Abstracts

Rationale: Visual naming declines occur in up to 60% of adults following dominant temporal lobe resection with up to 17% demonstrating substantial naming declines. However, the impact of naming impairments on patient functioning or quality of life remains unclear. This study examined the relationship between objective naming decline and subjective cognitive complaints following surgery. Methods: 171 patients (M=38 years; 54% female) completed objective (Boston Naming Test-BNT) and subjective (Memory Assessment Clinics Self-Rating Scale-MAC-S) measures of language before and after left temporal lobectomy. BNT change scores were categorized into 4 groups: no decline ( < 5 raw points; n=105), mild decline (5-10; n=32), moderate decline (11-20; n=23), or severe decline (20+; n=13). ANOVAs examined group differences in subjective complaints following surgery on the Ability and Frequency scales of the MAC-S as well as the two subscales most related to language/naming ability (Word Recall and Semantic Memory). Pearson correlations were used to examine the relationship between MAC-S scales and self-reported depressive symptoms. Results: Outcome groups differed in subjective complaints on the MAC-S Ability, Frequency, and Word Recall scales (p range .008-.017), and there was a trend on the Semantic Memory subscale (p=.063). Notably, patients with severe naming declines endorsed greater cognitive complaints following surgery, on all four scales, than those without naming declines. These patients also endorsed greater difficulty on the Ability and Frequency subscales compared to those with mild naming declines (Figure 1). Repeated measures ANOVAs revealed a group x time interaction on Semantic Memory [p < .05, ?2p=.049]; patients with severe naming declines endorsed steep subjective declines on this scale after surgery while scores of the other groups remained largely unchanged (Figure 2). Depressive symptoms were significantly, negatively correlated with the MAC-S scales among all patient groups (-.19 to -.64, p range .06 to .000), except the severe decline group (.03 to -.36, p range .23 to .93). Conclusions: Patients who experience objective postoperative naming declines also endorse subjective functional deficits, particularly when naming declines are severe. Among the most severely affected patients, depression appears to have little influence on subjective report. Funding: Primary support for this research was provided by the Cleveland Clinic Epilepsy Center. Additional support was provided by the Clinical and Translational Science Collaborative of Cleveland KL2TR000440 from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health and NIH roadmap for Medical Research (to R.M.B.), and the National Institute of Neurological Disorders and Stroke 1K23NS091344 - 01A1 (to D.P.F.). Its contents are solely the responsibility of the authors and do not necessarily represent the official views of the NIH.