INS NYC 2024 Program

Poster	Poster Session 09 Program Schedule 02/16/2024 03:30 pm - 04:45 pm Room: Shubert Complex (Posters 1-60) Poster Session 09: Epilepsy \| Oncology \| MS \| Infectious Disease Final Abstract #28 Utility of the Rey Auditory Verbal Learning Test for Identifying Left and Right Temporal Lobe Epilepsy Using the Mayo Normative Studies Norms Brittany Crowley, University of Colorado Anschutz School of Medicine, Aurora, United States Joie Molden, University of Colorado Anschutz School of Medicine, Aurora, United States Katie Riggs, University of Colorado Hospital, Aurora, United States Thomas Wodushek, University of Colorado Anschutz School of Medicine, Aurora, United States Christopher Domen, University of Colorado Anschutz School of Medicine, Aurora, United States Category: Epilepsy/Seizures Keyword 1: epilepsy / seizure disorders Keyword 2: temporal lobes Keyword 3: assessment Objective: The Rey Auditory Verbal Learning Test (RAVLT) has demonstrated sensitivity to left (dominant hemisphere) temporal lobe epilepsy (TLE) and is recommended to assess verbal memory in epilepsy patients. The aim of this study was to determine whether employing the Mayo Normative Studies (MNS) RAVLT norms, which include corrections for age, gender, and education, improves classification accuracy for left TLE, right TLE, or extratemporal epilepsy relative to the age-corrected RAVLT metanorms included in the commercial handbook. Participants and Methods: This was a retrospective review of a patient sample drawn from consecutive referrals to the neuropsychology service of a large academic medical center for presurgical epilepsy evaluation between 1/2020 and 12/2022. Patients were characterized as having left TLE (n = 7), right TLE (n = 8), or extratemporal epilepsy (n = 5) based on invasive (phase II) video-EEG and/or history of resective, ablative, or RNS surgery and exhibited bilateral or left hemisphere language dominance on Wada or fMRI. The RAVLT was routinely administered to all patients. RAVLT Total Learning (Total) and Long-Delay Free Recall (LDFR) raw scores were converted to T-scores using both the MNS RAVLT norms (available for ages 30-91) and RAVLT metanorms. One-way analysis of variance (ANOVA) compared T-scores for patients in the left TLE, right TLE, and extratemporal groups. In cases of violation to the assumption of data normality, Kruskal-Wallis H tests were used instead. Logistic regression subsequently analyzed whether the MNS or metanorms would better characterize patients based on their respective RAVLT Total and LDFR T-scores. Results: There were no significant differences between groups for the RAVLT Total metanorm scores, RAVLT LDFR metanorm scores, or RAVLT Total MNS norm scores (all p-values > .05). There was a difference between groups for the RAVLT LDFR MNS norm scores, for which a Kruskal-Wallis H test was conducted given that the extratemporal epilepsy group mildly violated normality assumptions [left TLE mean T = 33.71, right TLE mean T = 48.13, extratemporal mean T = 50.40; x²(2, 20) = 6.26, p = .044], with marginally non-significant pairwise differences between the left TLE and right TLE groups as well as the left TLE and extratemporal groups when α was Bonferroni-corrected (α = .0125). Logistic regression models were not significant; however, the sample size was very small. Thus, we subsequently examined counts of patients in each epilepsy group with a T-score ≤ 35 on RAVLT LDFR using both norm sets. Using the MNS norms, 4/7 left TLE, 1/8 right TLE, and 1/5 extratemporal patients performed below criterion, whereas 3/7 left TLE, 3/8 right TLE, and 1/5 extratemporal patients performed below criterion applying the metanorms. Conclusions: Trends were observed suggesting that the RAVLT LDFR MNS norms (which correct for age, gender, and education) best differentiate patients with left TLE versus right TLE or extratemporal epilepsy. Though results did not reach the level of statistical significance to make definitive analytic conclusions, likely due to small sample size, this study provides a good foundation for replication in larger samples.

Poster

02/16/2024
03:30 pm - 04:45 pm
Room: Shubert Complex (Posters 1-60)

Poster Session 09: Epilepsy | Oncology | MS | Infectious Disease

Final Abstract #28

Utility of the Rey Auditory Verbal Learning Test for Identifying Left and Right Temporal Lobe Epilepsy Using the Mayo Normative Studies Norms

Brittany Crowley, University of Colorado Anschutz School of Medicine, Aurora, United States
Joie Molden, University of Colorado Anschutz School of Medicine, Aurora, United States
Katie Riggs, University of Colorado Hospital, Aurora, United States
Thomas Wodushek, University of Colorado Anschutz School of Medicine, Aurora, United States
Christopher Domen, University of Colorado Anschutz School of Medicine, Aurora, United States

Category: Epilepsy/Seizures

Keyword 1: epilepsy / seizure disorders
Keyword 2: temporal lobes
Keyword 3: assessment

Objective:

The Rey Auditory Verbal Learning Test (RAVLT) has demonstrated sensitivity to left (dominant hemisphere) temporal lobe epilepsy (TLE) and is recommended to assess verbal memory in epilepsy patients. The aim of this study was to determine whether employing the Mayo Normative Studies (MNS) RAVLT norms, which include corrections for age, gender, and education, improves classification accuracy for left TLE, right TLE, or extratemporal epilepsy relative to the age-corrected RAVLT metanorms included in the commercial handbook.

Participants and Methods:

This was a retrospective review of a patient sample drawn from consecutive referrals to the neuropsychology service of a large academic medical center for presurgical epilepsy evaluation between 1/2020 and 12/2022. Patients were characterized as having left TLE (n = 7), right TLE (n = 8), or extratemporal epilepsy (n = 5) based on invasive (phase II) video-EEG and/or history of resective, ablative, or RNS surgery and exhibited bilateral or left hemisphere language dominance on Wada or fMRI. The RAVLT was routinely administered to all patients. RAVLT Total Learning (Total) and Long-Delay Free Recall (LDFR) raw scores were converted to T-scores using both the MNS RAVLT norms (available for ages 30-91) and RAVLT metanorms. One-way analysis of variance (ANOVA) compared T-scores for patients in the left TLE, right TLE, and extratemporal groups. In cases of violation to the assumption of data normality, Kruskal-Wallis H tests were used instead. Logistic regression subsequently analyzed whether the MNS or metanorms would better characterize patients based on their respective RAVLT Total and LDFR T-scores.

Results:

There were no significant differences between groups for the RAVLT Total metanorm scores, RAVLT LDFR metanorm scores, or RAVLT Total MNS norm scores (all p-values > .05). There was a difference between groups for the RAVLT LDFR MNS norm scores, for which a Kruskal-Wallis H test was conducted given that the extratemporal epilepsy group mildly violated normality assumptions [left TLE mean T = 33.71, right TLE mean T = 48.13, extratemporal mean T = 50.40; x²(2, 20) = 6.26, p = .044], with marginally non-significant pairwise differences between the left TLE and right TLE groups as well as the left TLE and extratemporal groups when α was Bonferroni-corrected (α = .0125). Logistic regression models were not significant; however, the sample size was very small. Thus, we subsequently examined counts of patients in each epilepsy group with a T-score ≤ 35 on RAVLT LDFR using both norm sets. Using the MNS norms, 4/7 left TLE, 1/8 right TLE, and 1/5 extratemporal patients performed below criterion, whereas 3/7 left TLE, 3/8 right TLE, and 1/5 extratemporal patients performed below criterion applying the metanorms.

Conclusions:

Trends were observed suggesting that the RAVLT LDFR MNS norms (which correct for age, gender, and education) best differentiate patients with left TLE versus right TLE or extratemporal epilepsy. Though results did not reach the level of statistical significance to make definitive analytic conclusions, likely due to small sample size, this study provides a good foundation for replication in larger samples.