Busch et al evaluated adults with epilepsy undergoing temporal lobe surgery. They developed a nomogram for predicting the risk of moderate to severe decline in naming. The authors are from the Cleveland Clinic, Columbia University, Emory University, University of Wisconsin and University of Washington Seattle.
Patient selection: temporal lobe surgery for epilepsy, age of onset from 0 to 60 years, BNT from 20 to 60
Outcome: moderate to severe decline in naming, defined as decline by >= 11 points in the 60-item Boston Naming Test (scored from 0 to 60)
Parameters:
(1) age at seizure onset
(2) site of resection (dominant vs nondominant temporal lobe)
(3) baseline Boston Naming Test (BNT), from 20 to 60
points for age at seizure onset =
= 1.5367 * (age at onset)
points for baseline BNT =
= (1.075 * (years)) - 10.5
|
Parameter
|
Finding
|
Points
|
|
site of resection
|
nondominant
|
0
|
|
|
dominant
|
95.1
|
total score =
= (points for age at seizure onset) + (points for site of resection) + (points for baseline BNT)
Interpretation:
• minimum score: 11
• maximum score: 241.3
• The risk of decline increases as the score increases.
|
Score
|
Risk of Moderate to Severe Decline in Naming
|
|
< 142
|
< 10%
|
|
142 to 241.3
|
(0.0025792 * ((score)^2)) - (0.44041 * (score)) + 21.35
|
Performance:
• The area under the ROC curve is 0.84.
