Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

Camila de Vasconcelos Geraldi; Sara Escorsi-Rosset; Pamela Thompson; Ana C. Gargaro Silva; Américo Ceiki Sakamoto

doi:10.1590/0004-282X20170050

Arquivos de Neuro-Psiquiatria, Table of Contents

CC BY-NC-ND 4.0 · Arq Neuropsiquiatr 2017; 75(06): 359-365
DOI: 10.1590/0004-282X20170050

ARTICLE

Potential role of a cognitive rehabilitation program following left temporal lobe epilepsy surgery

Reabilitação neuropsicológica em pacientes com epilepsia submetidos à lobectomia temporal dominante

Camila de Vasconcelos Geraldi

¹Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil;

²UCL Institute of Neurology, Department of Clinical and Experimental Epilepsy, London, UK;

,

Sara Escorsi-Rosset

¹Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil;

,

Pamela Thompson

²UCL Institute of Neurology, Department of Clinical and Experimental Epilepsy, London, UK;

³Epilepsy Society Research Centre, Buckinghamshire, UK.

,

Ana C. Gargaro Silva

¹Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil;

,

Américo Ceiki Sakamoto

¹Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brasil;

› Author Affiliations

Abstract

ABSTRACT

Research into memory and epilepsy has focused on measuring problems and exploring causes with limited attention directed at the role of neuropsychological rehabilitation in alleviating post-operative memory difficulties.

Objectives

To assess the effects of a memory rehabilitation program in patients with left temporal lobe epilepsy following surgery.

Methods

Twenty-four patients agreed to participate and 18 completed the study; nine received memory rehabilitation while nine had no input and were designated as controls. Verbal learning efficiency, naming abilities, memory subjective ratings, ecological activity measures and a language fMRI paradigm were used as outcome measures.

Results

Improved verbal learning and naming test performance, increase in memory strategy use and improved self-perception were observed following the rehabilitation. Changes in fMRI activation patterns were seen in the rehabilitation group over the long term.

Conclusion

The findings support the potential role of a cognitive rehabilitation program following left temporal lobe surgery.

RESUMO

As publicações na área de epilepsia e memória se focam em mensurar prejuízos e investigar causas, com poucos dados sobre reabilitação neuropsicológica em pacientes pós-cirúrgicos.

Objetivos

Avaliar os efeitos da reabilitação neuropsicológica em pacientes submetidos a lobectomia temporal dominante.

Métodos

Vinte e quatro pacientes iniciaram o estudo, apenas dezoito o concluíram, dos quais 9 foram participantes de sessões de reabilitação com enfoque em memória. Todos os participantes foram avaliados quanto a autopercepção de dificuldades de memória; ao uso de estratégias para minimizar tais dificuldades; a habilidade de nomeação e a aprendizagem verbal e foram submetidos à ressonância magnética funcional.

Resultados

Foi encontrado efeito significativo da reabilitação neuropsicológica na autopercepção de dificuldades de memória; no uso de estratégias compensatórias; na aprendizagem verbal e na nomeação. Alterações no padrão de ativação na RMf foram observadas no grupo submetido a reabilitação.

Conclusão

A reabilitação neuropsicológica pode beneficiar pacientes submetidos a lobectomia temporal antero-mesial dominante com prejuízos de memória.

epilepsy, temporal lobe - memory - neurologic rehabilitation - anterior temporal lobectomy

epilepsia do lobo temporal - memória - reabilitação neurológica - lobectomia temporal anterior

Full Text

References

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