JNNP: A randomized controlled trial of the results of the naming test for pre-temporal lobe excision and selective amygdala-sea horse excision

The surgical treatment of resuspensive temporal lobe epilepsy (TLE) has been very mature, and good results have been achieved in epilepsy control, patient quality of life (QOL) and treatment costs.
, however, postoperative cognitive decline is a concern.
in the dominant brain hemisphere, 25 to 60 percent of patients developed pronunciation disorders after a pre-temporal lobe excision (ATL).
selective amygdala-hippoctomy (SAH) is an alternative method in which the neoderal cortique of the temporal lobe is retained to reduce functional damage.
no controlled studies have been conducted to prove the results of these two methods.
it is necessary to determine whether the hemorrhage in the lower cavity of the cobwebs can better retain neuropsy psychological function.
study aims to determine different clinical outcomes of SAH and ATL through randomized controlled trial (RCT) design.
a parallel single-center randomized controlled trial at a third-tier medical facility between 2012 and 2018.
trials were suspended due to a decline in recruitment rates.
has not conducted an interim analysis.
be measured using the Boston Naming Test (BNT).
the instrument, which has been shown to reliably detect postoperative pronunciation disorders, is the most commonly used naming method for patients with epilepsy.
of auditory naming, quality of life, and depressive symptoms were measured as secondary results.
patients were randomly assigned to ATL or SAH groups using a closed random model by external managers.
surgery is performed within 1 week of joining the group, and all operations are performed by the same neurosurgeon.
patients were tested before and 1 year after surgery.
the difference between the average change score of naming, quality of life and mood compared to RCIs and the smallest clinically important difference (mcid) using the T-test.
to assess the relationship between temporal lobe insclerosis (MTS) and epilepsy onset and postoperative prognosis.
all data is counted in SPSS.
34 patients agreed to participate in the trial.
in 32 random patients with complete data, the MRI ratio of SAH and ATL groups was as follows: MTS 12:11, normal 3:3, spongiform cell tumor 1:1, and dysplate amygdala 0:1.
significantly increased in the men's celiac bleeding group, but there was no significant difference in the naming change scores between men and women after surgery.
in the joint queue, preoperative visual naming was impaired (43.8±11; average ±sa standard deviation), further decreased after surgery, with 50% of patients scoring more than RCI.
19 percent of patients had significant improvements in postoperative visual naming, with 13 percent having a change score above RCI.
difference in visual naming change scores between the two groups (95% CI-4.8 to 6.4, p-0.4).
6% of SAH patients and 13% of ATL patients improved more than RCI, 56% of SAH patients and 44% of ATL patients decreased more than RCI.
in the consolidated queue, the visual naming of BNT decreased by an average of 5.9±9.1 (95% CI-9.2 to -2.6, p=0.001), and the average decline of the SAH group was -6.3±8 (95%) CI-9.9 to -2.8, p=0.0035), the average decrease in the ATL group is -5.5±9.7 (95% CI-9.6 to -0.98, p=0.002).
the visual naming of patients without MTS evidence decreased significantly (p-0.05).
, there were significant differences in postoperative auditory naming between the two groups (95% CI-9.1 to -0.9, s5, p=0.025).
using the Auditory Naming Test (ANT), 63% of patients in the SAH group improved RCI by more than 4 points and 6% in the ATL group.
group increased by 2.7±7.2 points (95% ci0.54 to 4.9, p-0.021) in auditory naming, down 13% over RCI.
quality of life improved significantly in the combined group of patients after surgery (95% CI 11.2 to 21.4, p-lt;0.001) and decreased depressive symptoms (95% CI-7.98 to -0.83, p-0.017), respectively, with clinically significant improvements in 72% and 22% of patients.
18 cases, there were no seizures for 1 year after surgery. the results of
randomized controlled trials showed no significant difference in visual naming in patients who received ATL and SAH one year after surgery (95% CI, a randomized controlled trial, showed that subcanceral bleeding produced better, significant, improved auditory naming results, but did not reduce visual naming loss).
This suggests that it is valuable to preserve the neothal cortical temporal lobe in patients with inner temporal lobe epilepsy in order to optimize auditory naming results, especially since auditory naming is a measurement method with higher ecological utility than visual naming.
while almost half of patients experienced a decline in visual naming that exceeded RCI, about one in five improved in visual naming and one in eight improved in visual naming.
MedSci Original Source: MedSci Original Copyright Notice: All text, images and audio and video materials on this website that state "Source: Mets Medicine" or "Source: MedSci Originals" are owned by Mets Medicine and are not authorized to be reproduced by any media, website or individual, and are authorized to be reproduced with the words "Source: Mets Medicine".
all reprinted articles on this website are for the purpose of transmitting more information and clearly indicate the source and author, and media or individuals who do not wish to be reproduced may contact us and we will delete them immediately.
at the same time reproduced content does not represent the position of this site.
leave a message here