Individual memory change after anterior temporal lobectomy: A base rate analysis using regression-based outcome methodology
Individual memory change after anterior temporal lobectomy: A base rate analysis using regression-based outcome methodology
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DOI：
10.1111/j.1528-1157.1998.tb01293.x
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发表时间：
1998-10-01
期刊：
影响因子：
5.6
通讯作者：
Kuzniecky, R
中科院分区：
文献类型：
--
作者：
Martin, RC;Sawrie, SM;Kuzniecky, R
目的：使用新开发的基于回归的结果方法来描述前颞叶切除术（ATL）后言语和视觉记忆测量的基本速率变化模式，该方法解释了练习和回归平均值的影响，并评论基线记忆测量的预测效用术后记忆结果。方法：在一组左（n = 53）和右（n = 48）ATL患者中，使用基于回归的变化规范对记忆变化进行操作化。所有患者进行测试的情节口头（散文回忆，列表学习）和视觉（数字再现）的记忆，语义记忆ATL.Results：ATL患者显示了广泛的记忆结果在口头和视觉记忆域。25-50%的左ATL患者在言语语义和情景记忆任务上表现出显着的性能下降，而三分之一的右ATL患者在即时和延迟的情景散文回忆中表现出显着的下降。在另外三分之一的右ATL患者中，延迟散文回忆的表现有显着改善。在即刻和延迟视觉记忆中，两个ATL组之间的基础速率变化相似。大约四分之一的患者在手术后的视觉记忆任务中表现出有临床意义的损失。术前记忆的措施和非标准化的变化分数之间的关系被削弱或逆转使用标准化的记忆outcome techniques.Conclusions：我们的研究结果表明，大量的组变异的ATL患者的记忆结果。这些结果扩展了以前的研究，将已知的实践效果和回归的平均值时，解决癫痫手术后有意义的神经心理学变化。我们的研究结果还表明，未来的神经心理学结果研究在得出预测性结论之前，应该采取措施控制回归平均值。
Purpose: To characterize patterns of base rate change on measures of verbal and visual memory after anterior temporal lobectomy (ATL) using a newly developed regression-based outcome methodology that accounts for effects of practice and regression towards the mean, and to comment on the predictive utility of baseline memory measures on postoperative memory outcome.Methods: Memory change was operationalized using regression-based change norms in a group of left (n = 53) and right (n = 48) ATL patients. All patients were administered tests of episodic verbal (prose recall, list learning) and visual (figure reproduction) memory, and semantic memory before and after ATL.Results: ATL patients displayed a wide range of memory outcome across verbal and visual memory domains. Significant performance declines were noted for 25-50% of left ATL patients on verbal semantic and episodic memory tasks, while one-third of right ATL patients displayed significant declines in immediate and delayed episodic prose recall. Significant performance improvement was noted in an additional one-third of right ATL patients on delayed prose recall. Base rate change was similar between the two ATL groups across immediate and delayed visual memory. Approximately one-fourth of all patients displayed clinically meaningful losses on the visual memory task following surgery. Robust relationships between preoperative memory measures and nonstandardized change scores were attenuated or reversed using standardized memory outcome techniques.Conclusions: Our results demonstrated substantial group variability in memory outcome for ATL patients. These results extend previous research by incorporating known effects of practice and regression to the mean when addressing meaningful neuropsychological change following epilepsy surgery. Our findings also suggest that future neuropsychological outcome studies should take steps towards controlling for regression-to-the-mean before drawing predictive conclusions.