Theses and Dissertations

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Date of Award

1-1-2010

Document Type

Dissertation - NSU Access Only

Degree Name

Doctor of Psychology (PhD)

Department

Center for Psychological Studies

First Advisor

Wiley Mittenberg

Second Advisor

Gustavo Rey

Third Advisor

Sarah Valley-Gray

Keywords

BRIEF, Epilepsy, Executive Function, Hemispherectomy, Intractable

Abstract

Hemispherectomy has gained widespread endorsement as a useful technique for treating seizures in patients with cerebral hemispheric dysfunction. Following this procedure, most patients experience seizure-freedom or a substantial decrease in the number of seizures occurring. Regarding other areas of functioning, patients generally maintain the same level of intelligence, language abilities, motor functioning, and visual ability, and experience improvements in behavioral disturbances and social skills. However, the current outcome literature lacks information regarding the effect of hemispherectomy on executive function. The purpose of this study is to evaluate executive function in pediatric patients with intractable epilepsy following a hemispherectomy. The parents of children who had undergone this surgical intervention completed the Behavior Rating Inventory of Executive Function (BRIEF; Gioia, Isquith, Guy, and Kenworthy, 2002) and their children's scores were compared to those of children with epilepsy treated with anticonvulsant medications (AEDs) only. The impact of clinical variables (i.e. age at time of surgery, lateralization of hemispherectomy, and amount of time since surgery) on BRIEF scores were also examined. Results indicated that children undergoing a hemispherectomy produced lower scores (less impaired) on several of the BRIEF scales as compared to those taking AEDs only. The left and right hemispherectomy group differed only on a subscale measuring behavioral inhibition, with the right hemispherectomy group producing a higher mean (meaning more impairment). Several BRIEF scores in the aggregate hemispherectomy group were positively correlated with time since surgery, such that longer post-operative periods were associated with poorer performances on the BRIEF. Several BRIEF measures were negatively correlated with age at time of surgery, suggesting that younger patients fared worse on the BRIEF than older patients.

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