Hostname: page-component-586b7cd67f-g8jcs Total loading time: 0 Render date: 2024-11-21T15:21:09.007Z Has data issue: false hasContentIssue false
  • English
  • Français

Reexamining the effects of epilepsy surgery on IQ in children: Use of regression-based change scores

Published online by Cambridge University Press:  27 August 2003

Elisabeth M.S. Sherman ,
Daniel J. Slick ,
Mary B. Connolly ,
Paul Steinbok ,
Roy Martin ,
Esther Strauss ,
Gordon J. Chelune  and
Kevin Farrell
Elisabeth M.S. Sherman*
Affiliation:
Department of Psychology, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
Daniel J. Slick
Affiliation:
Department of Psychology, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada
Mary B. Connolly
Affiliation:
Division of Neurology, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
Paul Steinbok
Affiliation:
Division of Neurosurgery, Section of Surgery, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada Division of Neurosurgery, Department of Surgery, University of British Columbia, Vancouver, British Columbia, Canada
Roy Martin
Affiliation:
University of Alabama at Birmingham Epilepsy Center, Birmingham, Alabama
Esther Strauss
Affiliation:
Department of Psychology, University of Victoria, Victoria, British Columbia, Canada
Gordon J. Chelune
Affiliation:
Mellen Center, Cleveland Clinic, Cleveland, Ohio
Kevin Farrell
Affiliation:
Division of Neurology, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada Division of Neurology, University of British Columbia, Vancouver, British Columbia, Canada
*
Reprint requests to: E.M.S. Sherman, Ph.D., Department of Psychology, British Columbia's Children's Hospital, K3-122, 4480 Oak Street, Vancouver, British Columbia V6H 3V4, Canada. E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Prior studies have found no adverse effects of pediatric epilepsy surgery on IQ. However, empirical techniques such as regression models, designed to account for confounding factors such as practice effects and test–retest reliability and able to provide a standardized method for evaluating outcome, have not been used in studying change after pediatric epilepsy. The goal of this study was to demonstrate the regression technique while empirically measuring the effect of epilepsy surgery on IQ in a group of pediatric patients. Predictors of retest IQ (e.g., baseline IQ, retest interval, demographics, epilepsy severity) were evaluated in a control group with intractable seizures (N = 23) assessed twice with the WISC–III. The resulting equation was used to evaluate IQ changes in a second group of children who underwent epilepsy surgery (N = 22). In controls, baseline IQ was a strong predictor of retest IQ. Number of AEDs was inversely related to retest IQ. Based on the control regression, four children (18%) in the surgical sample obtained significantly higher than expected postsurgical IQ scores and one child (5%) obtained a lower than expected IQ score. This study demonstrates that regression-based techniques yield informative estimates on outcome and may be an improvement over prior methods of measuring change after pediatric epilepsy surgery. (JINS, 2003, 9, 879–886.)

Keywords

EpilepsyIQRegressionChangeSurgeryOutcomePediatric
Type
Research Article
Information
Journal of the International Neuropsychological Society , Volume 9 , Issue 6 , September 2003 , pp. 879 - 886
Copyright
Copyright © The International Neuropsychological Society 2003

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, C.B.T., Beardsworth, E.D., Oxbury, S.M., Oxbury, J.M., & Fenwick, P.B.C. (1990). Temporal lobectomy in 44 children: Outcome and neuropsychological follow-up. Journal of Epilepsy, 3 (Suppl.), 157–168.Google Scholar
Aldenkamp, A.P. (2001). Effects of antiepileptic drugs on cognition. Epilepsia, 42 (Suppl. 1), 46–49.10.1046/j.1528-1157.2001.00516.xCrossRefGoogle ScholarPubMed
Bjornaes, H., Stabell, K., Heriksen, O., & Loyning, Y. (2001). Intelligence in pediatric and adult patients with refractory epileptic seizures: A longitudinal study [Abstract]. Epilepsia, 42 (Suppl. 7), 159.Google Scholar
Camfield, P.R. (1997). Recurrent seizures in the developing brain are not harmful. Epilepsia, 38, 735–737.10.1111/j.1528-1157.1997.tb01245.xCrossRefGoogle Scholar
Caplan, R., Guthrie, D., Shields, W.D., Peacock, W.J., Vinters, H.V., & Yudovin, S. (1993). Communication deficits in children undergoing temporal lobectomy. Journal of the American Academy of Child and Adolescent Psychiatry, 32, 604–611.10.1097/00004583-199305000-00017CrossRefGoogle ScholarPubMed
Chelune, G.J., Naugle, R.I., Luders, H., Sedlak, J., & Awad, I.A. (1993). Individual change after epilepsy surgery: Practice effects and base rate information. Neuropsychology, 1, 41–52.CrossRefGoogle Scholar
Crawford, J.R. & Howell, D.C. (1998). Regression equations in clinical neuropsychology: An evaluation of statistical methods for comparing predicted and obtained scores. Journal of Clinical and Experimental Neuropsychology, 20, 755–762.10.1076/jcen.20.5.755.1132CrossRefGoogle ScholarPubMed
Dikmen, S.S., Heaton, R.K., Grant, I., & Temkin, N.R. (1999). Test–retest reliability and practice effects of expanded Halstead–Reitan Neuropsychological Test Battery. Journal of the International Neuropsychological Society, 5, 346–356.10.1017/S1355617799544056CrossRefGoogle ScholarPubMed
Dodrill, C.B. & Matthews, C.G. (1992). The role of neuropsychology in the assessment and treatment of persons with epilepsy. American Psychologist, 47, 1139–1142.10.1037/0003-066X.47.9.1139CrossRefGoogle ScholarPubMed
Engel, J. Jr., Van Ness, P.C., Rasmussen, T.B., & Ojemann, L.M. (1993). Outcome with respect to epileptic seizures. In Engel, J. (Ed.), Surgical treatment of the epilepsies (2nd ed.), pp. 609–621. New York: Raven Press.Google ScholarPubMed
Gilliam, F., Wyllie, E., Kashden, J., Faught, E., Kotagal, P., Bebin, M., Wise, M., Comair, Y., Morawetz, R., & Kuzniecky, R. (1997). Epilepsy surgery outcome: Comprehensive assessment in children. Neurology, 48, 1368–1374.10.1212/WNL.48.5.1368CrossRefGoogle ScholarPubMed
Heaton, R.K., Temkin, N., Dikmen, S., Avitable, N., Taylor, M.J., Marcotte, T.D., & Grant, I. (2001). Detecting change: A comparison of three neuropsychological methods, using normal and clinical samples. Archives of Clinical Neuropsychology, 16, 75–91.10.1093/arclin/16.1.75CrossRefGoogle ScholarPubMed
Hermann, B.P., Wyler, A.R., VanderZwagg, R., LeBailly, R.K., Whitman, S., Somes, G., & Ward, J. (1991). Predictors of neuropsychological change following anterior temporal lobectomy: Role of regression toward the mean. Journal of Epilepsy, 4, 139–148.10.1016/S0896-6974(05)80039-8CrossRefGoogle Scholar
Hermann, B.P., Seidenberg, M., Schoenfeld, J., Peterson, J., Leveroni, C., & Wyler, A.R. (1996). Empirical techniques for determining the reliability, magnitude, and pattern of neuropsychological change following epilepsy surgery. Epilepsia, 37, 942–950.CrossRefGoogle Scholar
Hermann, B.P., Seidenberg, M., Bell, B., Rutecki, P., Sheth, R., Jones, J., & Wendt, G. (2001). The neurodevelopmental impact of childhood onset temporal lobe epilepsy on brain structure and cognition. [Abstract]. Epilepsia, 42 (Suppl. 7), 151–152.Google Scholar
Lindsay, J. (1990). Hemispherectomy outcome. Journal of Epilepsy, 3 (Suppl. 1), 253–256.Google Scholar
McSweeney, A.J., Naugle, R.I., Chelune, G.J., & Luders, H. (1993). “T-scores for change”: An illustration of a regression approach to depicting change in clinical neuropsychology. The Clinical Neuropsychologist, 6, 32–42.Google Scholar
Meyer, F.B., Marsh, R., Law, S.E., & Sharborough, F.W. (1986). Temporal lobectomy in children with epilepsy. Journal of Neurosurgery, 64, 371–376.CrossRefGoogle ScholarPubMed
Miranda, C. & Smith, M.L. (2001). Predictors of intelligence after temporal lobectomy in children with epilepsy. Epilepsy and Behavior, 2, 13–19.10.1006/ebeh.2000.0142CrossRefGoogle ScholarPubMed
Oxbury, S., Zwailla, Z., Adams, C., Middleton, J., & Oxbury, J. (1995). Hemispherectomy in childhood: Serial neuropsychological follow-up and prolonged improvement. Epilepsia, 36 (Suppl. 3), S24.Google Scholar
Pedhazur, E. (1997). Multiple regression in behavioral research. New York: Harcourt Brace.Google Scholar
Sawrie, S.M., Chelune, G.J., Naugle, R.I., & Luders, H.O. (1996). Empirical methods for assessing meaningful neuropsychological change following epilepsy surgery. Journal of the International Neuropsychological Society, 2, 556–564.10.1017/S1355617700001739CrossRefGoogle ScholarPubMed
Szabo, C.A., Wyllie, E., Stanford, L.D., Geckler, C., Kotagal, P., Comair, Y.G., & Thornton, A. (1998). Neuropsychological effect of temporal lobe resection in preadolescent children with epilepsy. Epilepsia, 39, 814–819.CrossRefGoogle ScholarPubMed
Tinuper, P., Andermann, F., Villemure, J., Rasmussen, T., & Quesney, L. (1988). Functional hemispherectomy for treatment of epilepsy associated with hemiplegia: Rationale, indications, results and comparison with callosotomy. Annals of Neurology, 24, 27–34.CrossRefGoogle ScholarPubMed
Wechsler, D. (1991). Wechsler Intelligence Scale for Children–Third Edition. San Antonio, Texas: The Psychological Corporation.Google Scholar
Westerveld, M., Sass, K.J., Chelune, G., Hermann, B., Barr, W., Loring, D., Strauss, E., Trennery, M., Perrine, K., & Spencer, D.D. (2000). Temporal lobectomy in children: Cognitive outcome. Journal of Neurosurgery, 92, 24–30.10.3171/jns.2000.92.1.0024CrossRefGoogle ScholarPubMed