Temporal lobe surgery in childhood and neuroanatomical predictors of long-term declarative memory outcome.

摘要: The temporal lobes play a prominent role in declarative memory function, including episodic (memory for events) and semantic facts concepts). Surgical resection medication-resistant well-localized lobe epilepsy has good prognosis seizure freedom, but is linked to difficulties adults, especially when the removal on left side. Children may benefit most from surgery, because brain plasticity facilitate post-surgical reorganization, cessation promote cognitive development. However, long-term impact of this intervention children not known. We examined function 53 (25 males, 28 females) who were evaluated surgery: 42 underwent unilateral resections left, 17 right, mean age at surgery 13.8 years), 11 treated only pharmacologically. Average follow-up was 9 years (range 5–15). Post-surgical change visual verbal memory, examined. Pre- T1-weighted MRI scans analysed extract hippocampal volumes, evaluate integrity. Language lateralization indices derived functional magnetic resonance imaging. There no significant pre- postoperative decrements associated with surgery. In contrast, gains seen after right improved indicating release unoperated reduction or cessation. any structure MRI. better greater residual robustly surgical participants. Better smaller volumes pole integrity Results independent intellectual language lateralization. Our findings indicate post-surgical, hemisphere-dependent material-specific improvement functions intact lobe. outcome anatomical system, that compensatory mechanisms are constrained by amount tissue which remains operated Careful tailoring undergoing enhance outcome.