Epilepsy Center, Neurological Institute Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
Department of Quantitative Health Sciences, Lerner Research Institute Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, United States.
Epilepsy Behav. 2019 Oct;99:106484. doi: 10.1016/j.yebeh.2019.106484. Epub 2019 Aug 30.
This retrospective, observational study investigated the relationship between objective naming decline and patient report of subjective decline in language functioning following epilepsy surgery. The role of depression in this relationship was also examined.
A total of 429 adults with pharmacoresistant epilepsy completed the Boston Naming Test (BNT) and Memory Assessment Clinics Self-Rating Scale (MAC-S) before and after resective surgery. Multiple regression analyses were used to examine the relationship between objective naming decline and subjective language functioning, while controlling for the confounding effect of depression.
Individuals who experienced moderate to severe naming decline (≥11 raw points on BNT) following surgery reported a decline in subjective language functioning (p < .001) and endorsed problems with word-retrieval as well as more general semantic abilities. Those who experienced mild naming decline (5-10 raw points) also reported an increase in subjective language problems (p = .006). Complaints in this group were less severe than in those with more marked naming declines and were primarily related to word-retrieval. Both of these relationships remained significant after controlling for the confounding effect of depression (p < .005-.014).
Individuals with epilepsy who experience naming decline following surgery perceive these declines in their daily life, regardless of whether or not they are depressed. Findings support the utilization of risk models to predict naming outcome and the importance of counseling patients regarding the risk for naming decline following surgery.
本回顾性观察研究调查了癫痫手术后客观命名能力下降与患者语言功能主观下降报告之间的关系。还研究了抑郁在这种关系中的作用。
共有 429 名药物难治性癫痫患者在切除性手术前后完成了波士顿命名测试(BNT)和记忆评估诊所自我评定量表(MAC-S)。采用多元回归分析来检验客观命名能力下降与主观语言功能之间的关系,同时控制抑郁的混杂影响。
手术后经历中度至重度命名能力下降(BNT 原始得分≥11 分)的个体报告主观语言功能下降(p<0.001),并表示存在词汇检索问题以及更普遍的语义能力问题。那些经历轻度命名能力下降(5-10 个原始得分)的个体也报告了主观语言问题的增加(p=0.006)。在这一组中,抱怨比那些命名能力下降更明显的个体更轻微,主要与词汇检索有关。在控制抑郁的混杂影响后(p<0.005-0.014),这两种关系仍然具有统计学意义。
癫痫手术后经历命名能力下降的个体在日常生活中感知到这些下降,无论他们是否抑郁。研究结果支持利用风险模型预测命名结果,以及在手术后面临命名能力下降的风险时向患者提供咨询的重要性。