Changes in individual and group spatial and verbal learning characteristics after anterior temporal lobectomy.

PURPOSE

To evaluate the effects of anterior temporal lobectomy (ATL) on individual and group spatial and verbal learning and memory abilities as a function of side of surgery and seizure control outcome.

METHODS

We evaluated pre- and postsurgical learning and memory abilities of 75 left-hemisphere language dominant individuals who underwent ATL (33 left, 42 right) using the 8-trial Nonverbal Selective Reminding test and the 12-trial Verbal Selective Reminding test.

RESULTS

Reliable change index methods indicated that 40.5% of individuals who underwent right-ATL had a clinically significant decline in spatial memory, and 62.5% of individuals who underwent left-ATL had a significant reduction in verbal memory. Growth curve analyses indicated that both side of surgery and poor seizure outcome independently affected the learning slope in the best fitting models. Left-ATL reduced the slope, but did not affect the overall shape, of verbal learning across trials. On the other hand, poor seizure control outcome affected the slope of spatial learning regardless of the side of surgery.

DISCUSSION

Results demonstrate both individual and group declines in spatial memory and learning after ATL. Results suggest that individuals who undergo right-ATL should be counseled regarding the likelihood of a decline in spatial memory and learning abilities after ATL. Results also suggest that individuals with poor seizure control after ATL should be referred for rehabilitation services given the significant declines in spatial and verbal memory that occurred in our sample regardless of side of surgery.