Executive dysfunction in post -amygdalo -hippocampectomized epilepsy patients.
Item
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Title
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Executive dysfunction in post -amygdalo -hippocampectomized epilepsy patients.
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Identifier
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AAI3159204
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identifier
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3159204
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Creator
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Bougakov, Dmitri.
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Contributor
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Adviser: Joan Borod
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Date
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2005
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Language
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English
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Publisher
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City University of New York.
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Subject
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Psychology, Clinical | Psychology, Cognitive
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Abstract
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There are two hypotheses regarding executive dysfunction in temporal lobe epilepsy (TLE). The nociferous hypothesis posits that epileptogenic cortex adversely affects the fronto-striatal regions that mediate executive functions, thereby resulting in performance deficits. The hippocampal hypothesis suggests that such impairments are due to direct hippocampal involvement in the mediation of executive functions and that performance deficits are directly attributable to hippocampal pathology.;The current study aimed to clarify the role of temporal lobe (TL) pathology in executive functions and to examine the impact of such variables as lesion side, gender, and modality on executive functions. Patients scheduled to undergo amygdalo-hippocampectomies to control their TLE were administered the following tests of executive functions before and one year after surgery: Wisconsin Card Sorting Test (WCST), Controlled Oral Word Association Test (COWAT), Ruff Figural Fluency Test (RFFT), and Trail Making Test (TMT). There were 42 right-handed pre- and post-amygdalo-hippocampectomized TLE patients (20 men and 22 women). Eleven women and 9 men underwent right TL (RTL) resection, and 11 women and 11 men underwent left TL (LTL) resection.;A mean z-score for each of the dependent measures in pre- and post-surgical conditions was compared to the normative sample's expected mean score of 0 via a one-sample West. Further, a repeated-measures ANOVA was conducted with gender (male vs. female) and side of involvement/resection (left vs. right) as between-subjects factors and testing time (pre- vs. post-surgery) as the within-subjects factor for each of the dependent variables.;Executive deficit was noted both pre- and post-surgically, and no significant improvement or decline was noted post-surgery, despite significant post-surgical seizure reduction. Therefore, the current study, while supporting reports of executive impairment in TLE patients, cannot provide support for either the nociferous or the hippocampal hypothesis. On the WCST, women performed more poorly than men, possibly reflecting more distributed functional brain organization. RTL patients performed more poorly on the RFFT than did LTL patients, further demonstrating that the RFFT is more dependent on right- than left-hemispheric mediation. The absence of significant deterioration in executive functions further validates TL resection as a safe treatment alternative for intractable seizures.
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Type
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dissertation
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Source
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PQT Legacy CUNY.xlsx
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degree
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Ph.D.
