Pre- and postoperative cognitive function scores in resective and destructive surgeries for pharmacoresistant epilepsy (as assessed by MoCA)
Bibliographic record
Abstract
Epilepsy is associated with comorbid diseases and cognitive impairment, which, even with successful compensation of seizures by medication and/or surgery, continue to have a negative impact on the quality of life of patients. The cognitive outcomes of surgery are variable: they may include positive changes or no changes, but there is also a risk of increasing cognitive dysfunction. Purpose of the study. To ascertain the impact of resective and destructive surgeries in pharmacoresistant epilepsy on cognitive functions, as assessed using the Montreal Cognitive Assessment (MoCA) screening scale. Materials and Methods. The article presents the results of an investigation into the impact of resective and destructive surgeries in pharmacoresistant epilepsy on cognitive functions, as assessed by the MoCA. The study comprised 50 patients with a verified diagnosis of focal pharmacoresistant epilepsy, divided into two groups: group 1 (25 patients) underwent resective surgery, while group 2 (25 patients) had destructive surgery. Cognitive function was evaluated using the Montreal Cognitive Assessment Scale (MoCA) prior to surgery and at intervals between six months and five years post-operatively. Results. The mean age of the subjects at the time of surgery was 33.2 ± 10.05 years, and the mean duration of epilepsy was 20.7 ± 10.98 years. In 50 % of patients, the epileptic focus was localized to the left side of the brain, while in 44 % of cases, it was localized to the right side. In 6 % of patients, the epileptic focus was bilateral. The majority of patients (70 %) exhibited temporal epilepsy, while 18 % demonstrated extratemporal epilepsy and 4 % showed both temporal and extratemporal epilepsy. At the preoperative stage, cognitive deficit was observed in the majority of patients (76 %), with an average score of 23.1 points. In the postoperative period, cognitive impairment was also observed in 76 % of patients, with no change in the mean MoCA score of 23.1. In group 1, 80 % of patients exhibited cognitive deficits prior to the operation, with an average score of 22.2. In the postoperative period, the score showed an increase, reaching 23.4. In group 2, cognitive deficit was also observed in the majority of patients (72 %) at the preoperative stage. The average score in group 2 was 21.7 points, which increased to 22.2 points after the operation. Conclusion. The practice of delaying surgical treatment for pharmacoresistant epilepsy persists, with cognitive functions preserved at the time of hospitalization in only a quarter of patients. The mean score on the Cognitive Function Assessment Screening Scale did not decline as a result of surgical intervention. However, a negative effect was observed in patients who did not show cognitive deficits prior to surgery. The findings will assist physicians in making informed decisions regarding the timing and approach to pharmacoresistant epilepsy treatment.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.001 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".