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Anomia Pre-habilitation in Temporal Lobe Epilepsy Surgery: A Pilot Study
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Poster B85 in Poster Session B, Tuesday, October 24, 3:30 - 5:15 pm CEST, Espace Vieux-Port
Véronique Sabadell1,2, Christelle Zielinski3, Elodie Garnier1, Didier Scavarda4, Fabrice Bartolomei1,4, Agnès Trébuchon1,4, F.-Xavier Alario2; 1Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, 2Aix-Marseille Univ, CNRS, LPC, 3Aix Marseille Univ, Institute of Language, Communication and the Brain, 4La Timone Hospital, Assitance Publique et Hopitaux de Marseille
The surgical treatment of drug-resistant Left Temporal Lobe Epilepsy (LTLE) carries a risk of increasing cognitive deficits, notably verbal memory impairments and word-finding difficulties (anomia) that negatively impact personal, social, and occupational activities. An emerging approach in various surgery domains is to propose pre-habilitation programs to strengthen the patient's functional abilities before a surgical intervention, to help them cope better with its consequences. We explored the potential benefits of a cognitive pre-habilitation program on word-finding abilities. Fifteen LTLE patients were invited to participate in a speech and language therapy program that was adapted to the specificity of their difficulties. The program combined a psycho-educational face to face approach with daily, self-administered language training sessions driven by an online app. This language pre-habilitation was based on theoretical considerations from the fields of neuropsychology, cognitive neuroscience, and re-adaptation sciences, to select the ingredients thought to be most active for LTLE patients. The data summarizing word production performance before and after the intervention were analyzed using a generalized linear mixed effects model. We found a significant effect of the interaction between the factors “time” (i.e., rehabilitation program weeks) and “training” (i.e., trained vs untrained items) on the rate of correct responses. Further analysis confirmed a significant effect from the beginning of the pre-habilitation phase. The effect was limited to trained items, suggesting the specificity of the intervention. We also observed encouraging results about the protective effect of the program on naming performance after LTLE surgery. Namely, the trained items showed a slight and non-significant performance increase after surgery compared to baseline, whereas untrained items showed a significant decline in the same comparison. We conclude that untrained items, despite their higher accuracy in the baseline phase, were less protected from post-surgical decline than trained items. Looking forward, we hypothesize that brain plasticity could have been induced by the pre-habilitation program; a reinforcement of the functional networks may have increased the cognitive reserve of the patients when faced with the surgical procedure. Our study lays the groundwork for more detailed and powerful examinations of the protective effect of pre-habilitation on language skills in LTLE.
Topic Areas: Speech-Language Treatment, Language Production