Preoperative language rehabilitation in drug-resistant temporal lobe epilepsy (PReLang). Preoperative language rehabilitation in drug-resistant temporal lobe epilepsy (PReLang): Protocol for a randomized controlled study

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Sabadell, Véronique | Zielinski, Christelle | Baumstarck, Karine | Tardoski, Sophie | Hammam, Kahina | Bartolomei, Fabrice | Alario, F.-Xavier | Trébuchon, Agnès

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Introduction: Drug-resistant epileptic patients who undergo a left anterior temporal lobectomy often experience increased naming difficulties following surgery (41% of cases). Prehabilitation, i.e., rehabilitation before surgery, could induce protective brain plasticity, likely to increase cognitive reserve, particularly for patients with high risk of postoperative cognitive decline. The efficiency of language prehabilitation on postsurgical outcomes has never been thoroughly tested. The present study is the first one testing a possible protective effect of preoperative language rehabilitation in temporal lobe epilepsy surgery.Methods and analysis: The planned study (PReLang – REPREO) is a two-year large-scale randomized controlled trial of the pre-surgical management of language processing in the context of left temporal lobe epilepsy surgery. A total of 214 subjects waiting for anterior temporal lobectomy will be randomized and assigned either to the control group —who will benefit from standard of care — or to the experimental group — who will benefit from a language prehabilitation designed to protect against post-operative language decline. Both groups will undergo the same language assessments and questionnaires before surgery, seven days after surgery, and six months far from surgery.

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