Intensive Preoperative Speech Rehabilitation in Drug-Resistant Temporal Epilepsy
- Conditions
- Temporal Lobe EpilepsyAnomiaEpilepsy
- Interventions
- Procedure: Speech therapyProcedure: Speech therapy assessment
- Registration Number
- NCT05609084
- Lead Sponsor
- Assistance Publique Hopitaux De Marseille
- Brief Summary
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.
- Detailed Description
Not available
Recruitment & Eligibility
- Status
- RECRUITING
- Sex
- All
- Target Recruitment
- 214
- Patient 16 years of age and older,
- Patient whose epileptogenic area involves the temporal structures of the hemisphere specialized for language,
- Patient whose hemispheric specialization for language is known
- 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,
- Patient with a known NTB score
- 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)
- Patient whose first language is French (1st language learned by the patient),
- Patient declaring to be familiar with the use of a computer and having access to an internet connection from home
- Patient affiliated or benefiting from a social security system.
- Patient with a speech disorder that may impair intelligibility and compromise the use of the interface;
- Patient with an uncorrected hearing impairment,
- Patients with a total intelligence quotient (IQ) <70 (assessed in the context of care, in the year preceding the surgical procedure)
- Patients who are pregnant, nursing, deprived of liberty, under guardianship or curatorship.
Study & Design
- Study Type
- INTERVENTIONAL
- Study Design
- PARALLEL
- Arm && Interventions
Group Intervention Description Experimental Speech therapy Patients will have speech therapy assessment and intensive speech rehabilitation Experimental Speech therapy assessment Patients will have speech therapy assessment and intensive speech rehabilitation Control Speech therapy assessment Patients will have speech therapy assessment in addition to standard care.
- Primary Outcome Measures
Name Time Method Effect of rehabilitation on immediate postoperative performances Day 7 after surgery Number of images quoted
- Secondary Outcome Measures
Name Time Method Lexical fluency 6 months after surgery lexical evocation tests limited to 2 minutes according to a formal criterion or an imposed categorical criterion
Impact of rehabilitation on long-term postoperative performance on standardized language tests 6 months after surgery % of correct answers of language tests
Impact of rehabilitation on immediate on standardized language tests Day 7 after surgery % of correct answers of language tests
Impact of preoperative rehabilitation on verbal memory 6 months after surgery Verbal memory task
Evaluation of Quality of life 6 months after surgery Quality Of Life in Epilepsy Inventory (QOLIE-31) (0 meaning better outcome, highest score meaning worse outcome)
Impact of rehabilitation on long-term postoperative performance 6 months after surgery Number of images quoted
Denomination of control lists 6 months after surgery Number of words quoted
Self-reported perception of anomia 6 months after surgery Ad-hoc scale graduated from 0 (no complaint) to 10 (maximum complaint)
Impact of pre-operative rehabilitation on the number of post-operative rehabilitation sessions 6 months after surgery Number of speech therapy sessions performed postoperatively
Trial Locations
- Locations (12)
Service EFSN - Hôpital Pellegrin
🇫🇷Bordeaux, France
Service de Neurologie de l'Epilepsie - CHU Grenoble-Alpes
🇫🇷Grenoble, France
Département de Neurophysiologie Clinique - Hôpital Roger Salengro - CHU Lille
🇫🇷Lille, France
Service de Neurologie - Hôpital central -CHU Nancy
🇫🇷Nancy, France
Hôpital Neurologique Pierre Wertheimer- Service de Neurologie Fonctionnelle et Epileptologie - Hospices Civils Lyon
🇫🇷Lyon, France
Service Epilptologie et Rythmologie Cérébrale
🇫🇷Marseille, France
Service de Neurochirurgie -GHU Sainte-Anne
🇫🇷Paris, France
Département de Neurologie - Hôpital de la Pitié-Salpêtrière - APHP
🇫🇷Paris, France
Service de Neurologie - Fondation ophtalmologique de Rothschild - Fondation Rothschild
🇫🇷Paris, France
Service de Neurologie - CHU de Rennes
🇫🇷Rennes, France
Explorations Neurophysiologiques, Pôle des Neurosciences - Hôpital Pierre Paul Riquet, Purpan
🇫🇷Toulouse, France
Service de Neurologie - Hôpitaux Universitaires, Hôpital de Hautepierre
🇫🇷Strasbourg, France