Sabadell Véronique, Zielinski Christelle, Garnier Elodie, Makhalova Julia, McGonigal Aileen, Lagarde Stanislas, Aubert Sandrine, Villeneuve Nathalie, Dufour Henry, Scavarda Didier, Bartolomei Fabrice, Alario F-Xavier, Trébuchon Agnès
Aix-Marseille University, INSERM, Institute of Systems Neuroscience, Marseille, France.
APHM, Timone Hospital, Neurology and Neuropsychology Unit, Marseille, France.
Epilepsia. 2025 Sep;66(9):3153-3167. doi: 10.1111/epi.18449. Epub 2025 May 10.
An emerging approach in surgery is to propose prehabilitation programs to strengthen the patient's functional abilities before surgical interventions, thus helping them cope better with its consequences. In drug-resistant language-dominant temporal lobe epilepsy (LdTLE), surgical treatment carries a risk of increasing cognitive deficits, notably word-finding difficulties (anomia) and verbal memory difficulties that negatively impact personal, social, and occupational activities. In this study, we invited 15 LdTLE patients to enroll in a speech and language prehabilitation program adapted to the specifics of their difficulties, organized daily during the preoperative period.
Naming performance (for trained and untrained words) was studied twice before prehabilitation, during prehabilitation, and 1 week and 6 months after surgery. Results were analyzed using a generalized linear mixed effects model.
We found a significant effect of prehabilitation on trained items before surgery. Postoperatively, trained items showed a slight and nonsignificant performance increase compared to baseline, whereas untrained items showed a significant decline in the same comparison.
We conclude that trained words were better protected from postsurgical decline than untrained words. Our research can contribute to patient support during surgical decision-making; ultimately, prehabilitation might be considered as part of individualized care. These encouraging results lay the groundwork for more detailed or powerful examinations of the protective effect of prehabilitation on language skills.
外科手术中一种新出现的方法是提出术前康复计划，以在手术干预前增强患者的功能能力，从而帮助他们更好地应对手术后果。在耐药性语言主导型颞叶癫痫（LdTLE）中，手术治疗存在增加认知缺陷的风险，尤其是找词困难（命名障碍）和言语记忆困难，这些会对个人、社交和职业活动产生负面影响。在本研究中，我们邀请了15名LdTLE患者参加一个根据他们困难的具体情况量身定制的言语和语言术前康复计划，该计划在术前阶段每天组织实施。
在术前康复前、康复期间、术后1周和6个月对命名表现（针对训练过和未训练过的单词）进行了两次研究。使用广义线性混合效应模型对结果进行分析。
我们发现术前康复对术前训练项目有显著影响。术后，与基线相比，训练项目的表现略有增加但不显著，而在相同比较中未训练项目表现显著下降。
我们得出结论，训练过的单词比未训练过的单词在术后衰退中得到了更好的保护。我们的研究有助于在手术决策过程中为患者提供支持；最终，术前康复可被视为个体化护理的一部分。这些令人鼓舞的结果为更详细或有力地检验术前康复对语言技能的保护作用奠定了基础。
