Biomedical subjects

Austin Woodard

Publications and source records attributed to Austin Woodard.

6 recordsLinked to original sources

PubMed2003

Epilepsy surgery outcome among US veterans.

We retrospectively studied the outcome of anterior temporal lobectomy (ATL) among a population of veterans and evaluated outcome related to comorbidities. Veterans who underwent ATL between 1990 and 2001 at the Veterans Administration Hospital in Madison, Wisconsin, were included. Data related to postoperative seizure outcome, quality of life outcome, and employment outcome were collected. Factors associated with favorable outcome and outcome related to comorbidities were evaluated. Twenty-seven patients were entered into the study. The mean age at onset of seizures was 25 years (+/-10.2). History of a non-substance abuse psychiatric diagnosis, and substance abuse was present in 26% (7/27) and 30% (9/27), respectively, prior to surgery. While 66.6% (18/27) had a good outcome (Engel's Class I), no difference in the frequency of good outcome was seen among the patients with a history of substance abuse, other psychiatric diagnosis (71%), or no psychiatric diagnosis (67%). There was a significant correlation between seizure outcome and quality of life score (r(s)=0.67, p<0.001) and postoperative employment gains (r(s)=0.48, p=0.01). Outcomes among veterans that underwent ATL can be satisfactory even in the context of the late mean age of epilepsy onset and the psychiatric diagnoses that were present in this sample.

Adult↗

PubMed2003

Negative symptoms and psychosocial status in temporal lobe epilepsy.

PURPOSE: To determine the relationship between negative symptoms, psychosocial function and quality of life in temporal lobe epilepsy. METHODS: 23 patients with temporal lobe epilepsy with negative symptoms were matched on gender, age, years of education, duration and age of epilepsy onset with 23 temporal lobe epilepsy patients exhibiting no negative symptoms as determined by a standardized rating system (SANS/SAPS). The matched groups were compared in regard to: (1). employment status, (2). dependence on government financial subsidy, (3). relationship/marital status, and (4). self-reported quality of life. RESULTS: Temporal lobe epilepsy patients with negative symptoms exhibited higher rates of unemployment, dependence on government aid, social isolation, and poorer self-reported quality of life relative to temporal lobe patients without negative symptoms. CONCLUSIONS: Interictal negative symptoms are associated with significantly increased psychosocial morbidity and poorer quality of life in temporal lobe epilepsy.

Adult↗

PubMed2003

Narrative and procedural discourse in temporal lobe epilepsy.

It is well established that some individuals with temporal lobe epilepsy (TLE) demonstrate language deficits at the single word level. However, discourse production rarely has been examined quantitatively within this group. This study compared adult TLE patients with an early seizure onset (< or = age 14 years, n = 27) to a control group (n = 28) on narrative and procedural discourse tasks. As a group, the TLE patients performed normally on the procedural discourse task, but differed significantly from the controls on several narrative discourse variables. At the individual level, 30% of the TLE patients versus 4% of the controls demonstrated impaired discourse ability (p and 0.01). Within this early onset TLE group, discourse performance was not associated with demographic or seizure history variables. Considering the cognitive domain, discourse performance correlated significantly with working memory. In summary, mild discourse dysfunction was present in a significant minority of early onset TLE patients, but this deficit was not closely associated with other language measures. Discourse ability and its neuropsychological, neuroanatomical and conversational speech correlates deserve further study in TLE patients.

Adolescent↗

PubMed2002

Ipsilateral Reorganization of Language in Early-Onset Left Temporal Lobe Epilepsy.

Purpose. Decline in confrontation naming ability occurs in a subset of temporal lobe epilepsy (TLE) patients following left (dominant) anterior temporal lobectomy (ATL). Patients with late age of onset of seizures are most vulnerable to such decline. In addition, object names typically acquired later in language development are the words most likely to be inaccessible after ATL. Early-onset left TLE patients may be at lower risk for post-ATL dysnomia either because they have a limited preoperative lexicon that does not include most late-age-of-acquistion names or they undergo early ipsilateral language reorganization, which results in a lexicon similar to that of late-onset TLE patients but offers protection from post-ATL naming decline.Methods. Sixty-five left hemisphere speech dominant left TLE patients who had undergone ATL were assessed pre- and postoperatively on the Boston Naming Test (BNT).Results. The early- and late-onset groups performed similarly across three BNT age-of-acquisition categories at the preoperative assessment. Words acquired relatively later in life were most likely to become inaccessible postoperatively for both groups, but the early-onset patients showed significantly less overall postoperative decline in naming ability compared with the late-onset group.Conclusions. The more stable pre- to postoperative naming performance exhibited by early-onset patients cannot be attributed to lack of acquisition of the words shown to be most vulnerable to postoperative decline (i.e., late-age-of-acquisition words). Their object naming stability suggests that early-onset left TLE patients undergo intrahemispheric reorganization of language early in life that provides protective benefits.

Journal Article↗

PubMed2002

Long-term psychosocial outcomes of anterior temporal lobectomy.

PURPOSE: To examine the long-term psychosocial outcomes of a consecutive series of patients who underwent anterior temporal lobectomy (ATL) compared with medically managed patients. This study focused primarily on actual long-term changes (mean, 5 years) in life performance. There are relatively few long-term controlled studies of actual lifetime performance changes. METHODS: The sample consisted of 61 adults who underwent ATL and 23 individuals who were evaluated for surgery but did not proceed to surgery and continued to receive medical management. Participants were interviewed 2-9 years after surgery. A structured clinical interview and review of medical records was conducted to obtain information regarding seizure frequency and psychosocial status, focusing on employment, education, driving status, financial assistance, and independent living. In addition, two questions regarding quality of life were included. Seizure frequency was evaluated for the year before the interview. RESULTS: Significant differences in psychosocial outcome were found between the surgery group and medical management group. Favorable psychosocial outcomes were more common among those who had surgery (46 vs. 4%). Results indicated that 68% of the surgery group exhibited improved psychosocial status compared with 5% of the medical management group. Individuals who had surgery were more likely to be driving, working full-time, living independently, and being financially independent. Remaining seizure free was not a prerequisite for improvements in psychosocial outcomes. CONCLUSIONS: Compared with medical management, surgery has a significant positive impact on psychosocial outcomes in terms of employment, independent living, driving, and financial independence. Additionally, a person does not necessarily have to be seizure free to achieve positive changes in psychosocial outcomes.

Activities of Daily Living↗

PubMed2002

Negative symptoms in temporal lobe epilepsy.

OBJECTIVE: This study examined the frequency of negative and positive symptoms in nonpsychotic patients with temporal lobe epilepsy and the relationship of negative and positive symptoms to cognition, quantitative magnetic resonance imaging (MRI) volumetrics, and depression. METHOD: Eighty-four patients with temporal lobe epilepsy and 74 healthy comparison subjects were evaluated for negative and positive symptoms and underwent comprehensive neuropsychological evaluation, quantitative MRI volumetrics, and assessment of mood state and depression. RESULTS: Negative symptoms were significantly more prevalent in the patients with temporal lobe epilepsy (31%) than in the comparison subjects (8%). There was no difference between groups in the rate of positive symptoms. Although the epilepsy patients as a group exhibited generalized cognitive impairment relative to the comparison subjects, the epilepsy patients with negative symptoms performed significantly worse than patients without negative symptoms and comparison subjects across measures of nonverbal intelligence, visuoperception, speeded visuomotor processing, and memory. The epilepsy patients with negative symptoms exhibited significantly greater diffuse atrophy than the healthy comparison subjects and higher CSF volumes than the epilepsy patients without negative symptoms. The epilepsy patients with and without negative symptoms had statistically equivalent Beck Depression Inventory scores and lifetime history of mood disorders, including major depression. CONCLUSIONS: Negative but not positive symptoms were more prevalent in temporal lobe epilepsy patients than in healthy comparison subjects. Negative symptoms were independent of current and past depression and were associated with neuropsychological deficits exceeding the general cognitive morbidity associated with temporal lobe epilepsy and with quantitative MRI indices suggesting greater cerebral atrophy.

Adolescent↗