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Graded extent of hippocampal resection is related to neuropsychological outcomes in temporal lobe epilepsy surgery.

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Title: Graded extent of hippocampal resection is related to neuropsychological outcomes in temporal lobe epilepsy surgery.
Authors: Reedy, Eliza M. (AUTHOR), Robinson, Emma (AUTHOR), Aung, Thandar (AUTHOR), Liégeois‐Chauvel, Catherine (AUTHOR), Carns, Danielle R. (AUTHOR), Sherry, Natalie (AUTHOR), Henry, Luke C. (AUTHOR), Mahon, Bradford Z. (AUTHOR), Mallela, Arka N. (AUTHOR), Gonzalez‐Martinez, Jorge A. (AUTHOR)
Source: Epilepsia (Series 4). Jun2026, Vol. 67 Issue 6, p2755-2767. 13p.
Subjects: Temporal lobectomy, Epilepsy surgery, Visual memory, Memory testing, Cognitive ability, Seizures (Medicine), University of Pittsburgh Medical Center (Company), Verbal memory
Abstract: Objective: Surgical resection for epilepsy seeks to maximize seizure freedom while minimizing new neurocognitive impairments. Tailored resections guided by anatomoelectroclinical (AEC) hypotheses offer the possibility of sparing parts of the hippocampus. The relationship between the extent of hippocampal resection and postoperative neurocognitive outcomes in this context has not been studied and has important implications for clinical practice. We test this relationship in a series of left and right tailored anterior temporal lobectomy (ATL) surgeries. Methods: We conducted a retrospective analysis of 34 adult patients with drug‐resistant temporal lobe epilepsy (18 left, 16 right) who underwent tailored ATL based on individualized AEC hypotheses at the University of Pittsburgh Medical Center. All patients completed standardized pre‐ and postoperative neuropsychological testing, and 85.3% underwent preoperative stereoelectroencephalography to guide resection. Surgical extent was tailored through a multidisciplinary process integrating AEC correlations and intraoperative electrophysiology. Preoperative and postoperative hippocampal volumes were measured and correlated with changes in verbal and visual memory, as well as language performance. Results: Greater extent of resection of the left hippocampus was significantly associated with worse postoperative outcomes in both verbal and visual recall. Extent of resection of the right hippocampus was not related to reductions in performance across any domain, with some indication of improvements in performance after right ATL surgery at the group level. Seizure outcomes (66.6% Engel I at 2 years) were consistent with the existing literature and did not vary with hippocampal resection extent. Significance: These findings highlight the critical role of the left hippocampus in supporting both verbal and visual memory and underscore the importance of preserving hippocampal tissue during left ATL when feasible. Our results support the utility of AEC‐guided tailored resections as a strategy to balance seizure control with cognitive preservation. [ABSTRACT FROM AUTHOR]
Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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PubType: Academic Journal
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  Data: Graded extent of hippocampal resection is related to neuropsychological outcomes in temporal lobe epilepsy surgery.
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  Data: <searchLink fieldCode="AR" term="%22Reedy%2C+Eliza+M%2E%22">Reedy, Eliza M.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Robinson%2C+Emma%22">Robinson, Emma</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Aung%2C+Thandar%22">Aung, Thandar</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Liégeois‐Chauvel%2C+Catherine%22">Liégeois‐Chauvel, Catherine</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Carns%2C+Danielle+R%2E%22">Carns, Danielle R.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Sherry%2C+Natalie%22">Sherry, Natalie</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Henry%2C+Luke+C%2E%22">Henry, Luke C.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mahon%2C+Bradford+Z%2E%22">Mahon, Bradford Z.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Mallela%2C+Arka+N%2E%22">Mallela, Arka N.</searchLink> (AUTHOR)<br /><searchLink fieldCode="AR" term="%22Gonzalez‐Martinez%2C+Jorge+A%2E%22">Gonzalez‐Martinez, Jorge A.</searchLink> (AUTHOR)
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  Data: <searchLink fieldCode="JN" term="%22Epilepsia+%28Series+4%29%22">Epilepsia (Series 4)</searchLink>. Jun2026, Vol. 67 Issue 6, p2755-2767. 13p.
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  Data: <searchLink fieldCode="DE" term="%22Temporal+lobectomy%22">Temporal lobectomy</searchLink><br /><searchLink fieldCode="DE" term="%22Epilepsy+surgery%22">Epilepsy surgery</searchLink><br /><searchLink fieldCode="DE" term="%22Visual+memory%22">Visual memory</searchLink><br /><searchLink fieldCode="DE" term="%22Memory+testing%22">Memory testing</searchLink><br /><searchLink fieldCode="DE" term="%22Cognitive+ability%22">Cognitive ability</searchLink><br /><searchLink fieldCode="DE" term="%22Seizures+%28Medicine%29%22">Seizures (Medicine)</searchLink><br /><searchLink fieldCode="DE" term="%22University+of+Pittsburgh+Medical+Center+%28Company%29%22">University of Pittsburgh Medical Center (Company)</searchLink><br /><searchLink fieldCode="DE" term="%22Verbal+memory%22">Verbal memory</searchLink>
– Name: Abstract
  Label: Abstract
  Group: Ab
  Data: Objective: Surgical resection for epilepsy seeks to maximize seizure freedom while minimizing new neurocognitive impairments. Tailored resections guided by anatomoelectroclinical (AEC) hypotheses offer the possibility of sparing parts of the hippocampus. The relationship between the extent of hippocampal resection and postoperative neurocognitive outcomes in this context has not been studied and has important implications for clinical practice. We test this relationship in a series of left and right tailored anterior temporal lobectomy (ATL) surgeries. Methods: We conducted a retrospective analysis of 34 adult patients with drug‐resistant temporal lobe epilepsy (18 left, 16 right) who underwent tailored ATL based on individualized AEC hypotheses at the University of Pittsburgh Medical Center. All patients completed standardized pre‐ and postoperative neuropsychological testing, and 85.3% underwent preoperative stereoelectroencephalography to guide resection. Surgical extent was tailored through a multidisciplinary process integrating AEC correlations and intraoperative electrophysiology. Preoperative and postoperative hippocampal volumes were measured and correlated with changes in verbal and visual memory, as well as language performance. Results: Greater extent of resection of the left hippocampus was significantly associated with worse postoperative outcomes in both verbal and visual recall. Extent of resection of the right hippocampus was not related to reductions in performance across any domain, with some indication of improvements in performance after right ATL surgery at the group level. Seizure outcomes (66.6% Engel I at 2 years) were consistent with the existing literature and did not vary with hippocampal resection extent. Significance: These findings highlight the critical role of the left hippocampus in supporting both verbal and visual memory and underscore the importance of preserving hippocampal tissue during left ATL when feasible. Our results support the utility of AEC‐guided tailored resections as a strategy to balance seizure control with cognitive preservation. [ABSTRACT FROM AUTHOR]
– Name: AbstractSuppliedCopyright
  Label:
  Group: Ab
  Data: <i>Copyright of Epilepsia (Series 4) is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=194752806
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      – Type: doi
        Value: 10.1002/epi.70162
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      – Code: eng
        Text: English
    PhysicalDescription:
      Pagination:
        PageCount: 13
        StartPage: 2755
    Subjects:
      – SubjectFull: Temporal lobectomy
        Type: general
      – SubjectFull: Epilepsy surgery
        Type: general
      – SubjectFull: Visual memory
        Type: general
      – SubjectFull: Memory testing
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      – SubjectFull: Cognitive ability
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      – SubjectFull: Seizures (Medicine)
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      – SubjectFull: University of Pittsburgh Medical Center (Company)
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      – SubjectFull: Verbal memory
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      – TitleFull: Graded extent of hippocampal resection is related to neuropsychological outcomes in temporal lobe epilepsy surgery.
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              M: 06
              Text: Jun2026
              Type: published
              Y: 2026
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