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Neuropsychological outcomes after Gamma Knife radiosurgery for mesial temporal lobe epilepsy: A prospective multicenter study
Author(s) -
Quigg Mark,
Broshek Donna K.,
Barbaro Nicholas M.,
Ward Mariann M.,
Laxer Kenneth D.,
Yan Guofen,
Lamborn Kathleen
Publication year - 2011
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/j.1528-1167.2011.02987.x
Subject(s) - neuropsychology , mood , psychology , verbal memory , beck depression inventory , verbal learning , radiosurgery , quality of life (healthcare) , temporal lobe , boston naming test , neuropsychological test , epilepsy , neuropsychological assessment , cognition , audiology , medicine , psychiatry , surgery , anxiety , radiation therapy , psychotherapist
Summary Purpose: To assess outcomes of language, verbal memory, cognitive efficiency and mental flexibility, mood, and quality of life (QOL) in a prospective, multicenter pilot study of Gamma Knife radiosurgery (RS) for mesial temporal lobe epilepsy (MTLE). Methods: RS, randomized to 20 Gy or 24 Gy comprising 5.5–7.5 ml at the 50% isodose volume, was performed on mesial temporal structures of patients with unilateral MTLE. Neuropsychological evaluations were performed at preoperative baseline, and mean change scores were described at 12 and 24 months postoperatively. QOL data were also available at 36 months. Key Findings: Thirty patients were treated and 26 were available for the final 24‐month neuropsychological evaluation. Language (Boston Naming Test), verbal memory (California Verbal Learning Test and Logical Memory subtest of the Wechsler Memory Scale‐Revised), cognitive efficiency and mental flexibility (Trail Making Test), and mood (Beck Depression Inventory) did not differ from baseline. QOL scores improved at 24 and 36 months, with those patients attaining seizure remission by month 24s accounting for the majority of the improvement. Significance: The serial changes in cognitive outcomes, mood, and QOL are unremarkable following RS for MTLE. RS may provide an alternative to open surgery, especially in those patients at risk of cognitive impairment or who desire a noninvasive alternative to open surgery.