Visual naming performance after ATL resection: Impact of atypical language dominance

• Published in: Neuropsychologia Vol. 48; no. 7; pp. 2221 - 2225
• Main Authors: Kovac, S., Möddel, G., Reinholz, J., Alexopoulos, A.V., Syed, T., Koubeissi, M.Z., Schuele, S.U., Lineweaver, T., Busch, R.M., Loddenkemper, T.
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01-06-2010; Elsevier
• Subjects: Adult; Adult and adolescent clinical studies; Amobarbital - therapeutic use; Analysis of Variance; Anterior Temporal Lobectomy - adverse effects; Biological and medical sciences; Boston Naming Test; Confrontation naming; Epilepsy - surgery; Female; Functional Laterality - physiology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Hypnotics and Sedatives - therapeutic use; Language Disorders - etiology; Language lateralization; Male; Medical sciences; Names; Nervous system (semeiology, syndromes); Neurology; Neuropsychological Tests; Organic mental disorders. Neuropsychology; Perceptual Disorders - etiology; Postoperative Complications - physiopathology; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Retrospective Studies; Temporal lobe epilepsy; Visual Perception - physiology; Young Adult; Temporal lobe epilepsy; Boston Naming Test; Confrontation naming; Language lateralization; Human; Nervous system diseases; Resection; Hemispheric specialization; Central nervous system; Complex partial epilepsy; Naming; Encephalon; Cerebral disorder; Language; Vision; Central nervous system disease; Perception; Laterality; Performance
• ISSN: 0028-3932; 1873-3514
• DOI: 10.1016/j.neuropsychologia.2010.03.013

To characterize the interaction between language dominance and lateralization of the epileptic focus for pre- and postoperative Boston Naming Test (BNT) performance in patients undergoing anterior temporal lobectomy (ATL).
Analysis of pre- and postoperative BNT scores depending on lateralization of language as measured by the intracarotid amobarbital procedure (IAP) versus lateralization of the temporal lobe epileptic focus.
Changes between pre- and postoperative BNT performance depended on epilepsy lateralization (effect size
=
0.189) with significant decrease in patients undergoing left ATL. Subgroup analysis in these showed that postoperative decline in BNT scores was significant in patients with atypical (
n
=
14;
p
<
0.05), but did not reach statistical significance in patients with left language dominance (
n
=
36;
p
=
0.09). Chi-square test revealed a trend of higher proportions of patients experiencing significant postsurgical deterioration in naming performance in atypical (57.1%) as compared to left language dominance (30.6%;
p
=
0.082). Surgical failure was also associated with greater decline of BNT scores and was more common in atypical than in left language dominant patients (
χ
2 (1,
n
=
98)
=
4.62,
p
=
0.032). Age of onset, duration of epilepsy, and seizure frequency had no impact on changes in BNT performance.
Atypical language dominance is a predictor of change in visual naming performance after left ATL and may also impact postsurgical seizure control. This should be considered when counseling surgical candidates.