Investigation of executive function change following anterior temporal lobectomy: Selective normalization of verbal fluency

The nociferous cortex hypothesis predicts that electrophysiological normali zation to distal extratemporal brain regions following anterior temporal lo bectomy (ATL) will result in improvements in executive functioning. The pre sent study examined the effects of seizure laterality and seizure control o n executive function change. The authors administered the Wisconsin Card So rting Test (WCST), Trails B, and the Controlled Oral Word Association Test to 174 temporal lobe epilepsy patients who underwent ATL. No significant ch anges were found on the WCST or Trails B tests, regardless of surgery side or seizure-free status. However, verbal fluency significantly improved in s eizure-free patients. Findings were consistent with the nociferous cortex h ypothesis suggesting selective executive function improvement following ATL . These findings are discussed in terms of recent research demonstrating ex trahippocampal metabolic normalization following surgery.