Authors :
Presenting Author: Sarah Laughlin, PhD – Children's Hospital of Pittsburgh, UPMC
Melissa Sutcliffe, PhD – Children's Hospital of Pittsburgh, UPMC
Matthew Mesoros, BS – University of Pittsburgh
Leen Alkalbani, MD – Children's Hospital of Pittsburgh, UPMC
Himadri Patel, MD – Children's Hospital of Pittsburgh, UPMC
Geetha Vasudevan, MD – Children's Hospital of Pittsburgh, UPMC
Nicholas Benjamin, MD – Children's Hospital of Pittsburgh, UPMC
Mikaela Speakes, MD – Children's Hospital of Pittsburgh, UPMC
Taylor Abel, MD – Children's Hospital of Pittsburgh, UPMC
William Welch, MD – Children's Hospital of Pittsburgh, UPMC
Ruba Al-Ramadhani, MD – Children's Hospital of Pittsburgh, UPMC
Rationale:
The objective of this study was to evaluate cognitive, emotional/behavioral, and adaptive functioning outcomes in pediatric patients diagnosed with drug-resistant epilepsy (DRE) by comparing pre- and post-epilepsy surgery neuropsychological assessment data. Prior studies have suggested focal post-surgical cognitive changes (improvement/decline in 1-2 domains) and reported rates of post-surgical decline ranging from 4-35% and rates of improvement ranging from 2-31% (Kaur et al., 2022). Also, prior studies suggest parents often report improvement in patient’s emotional/behavioral function (Reilly et al., 2019), and unchanged (Shurtleff et al., 2021) or improved (Duarte Oliveira et al., 2025; Ueda et al., 2021) adaptive function post-surgically.Methods:
This is a retrospective chart review of neuropsychological assessment data collected over a one-year period at UPMC Children’s Hospital of Pittsburgh. Patients (N = 13) included in analysis underwent surgical intervention for DRE (resection: N = 6, neuromodulation: N = 3, both: N = 4) and pre- and postsurgical neuropsychological evaluation. Postsurgical testing occurred at eight months after surgery on average. Change scores for each patient were classified as decline, no change, or improvement based on reliable change indices (RCI) across the following neuropsychological variables: vocabulary (VC; N = 9), matrix reasoning (MR; N = 9), verbal intelligence quotient (VIQ; N = 7), performance intelligence quotient (PIQ; N = 7), externalizing problems (N = 10), internalizing problems (N = 10), and independence in activities of daily living (ADLs; N = 10).
Results:
On verbal measures, all patients showed no change (VC: 66.7%, VIQ: 71.4%) or decline (VC: 33.3%, VIQ: 28.6%) post-surgically. On perceptual/fluid reasoning measures, the majority of patient showed no change (MR: 77.8%, PIQ: 57.1%) and a minority showed decline (MR: 11.1%, PIQ: 28.6%) or improvement (MR: 11.1%, PIQ: 14.3%) following surgery. On measures of psychiatric symptoms, all patients showed no change or improvement in parent-reported internalizing symptoms post-surgery. There was an increase in parent-reported externalizing symptoms following surgery for some patients (20%), but the majority showed no change (20%) or improvement (60%). Finally, for most patients there was no change in parent-reported independence in ADLs following surgery (80%).
Conclusions:
The majority of patients in this study showed no cognitive change and stable to improved behavioral, emotional, and adaptive function postoperatively. Rates of cognitive improvement and decline were similar to prior reports (Kaur et al., 2022). Declines in function were most common in the language domain and a minority of patients showed increased externalizing symptoms post-surgery. Future analyses will include additional patient data, and evaluate relations between outcome variables and surgical site, surgical intervention type, and patient age.
Funding: There was no funding received in support of this abstract.