Document Type


Publication Date


Publication Title


First Page


Last Page




Purpose- To characterize the interaction between language dominance and lateralization of the epileptic focus for pre- and postoperative Boston Naming Test (BNT) performance in patients undergoing anterior temporal lobectomy (ATL).

Methods- Analysis of pre- and postoperative BNT scores depending on lateralization of language as measured by the intracarotid amobarbital procedure (IAP) versus lateralization of the temporal lobe epileptic focus.

Results- Changes between pre- and postoperative BNT performance depended on epilepsy lateralization (effect size = 0.189) with significant decrease in patients undergoing left ATL. Subgroup analysis in these showed that postoperative decline in BNT scores was significant in patients with atypical (n = 14; p < 0.05), but did not reach statistical significance in patients with left language dominance (n = 36; p = 0.09). Chi-square test revealed a trend of higher proportions of patients experiencing significant postsurgical deterioration in naming performance in atypical (57.1%) as compared to left language dominance (30.6%; p = 0.082). Surgical failure was also associated with greater decline of BNT scores and was more common in atypical than in left language dominant patients (χ2 (1, n = 98) = 4.62, p = 0.032). Age of onset, duration of epilepsy, and seizure frequency had no impact on changes in BNT performance.

Conclusion- Atypical language dominance is a predictor of change in visual naming performance after left ATL and may also impact postsurgical seizure control. This should be considered when counseling surgical candidates.


NOTICE: this is the author’s version of a work that was accepted for publication in Neuropsychologia. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in Neuropsychologia, 48, (2010) DOI# 10.1016/j.neuropsychologia.2010.03.013