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Cortical naming sites and increasing age in adults with refractory epilepsy: More might be less
Author(s) -
Hamberger Marla J.,
Schevon Catherine A.,
Seidel William T.,
McKhann Guy M.,
Morrison Chris
Publication year - 2019
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16097
Subject(s) - epilepsy , young adult , psychology , incidence (geometry) , lateralization of brain function , audiology , pediatrics , medicine , developmental psychology , neuroscience , physics , optics
Objective Critical decisions regarding resection boundaries for epilepsy surgery are often based on results of electrical stimulation mapping ( ESM ). Despite the potentially serious implications for postoperative functioning, age‐referenced data that might facilitate the procedure are lacking. Age might be particularly relevant, as pediatric ESM studies have shown a paucity of language sites in young children followed by a rapid increase at approximately 8‐10 years. Beyond adolescence, it has generally been assumed that the language system remains stable, and therefore, potential age‐related changes across the adult age span have not been examined. However, increasing age during adulthood is associated with both positive and negative language‐related changes, such as a broadening vocabulary and increased word finding difficulty. Because most patients who undergo ESM are adults, we aimed to determine the potential impact of age on the incidence of ESM ‐identified naming sites across the adult age span in patients with refractory epilepsy. Methods We analyzed clinical language ESM results from 47 patients, ages 17‐64 years, with refractory dominant‐hemisphere epilepsy. Patients had comparable location and number of cortical sites tested. The incidence of naming sites was examined as a function of age, and compared between younger and older adults. Results Significantly more naming sites were found in older than younger adults, and age was found to be a significant predictor of number of naming sites identified. Significance Unlike the developmental changes that coincide with increased naming sites in children, increased naming sites in older adults might signify greater vulnerability of the language system to disruption. Because preservation of language sites can limit the extent of the resection, and thereby reduce the likelihood of seizure freedom, further work should aim to determine the clinical relevance of increased naming sites in older adults.