Speech therapy before surgery for drug-resistant temporal lobe epilepsy
Tests speech therapy before surgery in people with drug-resistant temporal epilepsy.
Plain-language title generated from the registry record
Registry title: Intensive Preoperative Speech Rehabilitation in Drug-Resistant Temporal Epilepsy
Key facts
- Where
- Bordeaux, Grenoble, Lille, Lyon, Marseille, Nancy, Paris, Rennes, Strasbourg, and Toulouse, FranceSee the 12 sites
Where in France
- Service EFSN - Hôpital PellegrinBordeaux, FranceTaking people
- Service de Neurologie de l'Epilepsie - CHU Grenoble-AlpesGrenoble, FranceTaking people
- Département de Neurophysiologie Clinique - Hôpital Roger Salengro - CHU LilleLille, FranceTaking people
- Hôpital Neurologique Pierre Wertheimer- Service de Neurologie Fonctionnelle et Epileptologie - Hospices Civils LyonLyon, FranceNot yet recruiting
- Service Epilptologie et Rythmologie CérébraleMarseille, FranceTaking people
- Service de Neurologie - Hôpital central -CHU NancyNancy, FranceNot yet recruiting
- Département de Neurologie - Hôpital de la Pitié-Salpêtrière - APHPParis, FranceNot yet recruiting
- Service de Neurochirurgie -GHU Sainte-AnneParis, FranceNot yet recruiting
- Service de Neurologie - Fondation ophtalmologique de Rothschild - Fondation RothschildParis, FranceTaking people
- Service de Neurologie - CHU de RennesRennes, FranceNot yet recruiting
- Service de Neurologie - Hôpitaux Universitaires, Hôpital de HautepierreStrasbourg, FranceTaking people
- Explorations Neurophysiologiques, Pôle des Neurosciences - Hôpital Pierre Paul Riquet, PurpanToulouse, FranceNot yet recruiting
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Assistance Publique Hopitaux De Marseille
- Trial code
- NCT05609084
- Record updated
- 18 July 2024
- Original description
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.Read full original descriptionShow less
Intensive Preoperative Speech Rehabilitation in Drug-Resistant Temporal Epilepsy
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.
Inclusion: 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.
Exclusion: Patients with a total intelligence quotient (IQ) <70 (assessed in the context of care, in the year preceding the surgical procedure); Patient with a speech disorder that may impair intelligibility and compromise the use of the interface; Patient with an uncorrected hearing impairment,; Patients who are pregnant, nursing, deprived of liberty, under guardianship or curatorship.