Abstract Details

Title Demographic and Neuropsychological Predictors of Declining Employment Following Standard Anterior Temporal Lobectomy for the Treatment of Focal Epilepsy

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P1 - Poster Session 1 (12:00 PM-1:00 PM)

Poster/Presentation
Number 12-009

Objective To find preoperative demographic and neuropsychological predictors of declining employment following Anterior Temporal Lobectomy (ATL) for refractory focal epilepsy.

Background ATL is a common procedure for refractory focal epilepsy. There are no known predictors of becoming unemployed after surgery other than the persistence of seizures, and it is commonly assumed that dominant temporal resection poses greater risk of losing work. The purpose of this project is to evaluate this assumption and to identify demographic and neuropsychological factors that may predict declining employment following ATL.

Design/Methods Retrospective analysis of preoperatively employed right-handed patients who had standard ATL; had preoperative neuropsychological evaluation including Boston Naming Test (BNT), California Verbal Learning Test-II (CVLT-II) delayed free recall, Beck Depression Inventory (BDI), and estimated premorbid intellectual functioning (IQ); and follow-up at two years. Statistical analyses: ??2 and multivariate logistic regression.

Results The sample included 102 patients (56% women, 48% left ATL), ages 15-69 (M=40.9, SD=12.5). Rates of declining employment did not differ by side of ATL (right: 26% declining employment; left: 24%; ??2(1,N=102)=0.05, p=0.82). In a demographic multivariate logistic regression model, female sex significantly predicted declining employment (OR=2.71, 95% CI=1.01-7.29, p=0.048), while age (p=0.30) and education did not (p=0.30). In a separate neuropsychological logistic regression model, baseline estimated premorbid IQ (p=0.21), BNT (p=0.67), CVLT-II (p=0.12), and BDI (p=0.67) did not predict declining employment.

Conclusions Dominant temporal resection is not associated with greater postoperative unemployment, and preoperative cognitive performance does not predict declining employment following ATL. Female gender is associated with markedly increased risk of becoming unemployed after ATL, for unclear reasons requiring additional investigation.

Authors/Disclosures
Patrick W. Kerns, MD, PhD PRESENTER	No disclosure on file
Kathryn Devlin	No disclosure on file
	No disclosure on file
Maromi Nei, MD	No disclosure on file
	No disclosure on file
	No disclosure on file
Michael R. Sperling, MD, FAAN (Thomas Jefferson University)	Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurelis. The institution of Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Medtronic. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for UCB Pharma. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Medscape. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for International Medical Press. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Projects for Knowledge. The institution of Dr. Sperling has received research support from SK Life Science. The institution of Dr. Sperling has received research support from UCB Pharma . The institution of Dr. Sperling has received research support from Takeda. The institution of Dr. Sperling has received research support from Neurelis. The institution of Dr. Sperling has received research support from Engage Therapeutics . The institution of Dr. Sperling has received research support from Medtronic. The institution of Dr. Sperling has received research support from Cavion. The institution of Dr. Sperling has received research support from Xenon Pharma. The institution of Dr. Sperling has received research support from Cerevel. The institution of Dr. Sperling has received research support from National Institutes of Health . The institution of Dr. Sperling has received research support from DARPA. Dr. Sperling has received publishing royalties from a publication relating to health care. Dr. Sperling has received publishing royalties from a publication relating to health care. Dr. Sperling has received personal compensation in the range of $500-$4,999 for serving as a Vice President with Epilepsy Consortium .