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Executive Functioning Following Mesial Temporal Lobe Resective Surgery: A Systematic Review.

Vaia Sideropoulou1,2, Panayiotis Patrikelis1,2,3, Lambros Messinis4

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|November 22, 2025
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Mesial temporal lobe epilepsy (MTLE) surgery can improve executive functions. Seizure freedom after MTLE surgery is linked to better executive performance, possibly due to reduced neural noise.

Keywords:
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Area of Science:

  • Neuroscience
  • Epileptology
  • Cognitive Science

Background:

  • Mesial temporal lobe epilepsy (MTLE) surgery is a standard treatment for seizure control.
  • Cognitive changes beyond memory and language deficits can occur post-surgery.
  • Executive functioning is a critical cognitive domain potentially affected by MTLE and its treatment.

Purpose of the Study:

  • To systematically review executive functioning changes after MTLE resective surgery.
  • To understand the impact of MTLE surgery on executive domains.
  • To explore the relationship between seizure freedom and executive performance.

Main Methods:

  • Systematic review of studies assessing executive functioning pre- and postoperatively.
  • Inclusion of patients aged 15 years and over undergoing MTLE resective surgery.
  • Literature search conducted across PubMed, Elsevier, and Google Scholar databases.

Main Results:

  • Patients with refractory MTLE exhibit executive deficits prior to surgery.
  • Postoperative executive performance shows variability.
  • Seizure freedom correlates with improvements in executive functioning.

Conclusions:

  • MTLE surgery can lead to executive function improvements, particularly when seizure freedom is achieved.
  • Reduced epileptic neural noise propagation from temporolimbic to frontal areas may underlie cognitive gains.
  • Further research is needed to fully elucidate the neurocognitive effects of MTLE surgery.