Neuropsychological outcomes after Gamma Knife radiosurgery for mesial temporal lobe epilepsy: A prospective multicenter study
Mark Quigg
Department of Neurology, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorDonna K. Broshek
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorNicholas M. Barbaro
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Department of Neurology, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorMariann M. Ward
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorKenneth D. Laxer
California Pacific Medical Center, San Francisco, California, U.S.A.
Search for more papers by this authorGuofen Yan
Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorKathleen Lamborn
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorthe Radiosurgery Epilepsy Study Group
Members of the Radiosurgery Epilepsy Study Group are present in Acknowledgment.
Search for more papers by this authorMark Quigg
Department of Neurology, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorDonna K. Broshek
Department of Psychiatry and Neurobehavioral Sciences, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorNicholas M. Barbaro
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Department of Neurology, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorMariann M. Ward
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorKenneth D. Laxer
California Pacific Medical Center, San Francisco, California, U.S.A.
Search for more papers by this authorGuofen Yan
Department of Public Health Sciences, University of Virginia, Charlottesville, Virginia, U.S.A.
Search for more papers by this authorKathleen Lamborn
Department of Neurological Surgery, University of California at San Francisco, San Francisco, California, U.S.A.
Search for more papers by this authorthe Radiosurgery Epilepsy Study Group
Members of the Radiosurgery Epilepsy Study Group are present in Acknowledgment.
Search for more papers by this authorSummary
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.
Supporting Information
Table S1. Individual data for radiosurgery for mesial temporal lobe epilepsy.
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| EPI_2987_sm_WebDataTable.xls76.5 KB | Supporting info item |
Please note: The publisher is not responsible for the content or functionality of any supporting information supplied by the authors. Any queries (other than missing content) should be directed to the corresponding author for the article.
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