Empirical techniques for determining the reliability, magnitude, and pattern of neuropsychological change after epilepsy surgery.

Abstract

PURPOSE:

We assessed test-retest neuropsychological performance in patients with complex partial seizures to derive reliable change indices (RCIs) and regression-based norms for change, indices that may be helpful in assessing cognitive outcome after anterior temporal lobectomy.

METHODS:

Forty patients with complex partial seizures (CPS) who did not undergo epilepsy surgery were administered a comprehensive neuropsychological battery on two occasions. Their test-retest data were used to compute both RCIs and regression-based norms for change for each neuropsychological index. RCIs corrected for practice effects provide a confidence interval (CI) indicating the degree of performance change required to exceed the variability attributable to sources of error (e.g., practice, test-retest reliability). Regression-based norms for change also correct for several sources of measurement error and examine observed versus expected test-retest changes on a common metric, thereby facilitating determination of the degree and relative magnitude of change across cognitive domains.

RESULTS:

Mean changes in test-retest performance were generally modest, but were evident across several test measures. Our data indicate a considerable degree of individual variability in test-retest performance.

CONCLUSIONS:

RCIs and regression-based norms are complementary indexes and can be particularly useful in examining the test-retest performance of individual patients who undergo epilepsy surgery as well as in the more general investigation of cognitive outcome after epilepsy surgery.

• Authors: B P Hermann, M Seidenberg, J Schoenfeld, J Peterson, C Leveroni, A R Wyler
• Journal: Epilepsia (Epilepsia) Vol. 37 Issue 10 Pg. 942-50 (Oct 1996) ISSN: 0013-9580 [Print] United States
• PMID: 8822692 (Publication Type: Case Reports, Journal Article, Research Support, U.S. Gov't, P.H.S.)

Topics

• Adult
• Age of Onset
• Cognition
• Cognition Disorders (diagnosis, psychology)
• Confidence Intervals
• Epilepsy, Complex Partial (diagnosis, psychology, surgery)
• Female
• Functional Laterality
• Humans
• Male
• Middle Aged
• Neuropsychological Tests (statistics & numerical data)
• Postoperative Complications (diagnosis, psychology)
• Psychomotor Performance
• Regression Analysis
• Reproducibility of Results
• Sex Factors
• Temporal Lobe (surgery)
• Treatment Outcome
• Wechsler Scales