Objective

Frontal lobectomy is often used as a surgical treatment for frontal lobe epilepsy, especially when a large epileptogenic zone in the frontal lobe is inferred from preoperative evaluation. The frontal lobe is important for cognitive functions such as executive functions and verbal fluency, but the neuropsychological outcome after a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex has not been studied thoroughly. In the present study, we evaluated neuropsychological outcomes after patients with frontal lobe epilepsy received a frontal or prefrontal lobectomy.

Methods

We retrospectively reviewed the data of patients with frontal lobe epilepsy who underwent a frontal or prefrontal lobectomy that includes both the dorsolateral prefrontal cortex and ventral prefrontal cortex at 16 years or older from October 2004 to December 2014, with a minimum postoperative follow-up of 24 months. We analyzed and compared neuropsychological outcomes, including executive functions, verbal fluency, intelligence, and memory, before and after the operation.

Results

Eighteen patients were 16 years or older and underwent pre- and postoperative (2 years after the operation) neuropsychological evaluations. Patients showed significant deterioration only on the Benton Visual Retention Test. Performance on tests of frontal lobe functions, such as executive function and verbal fluency, showed no significant deterioration.

Conclusions

Overall cognitive performance, including functions widely thought to depend on the frontal lobe, is stable after a frontal or prefrontal lobectomy to treat frontal lobe epilepsy.

中文翻译：

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额叶切除术治疗顽固性癫痫后的神经心理学结果

客观的

额叶切除术常被用作额叶癫痫的手术治疗，特别是当从术前评估推断出额叶中有大的致痫区时。额叶对于执行功能和语言流畅性等认知功能很重要，但包括背外侧前额叶皮层和腹侧前额叶皮层的额叶或前额叶切除术后的神经心理学结果尚未得到彻底研究。在本研究中，我们评估了额叶癫痫患者接受额叶或前额叶切除术后的神经心理学结果。

方法

我们回顾性地回顾了 2004 年 10 月至 2014 年 12 月期间接受包括背外侧前额叶皮层和腹侧前额叶皮层在内的额叶或前额叶切除术的额叶癫痫患者的数据，这些患者的术后随访时间至少为 24个月。我们分析和比较了手术前后的神经心理学结果，包括执行功能、语言流畅性、智力和记忆力。

结果

18 名患者年龄在 16 岁或以上，并接受了术前和术后（手术后 2 年）神经心理学评估。患者仅在本顿视觉保留测试中表现出显着恶化。额叶功能测试的表现，如执行功能和语言流畅性，没有显着恶化。

结论

在接受额叶或前额叶切除术治疗额叶癫痫后，整体认知表现，包括广泛认为依赖于额叶的功能，是稳定的。