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Title

The selective amobarbital test in the anterior choroidal artery: perfusion pattern assessed by intraarterial SPECT and prediction of postoperative verbal memory

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Published in Epilepsy & Behavior. 2008, vol. 12, no. 3, p. 445-55
Abstract To screen for patients at risk for memory decline after temporal lobe epilepsy (TLE) surgery, selective amobarbital procedures, such as injection into the anterior choroidal artery (ACA-IAT), are sometimes used. We investigated the extent of the territory affected during ACA-IAT and its predictive value with respect to postoperative memory. Seventeen patients with TLE underwent ACA-IAT. In 9 of 17 patients, intraarterial SPECT co-registrated to MRI allowed delineation of amobarbital-perfused structures. Another subgroup of 9 of 17 patients underwent anterior temporal lobectomy. Verbal memory was tested pre- and postoperatively and during ACA-IAT. Major variations in the ACA-IAT perfusion pattern occurred and were not correlated with the verbal memory scores during ACA-IAT. Postoperatively, no patient experienced a severe verbal memory decline, but individual postoperative performance was not correlated with results during ACA-IAT. Our study suggests that ACA-IAT can be used to screen for severe postoperative amnesia in inconclusive cases, but cannot predict individual outcome, even when the perfusion pattern is taken into account.
Keywords AdolescentAdultAmobarbital/administration & dosageAnterior Temporal Lobectomy/methodsCarotid Artery InternalElectroencephalographyEpilepsyTemporal Lobe/physiopathology/radionuclide imaging/surgeryEvaluation Studies as TopicFemaleFunctional Laterality/drug effects/physiologyHumansHypnotics and Sedatives/administration & dosageMagnetic Resonance ImagingMaleMemory/drug effects/physiologyMiddle AgedNeuropsychological TestsPostoperative PeriodPredictive Value of TestsRetrospective StudiesTomography Emission-Computed Single-PhotonVerbal Learning/drug effects/physiology
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PMID: 18248852
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Research groups Epilepsie et Chirurgie (149)
Neuropsychologie clinique appliquée et neurosciences cognitives (703)
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VULLIEMOZ, Serge et al. The selective amobarbital test in the anterior choroidal artery: perfusion pattern assessed by intraarterial SPECT and prediction of postoperative verbal memory. In: Epilepsy & Behavior, 2008, vol. 12, n° 3, p. 445-55. https://archive-ouverte.unige.ch/unige:860

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Deposited on : 2009-02-19

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