9 (7_suppl3) ◽  
pp. 2325967121S0012
Author(s):  
Jessie R. Oldham ◽  
David R. Howell ◽  
Corey J. Lanois ◽  
Paul D. Berkner ◽  
Rebekah C. Mannix ◽  
...  
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Visual Memory ◽  
Symptom Burden ◽  
Reliable Change Index ◽  
Neurocognitive Performance ◽  
Head Impacts ◽  
Repetitive Head Impacts ◽  
Sport Type ◽  
Composite Scores

Background: Athletes who participate in collision sports may experience more repetitive head impacts than other sport types. These repetitive head impacts have been theorized as a potential catalyst for cognitive problems later in life. It is unknown, however, if sport type influences neurocognitive performance. Hypothesis/Purpose: Our purpose was to investigate the association between sport type and baseline neurocognitive scores in a high school athletic population. We hypothesized that athletes participating in collision sports would demonstrate worse scores on baseline neurocognitive tests compared to those in contact or non-contact sports. Methods: We conducted a cross-sectional, observational study using baseline computerized neurocognitive scores of 186,117 high school student-athletes (age: 15.47±2.28 years, height: 168.53±10.77 cm, weight: 63.02±14.83 kg, 45% female) in the state of Massachusetts. The dependent variables were five composite scores (verbal memory, visual memory, visual motor, reaction time, and impulse control) and total symptom score. The independent variables included sport type (collision, contact, non-contact), age, sex, and concussion history. We used univariable one-way ANOVAS to compare composite scores between sport type. We conducted a series of multivariable regression models, controlling for age, sex, and number of previous concussions, to examine the independent association between sport type and composite scores. Results: There was a minimal but statistically significant association between sport type and composite scores, with collision sport athletes performing slightly worse than other athletes on most composite scores. Collision sport athletes had a slightly lower symptom burden. (Tables 1 and 2) Conclusion: While statistically significant, the differences in neurocognitive function and symptom burden between sport type are of questionable clinical significance. In fact, all of them fall within the reliable change index values of each respective score. As participants were in high school at the time of the study, we cannot determine the potential for associations later in life. Tables/Figures: [Table: see text][Table: see text]

Epilepsy surgery for Rasmussen encephalitis: the UCLA experience

2020 ◽  
Vol 26 (4) ◽  
pp. 389-397
Author(s):  
Nikhil Bellamkonda ◽  
H. Westley Phillips ◽  
Jia-Shu Chen ◽  
Alexander M. Tucker ◽  
Cassia Maniquis ◽  
...  
Keyword(s):  
Epilepsy Surgery ◽  
Outcome Data ◽  
Seizure Freedom ◽  
Rasmussen Encephalitis ◽  
Seizure Recurrence ◽  
Functional Hemispherectomy ◽  
Significant Difference ◽  
Seizure Relapse ◽  
Drug Resistant Epilepsy ◽  
Postoperative Seizure

OBJECTIVERasmussen encephalitis (RE) is a rare inflammatory neurological disorder typically involving one hemisphere and resulting in drug-resistant epilepsy and progressive neurological decline. Here, the authors present seizure outcomes in children who underwent epilepsy surgery for RE at a single institution.METHODSThe records of consecutive patients who had undergone epilepsy surgery for RE at the UCLA Mattel Children’s Hospital between 1982 and 2018 were retrospectively reviewed. Basic demographic information, seizure history, procedural notes, and postoperative seizure and functional outcome data were analyzed.RESULTSThe cohort included 44 patients, 41 of whom had sufficient data for analysis. Seizure freedom was achieved in 68%, 48%, and 22% of the patients at 1, 5, and 10 years, respectively. The median time to the first seizure for those who experienced seizure recurrence after surgery was 39 weeks (IQR 11–355 weeks). Anatomical hemispherectomy, as compared to functional hemispherectomy, was independently associated with a longer time to postoperative seizure recurrence (HR 0.078, p = 0.03). There was no statistically significant difference in postoperative seizure recurrence between patients with complete hemispherectomy and those who had less-than-hemispheric surgery. Following surgery, 68% of the patients could ambulate and 84% could speak regardless of operative intervention.CONCLUSIONSA large proportion of RE patients will have seizure relapse after surgery, though patients with anatomical hemispherectomies may have a longer time to postoperative seizure recurrence. Overall, the long-term data in this study suggest that hemispheric surgery can be seen as palliative treatment for seizures rather than a cure for RE.

Neurocognitive outcomes in adults following cerebral hypoxia: A systematic literature review

2020 ◽  
Vol 47 (2) ◽  
pp. 83-97
Author(s):  
Naomi N. M. Brownlee ◽  
F. Colin Wilson ◽  
David B. Curran ◽  
Nigel Lyttle ◽  
John P. McCann
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Data Interpretation ◽  
Study Data ◽  
Learning Ability ◽  
Performance Validity ◽  
Mesh Terms ◽  
Significant Difference ◽  
Cognitive Sequelae ◽  
And Performance

BACKGROUND: Hypoxic ischemic brain injury (HIBI) occurs as a result of complete or partial disruption of cerebral oxygen supply. The physical and cognitive sequelae of adults following hypoxia varies widely. OBJECTIVE: To systematically review studies exploring the neuropsychological outcomes following hypoxic brain insult in adults. METHODS: Data was sourced using six databases (CINAHL, Cochrane, Embase, Medline, PsycInfo and Web of Science). Initial MESH terms identified 2,962 articles. After a three-stage independent review process, 18 articles, 9 case studies and 9 group studies were available for data synthesis from 1990-2012. Case study data was converted to standardised scores and compared to available test norms. Cohen’s d was calculated to permit group data interpretation. RESULTS: Intellectual decrement was observed in some studies although difficult to delineate given the lack of use of measures of premorbid ability. Cognitive sequelae varied albeit with predominant disturbance in verbal memory, learning ability and executive function observed across studies. Wechsler Memory Scale Revised (WMS-R) visual memory was comparable to normative data. Impaired Rey Osterrieth Complex Figure (ROCFT) performance was found among group studies. Across visuo-constructional and attention domains, performance varied, although no significant difference relative to reported means was observed. CONCLUSIONS: Future studies should consider the use of standardised assessment protocols, which include measures of premorbid functioning and performance validity.

scholarly journals Test-Retest Reliability of ImPACT Across a Two-Year Interval in Collegiate Athletes

2019 ◽  
Vol 34 (5) ◽  
pp. 778-778
Author(s):  
C Burley ◽  
A Datoc ◽  
R Bennett ◽  
L Lashley
Keyword(s):  
Verbal Memory ◽  
Visual Memory ◽  
Intraclass Correlation ◽  
Collegiate Athletes ◽  
Motor Speed ◽  
Retest Reliability ◽  
Symptom Scores ◽  
Visual Motor ◽  
Composite Scores ◽  
Test Retest Reliability

Abstract Purpose To examine the two-year test-retest reliability of Immediate Post-concussion Assessment and Cognitive Testing (ImPACT) in a sample of collegiate athletes. Methods A total of 163 college athletes (63.8% female) completed two pre-season baseline assessments two years apart as mandated by their athletic programs. Participants completed the first baseline prior to their first year of competition (M age=18.38, M edu=12.13). Individuals with baselines flagged as invalid by ImPACT were excluded. No diagnosed concussions occurred between baseline assessments. Results Pearson r correlations for ImPACT composite scores between assessments ranged from .32 to .70. Paired samples t-tests indicated significant differences between verbal memory (t(162)=-4.61, p<.001, MD=-3.6) and visual-motor speed (t(162)=-4.10, p<.001, MD=-1.5) at time 1 and time 2. Intraclass correlation coefficients (ICCs) with a “two-way mixed” model and “consistency” type indicated higher reliability for all composite scores. Visual-motor speed (mean ICC=.83; .76–.87 95% confidence interval [CI]) was the most reliable composite score, followed by visual memory (.66; 95% CI .53-.75), impulse control (.62; 95% CI .48–.72), verbal memory (.58; 95% CI .43–.69), and reaction time (.49; 95% CI .30-.62). The total symptom score showed moderate reliability (.63; 95% CI .50–.73). Conclusion Overall, ImPACT composite and total symptom scores appear to maintain relative long-term stability in a collegiate sample across a two-year period. ImPACT composite scores showed moderate to good reliability, and total symptom scores showed moderate reliability. Results of this study corroborate previous research indicating moderately stable ImPACT scores across a 2-year test-retest period in collegiate athletes (Schatz, 2010).

scholarly journals High Baseline Postconcussion Symptom Scores and Concussion Outcomes in Athletes

2016 ◽  
Vol 51 (2) ◽  
pp. 136-141 ◽  
Author(s):  
Aimee Custer ◽  
Alicia Sufrinko ◽  
R. J. Elbin ◽  
Tracey Covassin ◽  
Micky Collins ◽  
...  
Keyword(s):  
High School ◽  
Verbal Memory ◽  
Repeated Measures ◽  
Visual Memory ◽  
Collegiate Athletes ◽  
Cognitive Test ◽  
Symptom Scale ◽  
Symptom Scores ◽  
High Level ◽  
Composite Scores

 Some healthy athletes report high levels of baseline concussion symptoms, which may be attributable to several factors (eg, illness, personality, somaticizing). However, the role of baseline symptoms in outcomes after sport-related concussion (SRC) has not been empirically examined.Context:  To determine if athletes with high symptom scores at baseline performed worse than athletes without baseline symptoms on neurocognitive testing after SRC.Objective:  Cohort study.Design:  High school and collegiate athletic programs.Setting:  A total of 670 high school and collegiate athletes participated in the study. Participants were divided into groups with either no baseline symptoms (Postconcussion Symptom Scale [PCSS] score = 0, n = 247) or a high level of baseline symptoms (PCSS score &gt; 18 [top 10% of sample], n = 68).Patients or Other Participants:  Participants were evaluated at baseline and 2 to 7 days after SRC with the Immediate Post-concussion Assessment and Cognitive Test and PCSS. Outcome measures were Immediate Post-concussion Assessment and Cognitive Test composite scores (verbal memory, visual memory, visual motor processing speed, and reaction time) and total symptom score on the PCSS. The groups were compared using repeated-measures analyses of variance with Bonferroni correction to assess interactions between group and time for symptoms and neurocognitive impairment.Main Outcome Measure(s):  The no-symptoms group represented 38% of the original sample, whereas the high-symptoms group represented 11% of the sample. The high-symptoms group experienced a larger decline from preinjury to postinjury than the no-symptoms group in verbal (P = .03) and visual memory (P = .05). However, total concussion-symptom scores increased from preinjury to postinjury for the no-symptoms group (P = .001) but remained stable for the high-symptoms group.Results:  Reported baseline symptoms may help identify athletes at risk for worse outcomes after SRC. Clinicians should examine baseline symptom levels to better identify patients for earlier referral and treatment for their injury. Additional investigation of baseline symptoms is warranted to help delineate the type and severity of premorbid symptoms.Conclusions:

Resective temporal lobe surgery in refractory temporal lobe epilepsy: prognostic factors of postoperative seizure outcome

2021 ◽  
pp. 1-10
Author(s):  
Valeri Borger ◽  
Motaz Hamed ◽  
Julia Taube ◽  
Gülsah Aydin ◽  
Inja Ilic ◽  
...  
Keyword(s):  
Temporal Lobe Epilepsy ◽  
Temporal Lobe ◽  
Multivariate Logistic Regression Analysis ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Depth Electrodes ◽  
Group I ◽  
Significant Difference ◽  
Class 1 ◽  
Postoperative Seizure

OBJECTIVETemporal lobe epilepsy (TLE) is one of the most common forms of epilepsy. In approximately 30% of patients, seizures are refractory to drug treatment. Despite the achievements of modern presurgical evaluation in recent years, the presurgical prediction of seizure outcome remains difficult. The aim of this study was to evaluate the seizure outcome in patients with drug-refractory TLE who underwent resective temporal lobe surgery (rTLS) and to determine features associated with unfavorable postsurgical seizure outcome.METHODSPatients with medically refractory TLE who underwent rTLS between 2012 and 2017 were reviewed from the prospectively collected epilepsy surgery database. A retrospective analysis of clinical, radiological, neuropsychological, histopathological, and perioperative findings of 161 patients was performed. The patients were divided into two groups according to seizure outcome (group I, International League Against Epilepsy [ILAE] class 1; group II, ILAE class ≥ 2). For identification of independent risk factors for unfavorable postoperative seizure outcome (ILAE class ≥ 2), a multivariate logistic regression analysis was performed.RESULTSSeizure freedom (ILAE class 1) was achieved in 121 patients (75.2%). The neuropsychological evaluation demonstrated that losses in cognitive performance were more pronounced in verbal memory after resections in the left temporal lobe and in nonverbal memory after right-sided resections, whereas attention improved after surgery. Overall, postoperative visual field deficits (VFDs) were common and occurred in 51% of patients. There was no statistically significant difference in the incidence of VFD in patients with selective surgical procedures compared to the patients with nonselective procedures. The lack of MRI lesions and placement of depth electrodes were preoperatively identified as predictors for unfavorable seizure outcome.CONCLUSIONSrTLS is an effective treatment method in patients with refractory TLE. However, patients with a lack of MRI lesions and placement of depth electrodes prior to rTLS are at higher risk for an unfavorable postsurgical seizure outcome.

scholarly journals A-38 A Different Approach for Examining Gender Differences on Computerized Neurocognitive Testing: Percentile Ranks Versus Composite Scores

2020 ◽  
Vol 35 (5) ◽  
pp. 634-634
Author(s):  
P Schatz ◽  
K Slicer ◽  
R J Elbin
Keyword(s):  
Gender Differences ◽  
Reaction Time ◽  
Verbal Memory ◽  
Visual Memory ◽  
Motor Speed ◽  
Age And Gender ◽  
Visual Motor ◽  
Gender Based ◽  
And Gender ◽  
Composite Scores

Abstract Objective ImPACT is a popular tool used to assess neurocognitive function after concussion. Age- and gender-based percentile ranks are provided as part of the ImPACT clinical report, but only raw composite scores are provided for research. Percentile ranks may provide an alternate look at gender differences on neurocognitive testing. We sought to compare the use of percentile ranks versus composite scores when comparing neurocognitive performance between male and females. Method Pre-season baseline data from 3,238 collegiate athletes were exported from a larger multi-site database, 1,714 male (53%) and 1,524 female (47%), ages 18–22 (Mean = 19.3, SD = 1.2). ImPACT composite scores were extracted (Verbal Memory, Visual Memory, Visual Motor Speed, Reaction Time) and Percentile Ranks were calculated using age- and gender-based reference tables in the ImPACT 2017–2012 Technical Manual. One-way analyses of variance (ANOVA) were conducted with gender as the IV and the four composite scores and their associated percentile ranks as the DVs. Bonferroni correction for 8 comparisons set the alpha level to p &lt; .006. Results ANOVAs revealed a significant effect of gender on ImPACT Verbal Memory [F(1,3236) = 16.32, p &lt; .001], Visual Memory [F(1,3236) = 66.06, p &lt; .001], Visual Motor Speed [F(1,3236) = 15.61,p &lt; .001] but not Reaction Time [F(1,3236) = 2.59, p = .11]. When using percentile ranks, ANOVAs revealed a significant effect of gender on only Visual Motor Speed [F(1,3236) = 31.07, p &lt; .001], but not Verbal Memory [F(1,3236) = 2.43, p = .12], Visual Memory [F(1,3236) = 0.48, p = .49], or Reaction Time [F(1,3236) = 0.61, p = .44]. Conclusions Use of ImPACT Composite Scores in concussion research may exaggerate or inappropriately promote gender differences on computerized neurocognitive testing. Given that age- and gender-based normative data are available, use of percentile ranks is recommended.

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