Empirical techniques for determining the reliability, magnitude, and pattern of neuropsychological change after epilepsy surgery

Epilepsia. 1996 Oct;37(10):942-50. doi: 10.1111/j.1528-1157.1996.tb00531.x.

Abstract

Purpose: We assessed test-retest neuropsychological performance in patients with complex partial seizures to derive reliable change indices (RCIs) and regression-based norms for change, indices that may be helpful in assessing cognitive outcome after anterior temporal lobectomy.

Methods: Forty patients with complex partial seizures (CPS) who did not undergo epilepsy surgery were administered a comprehensive neuropsychological battery on two occasions. Their test-retest data were used to compute both RCIs and regression-based norms for change for each neuropsychological index. RCIs corrected for practice effects provide a confidence interval (CI) indicating the degree of performance change required to exceed the variability attributable to sources of error (e.g., practice, test-retest reliability). Regression-based norms for change also correct for several sources of measurement error and examine observed versus expected test-retest changes on a common metric, thereby facilitating determination of the degree and relative magnitude of change across cognitive domains.

Results: Mean changes in test-retest performance were generally modest, but were evident across several test measures. Our data indicate a considerable degree of individual variability in test-retest performance.

Conclusions: RCIs and regression-based norms are complementary indexes and can be particularly useful in examining the test-retest performance of individual patients who undergo epilepsy surgery as well as in the more general investigation of cognitive outcome after epilepsy surgery.

Publication types

  • Case Reports
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adult
  • Age of Onset
  • Cognition Disorders / diagnosis
  • Cognition Disorders / psychology
  • Cognition*
  • Confidence Intervals
  • Epilepsy, Complex Partial / diagnosis
  • Epilepsy, Complex Partial / psychology
  • Epilepsy, Complex Partial / surgery*
  • Female
  • Functional Laterality
  • Humans
  • Male
  • Middle Aged
  • Neuropsychological Tests / statistics & numerical data*
  • Postoperative Complications / diagnosis
  • Postoperative Complications / psychology
  • Psychomotor Performance
  • Regression Analysis
  • Reproducibility of Results
  • Sex Factors
  • Temporal Lobe / surgery*
  • Treatment Outcome
  • Wechsler Scales