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The course of language functions after temporal lobe epilepsy surgery: a prospective study
Author(s) -
Giovagnoli A. R.,
Parente A.,
Didato G.,
Manfredi V.,
Deleo F.,
Tringali G.,
Villani F.
Publication year - 2016
Publication title -
european journal of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.881
H-Index - 124
eISSN - 1468-1331
pISSN - 1351-5101
DOI - 10.1111/ene.13113
Subject(s) - fluency , temporal lobe , audiology , laterality , verbal fluency test , boston naming test , comprehension , lateralization of brain function , medicine , epilepsy , sentence , psychology , linguistics , cognition , neuropsychology , psychiatry , philosophy , mathematics education
Background and purpose Anterior temporal lobectomy ( ATL ) within the language‐dominant hemisphere can impair naming. This prospective study examined the pre‐operative to post‐operative course of different language components, clarifying which changes are relevant within the short‐term and long‐term outcome of language.Methods Patients with drug‐resistant temporal lobe epilepsy ( TLE ) were evaluated using the Token, Boston Naming and Word Fluency tests assessing sentence comprehension and word‐finding on visual, semantic or phonemic cues.Results A total of 106 patients were evaluated before and 6 months, 1 and 2 years after ATL ; 60 patients were also evaluated after 5 years and 38 controls were assessed at baseline. Seizure outcome was comparable between the left and right TLE patients. Before surgery, naming and word fluency were impaired in the left and right TLE patients, whereas sentence comprehension was normal. After left or right ATL , word fluency progressively improved, naming showed early worsening and late improvement after left ATL and progressive improvement after right ATL , and sentence comprehension did not change. At the 5‐year follow‐up, naming improvement was clinically significant in 31% and 71% of the left and right TLE patients, respectively. Pre‐operative naming, ATL laterality, schooling, and post‐operative seizure frequency and number of antiepileptic drugs predicted post‐operative naming. Pre‐operative word fluency and schooling predicted post‐operative word fluency.Conclusions Left or right TLE can impair word‐finding but not sentence comprehension. After ATL , word‐finding may improve for a long time, depending on TLE laterality, seizure control and mental reserve. These findings may clarify prognosis prior to treatment.