Abstracts

Confrontation naming tasks, such as the Boston Naming Test (BNT), have long been presumed to be sensitive to left temporal dysfunction and, consequently, are frequently used in the evaluation of surgical epilepsy patients. Several recent studies have demonstrated the diagnostic utility of the BNT in predicting seizure lateralization (i.e., ultimate side of surgery) in patients with temporal lobe epilepsy (TLE)^{1, 2}. However, despite wide and frequent use of this instrument, few studies have examined factors that may moderate this relationship, and no known studies have examined the incremental validity of confrontation naming tasks in individuals with epilepsy. The current study examined the pre-surgical BNT performance of 242 right-handed adult patients with intractable epilepsy (Left = 120; Right = 122) to examine potential factors that may moderate the relationship between BNT performance and seizure lateralization and to determine the incremental validity of this measure in predicting seizure lateralization. The results support the clinical utility of the BNT in determining ultimate side of surgery and indicate that age of seizure onset strongly moderates this relationship. BNT performance was helpful in identifying ultimate side of surgery in patients with later age of seizure onset (i.e., [gt]6 years). This relationship was not apparent in patients with younger age of seizure onset. In addition, site of seizure focus (i.e., temporal vs. nontemporal) approached significance as a moderating variable with more robust relationships apparent in patients with temporal lobe epilepsy. FSIQ and duration of epilepsy were not significant moderating variables. Hierarchical logistic regression analyses supported the role of the BNT in predicting ultimate side of surgery and further demonstrated that this instrument has incremental validity over and beyond memory and IQ laterality scores. This study supports the clinical utility of the BNT in the pre-operative evaluation of candidates for epilepsy surgery, particularly for patients with later seizure onset.

1. Kubu CS, Carswell L, Harnadek M, Galvan N. The diagnostic utility of the Boston and Benton Naming Tests in epilepsy [abstract]. J Int Neuropsychol Soc. 2001; 7(2):210
2. Schefft BK, Testa SM, Dulay MF et al. Preoperative assessment of confrontation naming ability and interictal paraphasia production in unilateral temporal lobe epilepsy. Epilepsy Behav. 2003;4:161-168