We investigated neuropsychological outcome in patients with pharmacoresistant pediatric-onset epilepsy caused by focal cortical dysplasia (FCD), who underwent frontal lobe resection during adolescence and young adulthood. Twenty-seven patients were studied, comprising 15 patients who underwent language-dominant side resection (LDR) and 12 patients who had languagenondominant side resection (n-LDR). We evaluated intelligence (language function, arithmetic ability, working memory, processing speed, visuo-spatial reasoning), executive function, and memory in these patients before and two years after resection surgery. We analyzed the relationship between neuropsychological outcome and resected regions (side of language dominance and location). Although 75% of the patients showed improvement or no change in individual neuropsychological tests after surgical intervention, 25% showed decline. The cognitive tests that showed improvement or decline varied between LDR and n-LDR. In patients who had LDR, decline was observed in Vocabulary and Phonemic Fluency (both 5/15 patients), especially after resection of ventrolateral frontal cortex, and improvement was observed in WCST-Category (7/14 patients), Block Design (6/15 patients), Digit Symbol (4/15 patients), and Delayed Recall (3/9 patients). In patients who underwent n-LDR, improvement was observed in Vocabulary (3/12 patients), but decline was observed in Block Design (2/9 patients), and WCST-Category (2/9 patients) after resection of dorsolateral frontal cortex; and Arithmetic (3/10 patients) declined after resection of dorsolateral frontal cortex or ventrolateral frontal cortex. General Memory (3/8 patients), Visual Memory (3/8 patients), Delayed Recall (3/8 patients), Verbal Memory (2/9 patients), and Digit Symbol (3/12 patients) also declined after n-LDR. Postoperative changes in cognitive function varied depending on the location and side of the resection. For precise presurgical prediction of neuropsychological outcome after surgery, further prospective studies are needed to accumulate data of cognitive changes in relation to the resection site.

中文翻译：

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青少年和年轻人额部手术治疗伴有局灶性皮质发育不良的小儿癫痫后的神经心理学结果

我们调查了由局灶性皮质发育不良（FCD）引起的耐药性儿童发作性癫痫患者的神经心理学结果，这些患者在青春期和成年早期接受了额叶切除术。研究对象为 27 名患者，其中 15 名患者接受了语言主导侧切除术 (LDR)，12 名患者接受了语言非主导侧切除术 (n-LDR)。我们在切除手术前和术后两年评估了这些患者的智力（语言功能、算术能力、工作记忆、处理速度、视觉空间推理）、执行功能和记忆力。我们分析了神经心理学结果和切除区域（语言优势一侧和位置）之间的关系。尽管75%的患者在手术干预后的个体神经心理学测试中表现出改善或没有变化，但25%的患者表现出下降。 LDR 和 n-LDR 之间显示改善或下降的认知测试有所不同。在患有 LDR 的患者中，观察到词汇和音素流利度下降（均为 5/15 患者），特别是在切除腹外侧额叶皮层后，观察到 WCST 类别（7/14 患者）、块设计（6/ 15 名患者）、数字符号（4/15 名患者）和延迟回忆（3/9 名患者）。在接受 n-LDR 的患者中，背外侧额叶皮质切除后，词汇量（3/12 名患者）有所改善，但区组设计（2/9 名患者）和 WCST 类别（2/9 名患者）出现下降;切除背外侧额叶皮质或腹外侧额叶皮质后，算术（3/10 患者）下降。一般记忆（3/8 名患者）、视觉记忆（3/8 名患者）、延迟回忆（3/8 名患者）、言语记忆（2/9 名患者）和数字符号（3/12 名患者）在 n- 治疗后也有所下降。 LDR。术后认知功能的变化取决于切除的位置和侧面。为了在术前精确预测手术后的神经心理学结果，需要进一步的前瞻性研究来积累与切除部位相关的认知变化的数据。