Abstract Details

Title Final Neuropsychological Outcomes Following Epilepsy Laser Interstitial Thermal Therapy: A Multicenter Cohort

Topic Epilepsy/Clinical Neurophysiology (EEG)

Presentation(s) P7 - Poster Session 7 (5:00 PM-6:00 PM)

Poster/Presentation
Number 9-003

Objective To assess post operative cognitive changes following epilepsy laser ablation

Background Laser interstitial thermal therapy (LITT) is a minimally invasive neurosurgical tool used to ablate epileptic foci, with positive evidence for post-operative seizure freedom and cognition. Still, post-operative LITT neuropsychological outcomes are less known. The LAANTERN (Laser Ablation of Abnormal Neurological Tissue Using Robotic NeuroBlate system) Registry is a prospective multi-center study. A sub-study in epilepsy, PatiEnt Neuropsychological outcomeS After laseR ablation (PENSAR), captured cognitive outcomes for select LAANTERN sites.

Design/Methods Select pre- and post-operative neuropsychological test (NT) outcomes were obtained. Outcomes were stratified by epilepsy localization. Changes from pre- to post-operative NT were evaluated utilizing raw and demographically corrected T-scores. A post-operative change was defined as >1 standard deviation from pre-operative testing. Corrected scores were obtained using normative samples from the Calibrated Neuropsychological Normative System (CNNS, PAR Inc.)

Results Forty-seven patients (27 male) from seven centers completed the study. Mesial temporal lobe LITT (N=40) was the most common procedure. There were no significant post operative raw score changes. For corrected scores, verbal memory was stable for all post-LITT localizations. Processing speed and visual memory declines were seen post left-temporal LITT (35.7% and 25%, respectively) as well as right-temporal LITT (42.9% and 35.7%, respectively). Extra-temporal LITT patients were more likely to experience decline involving processing speed and executive functioning (66.7% and 50% respectively).

Conclusions Cognitive functioning was largely unchanged following LITT, notably including verbal memory. Non-significant declines were seen in processing speed and visual memory following temporal lobe LITT and executive functioning following extra-temporal LITT. Processing speed also was impacted post-LITT. These findings suggest LITT is a safe alternative in terms of cognitive functioning for those considering epilepsy surgery. Although the lack of post-LITT significant decline is promising, direct comparison to open resection would further elucidate relative cognitive risk following LITT.

Authors/Disclosures
Patrick Landazuri, MD, FAAN (University of Kansas - Department of Neurology - Comprehensive Epilepsy Center) PRESENTER	Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neuropace. Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Neuropace. Dr. Landazuri has received personal compensation in the range of $500-$4,999 for serving as an Expert Witness for Federal Public Defender - District of Kansas. Dr. Landazuri has received publishing royalties from a publication relating to health care.
Jennifer Gess, PhD	Dr. Gess has nothing to disclose.
David Denney, PhD	Dr. Denney has nothing to disclose.
Bradley Folley (Norton Neuroscience Institute)	No disclosure on file
Christian LoBue, PhD	The institution of Dr. LoBue has received research support from Department of Defense. The institution of Dr. LoBue has received research support from NIH.
Melissa Sutcliffe, PhD	Dr. Sutcliffe has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for National Academy of Neuropsychology. Dr. Sutcliffe has received personal compensation in the range of $5,000-$9,999 for serving as an Expert Witness for Miller, Dawson, Sigal, & Ward. The institution of Dr. Sutcliffe has received research support from PCORI. The institution of Dr. Sutcliffe has received research support from NICHD. The institution of Dr. Sutcliffe has received research support from NINDS.
Taylor Abel, MD	Dr. Abel has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Monteris Medical .
James Baumgartner (Advent Health for Children)	No disclosure on file
Joseph S. Neimat, MD	Dr. Neimat has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for MonterisInc. .
Viktoras Palys, MD, FAANS, FCNS	Dr. Palys has nothing to disclose.
Caleb Pearson, PhD (University of Kansas Medical Center)	Dr. Pearson has received publishing royalties from a publication relating to health care.

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