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Arch Neurol. 1996 Jan;53(1):72-6.

Word-finding deficits persist after left anterotemporal lobectomy.

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  • 1Department of Neurology, University of Rochester, NY, USA.

Abstract

OBJECTIVE:

To determine the incidence and extent of exacerbation of word-finding difficulty following anterotemporal lobectomy and to identify predictors of change.

DESIGN:

Case-series study of qualitative and quantitative changes in confrontation naming ability before surgery and 1 year after surgery. Stepwise multiple regression analysis of predictors of postoperative naming change.

SETTING:

A university epilepsy surgery program.

PARTICIPANTS:

Fifty-nine consecutive patients.

INTERVENTION:

Standard, en bloc anterotemporal lobectomy.

MAIN OUTCOME MEASURE:

Raw scores and types of errors on the 85-item Boston Naming Test.

RESULTS:

A significant exacerbation of word-finding difficulty was noted that persisted at least 1 year after surgery in 25% of patients with left, speech-dominant anterotemporal lobectomy (Laterality x Time interaction [F = 24.5; P < .0005]). "Tip-of-the-tongue"-type errors were most frequent (F = 54.66; P < .001), as opposed to paraphasic-type errors seen more frequently among patients with aphasia or dementia. Word-finding decline was worse among patients who underwent a left anterotemporal lobectomy and who were left-hemisphere speech dominant, older, or evaluated earlier in the postoperative course.

CONCLUSIONS:

Significant, persisting worsening of word-finding difficulties is not a rare consequence of a left anterotemporal lobectomy, as suggested by previous studies. Differences between these results and those of previous studies may reflect differences in extent of surgical resection and/or differential sensitivity of psychometric measures of naming to word-finding problems. Information regarding extent, frequency, and predictors of word-finding declines may be used in counseling surgical candidates about the potential cognitive side effects of anterotemporal lobectomy.

PMID:
8599562
[PubMed - indexed for MEDLINE]
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