Intensive Preoperative Speech Rehabilitation in Drug-Resistant Temporal Epilepsy

Assistance Publique Hopitaux De Marseille214 enrolled

Overview

Out of 30,000 new cases per year in France, 30% of epileptic patients are drug-resistant. Neurosurgery, which consists in resecting the epileptogenic zone, is the only chance of cure. In the case of temporal epilepsy of the language-dominant hemisphere (TLE), this procedure presents a high risk of increasing cognitive difficulties and may even be contraindicated for this reason alone. The difficulties found are impairments in lexical access (anomia) and verbal memory and affect more than 60% of patients . Preoperative cognitive rehabilitation could influence brain plasticity mechanisms but there are currently no recommendations on this topic. In this context, the investigators have developed a speech rehabilitation procedure specific to the needs of ELTPR patients. They rely on cognitive hypotheses explaining the disorders but also on models of rehabilitation-induced neural plasticity likely to improve cognitive reserve before surgery. The investigators hypothesize that preoperative cognitive language rehabilitation in ELTPR patients may decrease surgical risk and improve postoperative language prognosis. The primary objective is to demonstrate the protective efficacy of preoperative speech rehabilitation on language performance postoperatively.

Study Type

INTERVENTIONAL

Allocation

RANDOMIZED

Purpose

PREVENTION

Masking

NONE

Enrollment

214

Conditions

Epilepsy Anomia

Eligibility

Sex: ALLMin age: 16 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Patient 16 years of age and older, 2. Patient whose epileptogenic area involves the temporal structures of the hemisphere specialized for language, 3. Patient whose hemispheric specialization for language is known 4. Patient willing to undergo resective surgery such as anterior temporal lobectomy or resection in the temporal lobe involving the hippocampus and/or the baso-temporal language area and whose planned surgery date is compatible with the performance of the study, 5. Patient with a known NTB score 6. Patient who has signed an informed consent or patient whose parents or legal guardians have signed the informed consent (or a single parent or legal guardian if applicable) 7. Patient whose first language is French (1st language learned by the patient), 8. Patient declaring to be familiar with the use of a computer and having access to an internet connection from home 9. Patient affiliated or benefiting from a social security system. Exclusion Criteria: 1. Patient with a speech disorder that may impair intelligibility and compromise the use of the interface; 2. Patient with an uncorrected hearing impairment, 3. Patients with a total intelligence quotient (IQ) \<70 (assessed in the context of care, in the year preceding the surgical procedure) 4. Patients who are pregnant, nursing, deprived of liberty, under guardianship or curatorship.

Locations (12)

Service EFSN - Hôpital Pellegrin

Bordeaux, France

RECRUITING

Service de Neurologie de l'Epilepsie - CHU Grenoble-Alpes

Grenoble, France

RECRUITING

Département de Neurophysiologie Clinique - Hôpital Roger Salengro - CHU Lille

Lille, France

RECRUITING

Hôpital Neurologique Pierre Wertheimer- Service de Neurologie Fonctionnelle et Epileptologie - Hospices Civils Lyon

Lyon, France

NOT_YET_RECRUITING

Service Epilptologie et Rythmologie Cérébrale

Marseille, France

RECRUITING

Service de Neurologie - Hôpital central -CHU Nancy

Nancy, France

NOT_YET_RECRUITING

Département de Neurologie - Hôpital de la Pitié-Salpêtrière - APHP

Paris, France

NOT_YET_RECRUITING

Service de Neurochirurgie -GHU Sainte-Anne

Paris, France

NOT_YET_RECRUITING

Service de Neurologie - Fondation ophtalmologique de Rothschild - Fondation Rothschild

Paris, France

RECRUITING

Service de Neurologie - CHU de Rennes

Rennes, France

NOT_YET_RECRUITING

...and 2 more locations

Outcomes

Primary Outcomes

Effect of rehabilitation on immediate postoperative performances

Number of images quoted

Time frame: Day 7 after surgery