{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T23:56:43Z","timestamp":1792454203168,"version":"4.5.0"},"reference-count":61,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2025,4,4]],"date-time":"2025-04-04T00:00:00Z","timestamp":1743724800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Epilepsia"],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Postoperative neuropsychological deficits pose a significant challenge for temporal lobe epilepsy (TLE) surgery, particularly in the language\u2010dominant hemisphere. Two surgical approaches have been suggested to mitigate such adverse outcomes: stereotactic laser amygdalohippocampectomy (SLAH) and hippocampus\u2010sparing anterior temporal lobectomy (HSATL). This retrospective cohort study compares the seizure control and neuropsychological outcomes of HSATL and SLAH in language\u2010dominant TLE.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A retrospective cohort study compared 27 patients (nine male, mean age\u2009=\u200935.8\u2009years) with drug\u2010resistant TLE and normal imaging localized to the language\u2010dominant left temporal lobe, undergoing either HSATL (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200922) or SLAH (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20095) between 2014 and 2021. Comprehensive pre\u2010 and \u22651\u2010year postoperative neuropsychological testing and imaging were performed, with seizure outcomes tracked for at least 1 year postoperatively. However, to assess the impact of mesial temporal sclerosis (MTS) on SLAH outcomes, we included seven additional patients with MTS who underwent SLAH in a secondary analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      HSATL led to significant declines in logical memory (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.04) despite sparing the hippocampus, which were not seen following SLAH in patients regardless of MTS status. SLAH trended toward improved semantic fluency, immediate verbal memory, and executive function despite hippocampal ablation. Including both MTS(+) and MTS(\u2212) patients, there was a significant decline in letter fluency following SLAH (.04), with subgroup analyses demonstrating significantly greater declines in MTS(+) patients undergoing SLAH (.02). Additionally, 100% of patients undergoing SLAH achieved seizure freedom versus 72.7% following HSATL (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u2009.046, including MTS[+] patients) at last follow\u2010up.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Significance<\/jats:title>\n                    <jats:p>In language\u2010dominant TLE, SLAH demonstrated comparable seizure outcomes and superior verbal memory retention compared to HSATL, albeit with greater letter fluency impairment. Preliminary findings challenge prioritizing hippocampal preservation for verbal memory function, suggesting potential cognitive advantages with SLAH specifically targeting mesial structures while maximally preserving cortical structures and white matter tracts critical for language networks. However, this intervention may negatively impact letter fluency, suggesting careful preoperative screening and discussion.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/epi.18388","type":"journal-article","created":{"date-parts":[[2025,4,5]],"date-time":"2025-04-05T11:58:38Z","timestamp":1743854318000},"page":"2465-2479","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Neuropsychological outcomes of hippocampus\u2010sparing anterior temporal lobectomy versus stereotactic laser amygdalohippocampectomy in language\u2010dominant temporal lobe epilepsy"],"prefix":"10.1111","volume":"66","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6236-6460","authenticated-orcid":false,"given":"Zeegan","family":"George","sequence":"first","affiliation":[{"name":"University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5051-8866","authenticated-orcid":false,"given":"Keaton","family":"Piper","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5012-5704","authenticated-orcid":false,"given":"Elliot G.","family":"Neal","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery and Brain Repair University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6986-788X","authenticated-orcid":false,"given":"Adam","family":"Alayli","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9860-8820","authenticated-orcid":false,"given":"Samantha","family":"Schimmel","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9801-7465","authenticated-orcid":false,"given":"Molly","family":"Monsour","sequence":"additional","affiliation":[{"name":"University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Long","family":"Di","sequence":"additional","affiliation":[{"name":"University of Miami Miller School of Medicine  Miami Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8155-3752","authenticated-orcid":false,"given":"Ushtar","family":"Amin","sequence":"additional","affiliation":[{"name":"Department of Neurology University of South Florida Morsani College of Medicine  Tampa Florida USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6919-4593","authenticated-orcid":false,"given":"Joseph J.","family":"Boscarino","sequence":"additional","affiliation":[{"name":"James A. 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