The impact of cerebrovascular risk factors on postoperative memory decline in patients with left temporal lobe epilepsy

Anny Reyes; Sanam J Lalani; Erik Kaestner; Kiera Hooper; Austin Chen; Anna Christina Macari; Brianna M Paul; Bruce P Hermann; Carrie R McDonald

doi:10.1016/j.yebeh.2019.106558

The impact of cerebrovascular risk factors on postoperative memory decline in patients with left temporal lobe epilepsy

Epilepsy Behav. 2020 Jan:102:106558. doi: 10.1016/j.yebeh.2019.106558. Epub 2019 Nov 13.

Authors

Anny Reyes¹, Sanam J Lalani², Erik Kaestner³, Kiera Hooper², Austin Chen³, Anna Christina Macari³, Brianna M Paul⁴, Bruce P Hermann⁵, Carrie R McDonald⁶

Affiliations

¹ San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA.
² Department of Neurology, University of California - San Francisco, San Francisco, CA, USA.
³ Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA.
⁴ Department of Neurology, University of California - San Francisco, San Francisco, CA, USA; UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA.
⁵ Matthews Neuropsychology Section, University of Wisconsin, USA.
⁶ San Diego State University/University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA; Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA. Electronic address: camcdonald@ucsd.edu.

Abstract

Cerebrovascular risk factors (CVRFs) and comorbid cardiovascular and metabolic disease have been linked to accelerated cognitive aging and dementia in the general population; however, the contribution of these comorbidities to the risk of post anterior temporal lobectomy (ATL) memory decline has been unexamined. We explored the effects of CVRFs on postoperative verbal memory decline in a cohort of 22 patients with left temporal lobe epilepsy (LTLE) who completed pre- and one-year postsurgical neuropsychological testing. Diagnoses of interest included preoperative cardiovascular and metabolic disorders, as well as CVRFs [pulse pressure proxy, body mass index (BMI), and fasting glucose]. Twenty-three percent of patients had a history of cardiovascular disease, 9% of metabolic disorders, and 38% had a BMI indicating overweight or obese status. Higher preoperative BMI and glucose were associated with greater decline in verbal memory. The association between BMI and memory decline remained significant after controlling for age and left hippocampal volume. These findings suggest that modifiable health-related risk factors, including CVRFs, may impact the risk of postoperative cognitive decline, and that BMI in particular could be an important factor to consider and/or target for intervention early in clinical care to protect cognitive health.

Keywords: Body mass index; Temporal lobe epilepsy; Vascular risk factors; Verbal memory.

Publication types

Research Support, N.I.H., Extramural

MeSH terms

Adult
Anterior Temporal Lobectomy / adverse effects
Anterior Temporal Lobectomy / trends
Body Mass Index*
Cerebrovascular Disorders / diagnosis
Cerebrovascular Disorders / epidemiology*
Epilepsy, Temporal Lobe / epidemiology*
Epilepsy, Temporal Lobe / surgery*
Female
Humans
Male
Memory Disorders / diagnosis
Memory Disorders / epidemiology*
Neuropsychological Tests
Postoperative Cognitive Complications / diagnosis
Postoperative Cognitive Complications / epidemiology*
Risk Factors
Temporal Lobe / surgery

Abstract

Publication types

MeSH terms

Grants and funding