Abstracts

It has been proposed that behavioral impairment in patients with amygdala dysfunction might be related to an inability to reverse their behavior despite receiving negative feedback.
Epileptic patients who undergo anterior temporal lobectomy represent an [quot]in vivo[quot] model to study the role of amygdala in cognitive flexibility.
The aim of this study is to evaluate cognitive flexibility in epileptic patients with amygdala resection when facing negative feedback. Ten epileptic patients who underwent anterior temporal lobectomy (6 left temporal lobectomy and 4 right temporal lobectomy) were matched for age and education with 10 healthy controls.
Subjects underwent an extensive neuropsychological and neuropsychiatric evaluation.
To asses cognitive flexibility we used a reversal [ndash]learning task. Patients[acute] mean and standard deviation score were: Beck depression Inventory 8[plusmn]1.5; PANSS (positive) 10 [plusmn]1.3; PANSS (negative) 14[plusmn]2.2; PANSS total 28.3[plusmn]2; verbal IQ 104.2[plusmn]7, nonverbal IQ 97.2[plusmn]6, full scale IQ 101.4[plusmn]6.3. Categories achieved on Wisconsin Card Sorting Test 5.7[plusmn]0.16. Patients had less number of reversions (mean:9.3) compared to controls (mean: 4.23; p[lt]0.001), and needed more trials before the first reversion (patients: 23.42 vs controls : 5; p[lt]0.05). Patients with epilepsy who undergo anterior temporal lobectomy appear to have post operative difficulties to perform a learning-reversal task. Their lack of cognitive flexibility cannot be explained by psychiatric comorbidity, low IQs or a dysexecutive syndrome.