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Intensive preoperative rehabilitation of word production in temporal drug resistant epilepsy: An experimental case study
Poster Session B, Wednesday, September 30, 4:30 - 6:30 pm, Wangari Maathai
F.-Xavier Alario1, Christelle Zielinski1, Agnès Trébuchon2,3, Véronique Sabadell2,3; 1Aix-Marseille Universite & CNRS, 2Aix-Marseille Université & INSERM, 3Assitance Publique Hôpitaux de Marseille
Of the 30,000 new cases of epilepsy in France every year, 30% are drug resistant. Surgery, which consists of resecting the epileptogenic zone, is the only chance of a cure. In the case of temporal lobe epilepsy (TLE) in the dominant hemisphere for language, this surgery presents a high risk of increasing cognitive difficulties and may even be contraindicated for this reason alone. The difficulties include problems of lexical access (anomia) and verbal memory, affect- ing more than 40% of patients (Bartha-Doering & Trinka, 2014; Busch et al., 2016). According to Mazur-Mosiewicz et al. (2015) and Baxendale (2020), pre-operative cognitive rehabilitation (prehabilitation) could influence cerebral plasticity mechanisms and thus provide a protective reserve, but there is currently very limited evidence for this hypothesis. In this context, we developed a speech therapy specific to the needs of patients with epilepsy and language and memory difficulties. Our intervention combines an e-health device enabling the patient’s self- rehabilitation at home with a face-to-face psychoeducation and support by the speech therapist. We proposed this pre-habilitation to six left TLE patients in the form of a Single Case Experimental Design (SCED). The results were analyzed both visually and statistically. Significant progress was reported during rehabilitation. Post-operative language performance remained stable in three patients, while one patient showed a worsening of performance post-operatively. Generalization effects to untrained items were variable. The data of the two other patients could not be interpreted. The poster will present in detail the protocol and its encouraging results. References: Bartha-Doering & Trinka, 2014: https://doi.org/10.1111/epi.12743. Busch et al., 2016: https://doi.org/10.1212/WNL.0000000000003378. Mazur-Mosiewicz et al., 2015: https://doi.org/10.1111/epi.12963. Baxendale (2020): https://doi.org/10.1016/j.yebeh.2020.107027.
Topic Areas: Speech-Language Treatment, Language Production