Predictors of Decline in Verbal Fluency after Frontal Lobe Epilepsy Surgery in Adults Abstract

Highlights

• A retrospective review of verbal fluency outcomes after FLE surgery was performed.
• 25% of the sample population experienced significant decline in verbal fluency.
• Predictors of decline were: a high pre-surgical fluency score and dominant resection.
• Poor post-op seizure outcome was also associated with low verbal fluency scores.

Abstract

Few studies have focused on language changes following frontal lobe epilepsy (FLE) surgery. The aim of the current study is to quantify the role of resection location and size in verbal fluency decline after FLE surgery and to examine its predictors. A retrospective chart review identified 36 adult patients who underwent FLE surgery. Verbal fluency was assessed using the Controlled Oral Word Association Test (COWAT). Nine (25%) of the patients had significant decline. Binary logistic regression incorporating side of resection and preoperative COWAT score significantly predicted decline and accounted for 25% of the variance. A trend was also noted for decliners to have higher postoperative seizure recurrence (p = 0.067). There was no effect of size of resection. Patients undergoing FLE surgery are at risk of verbal fluency decline, especially if they have a high presurgical verbal fluency score, undergo a frontal lobe resection in the language dominant hemisphere, and have poor seizure outcome.

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• R.A. Sarkis^a, , , 
• R.M. Busch^a, c, 
• D. Floden^b, c, 
• J.S. Chapin^a, c, 
• C. Kalman Kenney^c, 
• L. Jehi^a, 
• P. Ruggieri^d, 
• I. Najm^a
• ^a Cleveland Clinic Epilepsy Center, Neurological Institute, Cleveland, OH, USA
• ^b Center for Neurological Restoration, Neurological Institute, Cleveland, OH, USA
• ^c Department of Psychiatry & Psychology, Neurological Institute, Cleveland, OH, USA
• ^d Department of Diagnostic Radiology, Section of Neuroradiology, Neurological Institute, Cleveland, OH, USA