Patrick Landazuri1, Jennifer Gess2, David Denney4, Bradley Folley5, Christian Lobue4, Melissa Sutcliffe6, Taylor Abel7, James Baumgartner8, Joseph Neimat9, Viktoras Palys3, Caleb Pearson1
1Neurology, University of Kansas Medical Center, 2Psychiatry, 3Neurosurgery, University of Arkansas for Medical Sciences, 4Psychiatry, University of Texas Southwestern Medical Center, 5Neurosurgery, Norton Neuroscience Institute, University of Kentucky, 6Physical Medicine and Rehabilitation, 7Neurosurgery, University of Pittsburgh Medical Center, 8Surgery, Advent Health for Children, 9Neurosurgery, University of Louisville
Objective:
To assess standard of care neuropsychology testing across multiple level IV epilepsy centers
Background:
Laser interstitial thermal therapy (LITT) is a minimally invasive epilepsy surgery option with increasing evidence regarding efficacy outcomes for seizure freedom and cognition. While post operative neuropsychology outcomes are long published for open resection, data are less available for LITT. The standard of care LAANTERN (Laser Ablation of Abnormal Neurological Tissue Using NeuroBlate System) Registry is an ongoing prospective multi-center study of LITT patients which did not include neuropsychological outcomes. Standard of care multicenter neuropsychology testing collection is complicated by differing testing protocols between centers.
Design/Methods:
Active epilepsy LITT sites within LAANTERN were identified. An electronic survey instrument that interrogated standard of care neuropsychological measures and timing of administration at each site was distributed to 17 LAANTERN sites.
Results:
Ten respondents (60% neuropsychologist, 20% epileptologist/neurologist, 20% epilepsy surgeon) at nine sites completed the survey instrument. All ten respondents regularly assess each cognitive domain. All sites perform comprehensive neuropsychology testing pre-LITT; however, no single neuropsychology test is performed across all centers. The Boston Naming, Digit Span, Grooved Pegboard, Trail Making Test A&B, and Wechler’s Memory Scale were done by nine of ten respondents. Two thirds of tests are done by >50% of respondents. Most (90%) repeat neuropsychology testing between six to 12 months following surgery.
Conclusions:
All responding LAANTERN sites perform comprehensive preoperative neuropsychological testing. Neuropsychological test selection ranges greatly between centers which can impact multicenter study design. Based on survey results, seven tests can be considered “preferred”, which include the above-mentioned tests as well as the Brief Visuospatial Memory Test-Revised and the Animal Naming Test. A multicenter study (NCT05075850) was initiated from these results to explore potential changes across cognitive domains and raw scores after LITT.