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Saggi S, Garcia JH, Behzadi F, Mallela AN, Garcia PA, Chang EF, Knowlton RC. Surgical outcomes following resection in patients with language dominant posterior quadrant epilepsy. Epilepsy Behav Rep 2024; 27:100695. [PMID: 39157688 PMCID: PMC11327395 DOI: 10.1016/j.ebr.2024.100695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2024] [Revised: 06/08/2024] [Accepted: 07/13/2024] [Indexed: 08/20/2024] Open
Abstract
Posterior quadrant epilepsy surgery, involving the occipital lobe, parietal lobe, or the posterior border of the temporal lobe, accounts for a small percentage of focal resections for medically refractory epilepsy. Prior studies investigating seizure control from posterior quadrant epilepsy surgery are limited. In this study, a retrospective database of patients undergoing surgery for left sided posterior cortex epilepsy at a single large level 4 epilepsy center was analyzed between August 2008 to April 2021 in order to characterize seizure control outcomes. Nine patients presented with epileptogenic foci in the left posterior cortex with a malformation of cortical development deemed as the etiology of seizures for all but one patient. Absolute seizure freedom (Engel I) was achieved in 4 of 9 patients, with the remaining 5 patients achieving an improvement in the frequency of seizures (Engel II/III). Complete resection of the anatomic and physiologic abnormalities was performed in 3 of 4 patients with Engel 1 outcomes and 1 of 5 patients with Class II/III outcomes. Five patients developed new right sided visual field defects, all of which were expected based on the sub-lobar, occipital localization and were viewed as acceptable by the patients and did not interfere with activities of daily living. Overall, our study demonstrates the potential for surgical resection to yield excellent seizure-control outcomes with anticipated, tolerable neurological deficits. This information is important for patients with disabling seizures who may not benefit sufficiently from palliative procedures.
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Affiliation(s)
- Satvir Saggi
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Joseph H. Garcia
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Faraz Behzadi
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Arka N. Mallela
- Department of Neurological Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - Paul A. Garcia
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
| | - Edward F. Chang
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
| | - Robert C. Knowlton
- Department of Neurological Surgery, University of California San Francisco, San Francisco, CA, USA
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA
- Department of Radiology, University of California San Francisco, San Francisco, CA, USA
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Fedorenko E, Ivanova AA, Regev TI. The language network as a natural kind within the broader landscape of the human brain. Nat Rev Neurosci 2024; 25:289-312. [PMID: 38609551 DOI: 10.1038/s41583-024-00802-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2024] [Indexed: 04/14/2024]
Abstract
Language behaviour is complex, but neuroscientific evidence disentangles it into distinct components supported by dedicated brain areas or networks. In this Review, we describe the 'core' language network, which includes left-hemisphere frontal and temporal areas, and show that it is strongly interconnected, independent of input and output modalities, causally important for language and language-selective. We discuss evidence that this language network plausibly stores language knowledge and supports core linguistic computations related to accessing words and constructions from memory and combining them to interpret (decode) or generate (encode) linguistic messages. We emphasize that the language network works closely with, but is distinct from, both lower-level - perceptual and motor - mechanisms and higher-level systems of knowledge and reasoning. The perceptual and motor mechanisms process linguistic signals, but, in contrast to the language network, are sensitive only to these signals' surface properties, not their meanings; the systems of knowledge and reasoning (such as the system that supports social reasoning) are sometimes engaged during language use but are not language-selective. This Review lays a foundation both for in-depth investigations of these different components of the language processing pipeline and for probing inter-component interactions.
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Affiliation(s)
- Evelina Fedorenko
- Brain and Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA, USA.
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA.
- The Program in Speech and Hearing in Bioscience and Technology, Harvard University, Cambridge, MA, USA.
| | - Anna A Ivanova
- School of Psychology, Georgia Institute of Technology, Atlanta, GA, USA
| | - Tamar I Regev
- Brain and Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA, USA
- McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
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Otomo M, Osawa SI, Suzuki K, Kakinuma K, Ukishiro K, Suzuki H, Niizuma K, Narita N, Nakasato N, Tominaga T. Bilateral and asymmetrical localization of language function identified by the superselective infusion of propofol in an epilepsy patient with a mild malformation of cortical development: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2023; 6:CASE23451. [PMID: 38145562 PMCID: PMC10751223 DOI: 10.3171/case23451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 11/16/2023] [Indexed: 12/27/2023]
Abstract
BACKGROUND Atypical localization of language function can result in unexpected postsurgical deficits after cortical resection, but it is difficult to predict the risk in the presurgical evaluation. The authors experienced a rare case of the bilateral and independent existence of different components of language function identified by segmented evaluation of anatomical anterior and posterior language areas using the superselective infusion of propofol. OBSERVATIONS A 32-year-old right-handed female presented with drug-resistant epilepsy. Comprehensive epilepsy evaluation suggested that the epileptic foci involved the whole left frontal lobe but provided less evidence of structural abnormality. To estimate the extent of functional deterioration likely to be caused by an extended left frontal lobectomy, the authors evaluated segmented cortical function in the ipsi- and contralateral hemispheres by the superselective infusion of propofol into the branches of the intracranial artery. The results revealed bilateral and asymmetrical localization of language function because the patient presented with different components of aphasia in each hemisphere. Based on the authors' assessment of her functional tolerance, an extended left frontal lobectomy was performed and resulted in neurological deficits within the anticipated range. LESSONS An accurate understanding of the correlations between vascular and functional anatomy and the highly specific evaluation of language function provides more advanced presurgical assessment, allowing more tailored planning of cortical resection.
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Affiliation(s)
| | | | | | | | | | - Hiroyoshi Suzuki
- Department of Pathology, Sendai Medical Center, Sendai, Miyagi, Japan
| | - Kuniyasu Niizuma
- Departments of Neurosurgery
- Neurosurgical Engineering and Translational Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Miyagi, Japan
- Department of Neurosurgical Engineering and Translational Neuroscience, Graduate School of Biomedical Engineering, Tohoku University, Sendai, Miyagi, Japan; and
| | - Norio Narita
- Department of Neurosurgery, Kesennuma City Hospital, Kesennuma, Miyagi, Japan
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Heffelfinger AK, Kaseda ET, Holliday DD, Miller LE, Koop JI. Factor analysis of neuropsychological domains in a preschool clinic. J Clin Exp Neuropsychol 2023; 45:890-904. [PMID: 38391129 DOI: 10.1080/13803395.2024.2314777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2023] [Accepted: 12/13/2023] [Indexed: 02/24/2024]
Abstract
INTRODUCTION The clinical practice of preschool neuropsychology assumes that our assessment tools are measuring underlying neuropsychological functions, and that these functions are negatively impacted by early life neurological injury, disease, and disorder. This study hypothesized that general intellectual capacity and specific cognitive skills, both "broad" neuropsychological domains and "specific" subdomains within those broader clusters, would be differentiable in a preschool-age clinical population. METHODS Using neuropsychological data from 580 children (6 and 71 months) seen for a clinical neuropsychological evaluation in the Preschool and Infant Neuropsychological Testing (PINT) Clinic, exploratory factor analyses (EFA) were conducted. Results: A one-factor model provided a good fit when considering verbal, nonverbal, and adaptive functions. Consideration of one- versus two-factor solutions for broad neuropsychological domains indicated that a 2-factor solution provided a significantly better fit for the data. Factor 1 was defined by motor, language, and nonverbal reasoning abilities; Factor 2 was defined by inhibitory control and attention. Further consideration of specific neuropsychological functions also supported a 2-factor solution. Factor 1 ("thinking") was defined by nonverbal reasoning, receptive language, and expressive language; Factor 2 ("processing") was defined by impulse control, inhibitory control, inattention, visual-motor integration, and visuo-constructional abilities. Motor skills cross-loaded onto both factors. Secondary analyses suggest these models provide the best fit for preschool-aged children with > 70 overall intellectual functioning and no comorbid medical diagnosis. CONCLUSIONS In a clinical sample of preschool-age children, neuropsychological assessment data appears to assess a general level of intellectual capacity or functioning. Further differentiation between assessing "thinking" (knowledge and reasoning skills) and "processing" (cognitive attention and processing of information) can be considered clinically. Next steps include more recent clinical sample replication, consideration of whether neuropsychological profiles are detectable in the preschool-age range and whether the results of early life assessment are predictive of future functioning.
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Affiliation(s)
| | - Erin T Kaseda
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, USA
| | - Daniel D Holliday
- Department of Public Health, University of Milwaukee - Wisconsin, Milwaukee, USA
| | - Lauren E Miller
- Department of Neurology, Medical College of Wisconsin, Milwaukee, USA
| | - Jennifer I Koop
- Department of Neurology, Medical College of Wisconsin, Milwaukee, USA
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Binding LP, Dasgupta D, Taylor PN, Thompson PJ, O'Keeffe AG, de Tisi J, McEvoy AW, Miserocchi A, Winston GP, Duncan JS, Vos SB. Contribution of White Matter Fiber Bundle Damage to Language Change After Surgery for Temporal Lobe Epilepsy. Neurology 2023; 100:e1621-e1633. [PMID: 36750386 PMCID: PMC10103113 DOI: 10.1212/wnl.0000000000206862] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2022] [Accepted: 12/12/2022] [Indexed: 02/09/2023] Open
Abstract
BACKGROUND AND OBJECTIVES In medically refractory temporal lobe epilepsy (TLE), 30%-50% of patients experience substantial language decline after resection in the language-dominant hemisphere. In this study, we investigated the contribution of white matter fiber bundle damage to language change at 3 and 12 months after surgery. METHODS We studied 127 patients who underwent TLE surgery from 2010 to 2019. Neuropsychological testing included picture naming, semantic fluency, and phonemic verbal fluency, performed preoperatively and 3 and 12 months postoperatively. Outcome was assessed using reliable change index (RCI; clinically significant decline) and change across timepoints (postoperative scores minus preoperative scores). Functional MRI was used to determine language lateralization. The arcuate fasciculus (AF), inferior fronto-occipital fasciculus (IFOF), inferior longitudinal fasciculus, middle longitudinal fasciculus (MLF), and uncinate fasciculus were mapped using diffusion MRI probabilistic tractography. Resection masks, drawn comparing coregistered preoperative and postoperative T1 MRI scans, were used as exclusion regions on preoperative tractography to estimate the percentage of preoperative tracts transected in surgery. Chi-squared assessments evaluated the occurrence of RCI-determined language decline. Independent sample t tests and MM-estimator robust regressions were used to assess the impact of clinical factors and fiber transection on RCI and change outcomes, respectively. RESULTS Language-dominant and language-nondominant resections were treated separately for picture naming because postoperative outcomes were significantly different between these groups. In language-dominant hemisphere resections, greater surgical damage to the AF and IFOF was related to RCI decline at 3 months. Damage to the inferior frontal subfasciculus of the IFOF was related to change at 3 months. In language-nondominant hemisphere resections, increased MLF resection was associated with RCI decline at 3 months, and damage to the anterior subfasciculus was related to change at 3 months. Language-dominant and language-nondominant resections were treated as 1 cohort for semantic and phonemic fluency because there were no significant differences in postoperative decline between these groups. Postoperative seizure freedom was associated with an absence of significant language decline 12 months after surgery for semantic fluency. DISCUSSION We demonstrate a relationship between fiber transection and naming decline after temporal lobe resection. Individualized surgical planning to spare white matter fiber bundles could help to preserve language function after surgery.
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Affiliation(s)
- Lawrence Peter Binding
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia.
| | - Debayan Dasgupta
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Peter Neal Taylor
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Pamela Jane Thompson
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Aidan G O'Keeffe
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Jane de Tisi
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Andrew William McEvoy
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Anna Miserocchi
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Gavin P Winston
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - John S Duncan
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
| | - Sjoerd B Vos
- From the Department of Computer Science (L.P.B., S.B.V.), Centre for Medical Image Computing, Department of Clinical and Experimental Epilepsy (L.B.P., D.D., P.N.T., P.J.T., J.d.T., A.W.M., A.M., G.P.W., J.S.D.), UCL Queen Square Institute of Neurology, and Neuroradiological Academic Unit (S.B.V.), UCL Queen Square Institute of Neurology, University College London; Victor Horsley Department of Neurosurgery (D.D., A.W.M., A.M.), and Department of Neuropsychology (P.J.T.), National Hospital for Neurology and Neurosurgery, Queen Square, London; CNNP Lab (P.N.T.), Interdisciplinary Computing and Complex BioSystems Group, School of Computing Science, Newcastle University; School of Mathematical Sciences (A.G.O.), University of Nottingham; Epilepsy Society MRI Unit (J.d.T., G.P.W., J.S.D.), Chalfont Centre for Epilepsy, Chalfont St Peter, United Kingdom; Department of Medicine (G.P.W.), Division of Neurology, Queen's University, Kingston, Canada; and Centre for Microscopy (S.B.V), Characterisation, and Analysis, The University of Western Australia, Nedlands, Australia
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Koop JI, Credille K, Wang Y, Loman M, Marashly A, Kim I, Lew SM, Maheshwari M. Determination of language dominance in pediatric patients with epilepsy for clinical decision-making: Correspondence of intracarotid amobarbitol procedure and fMRI modalities. Epilepsy Behav 2021; 121:108041. [PMID: 34082317 DOI: 10.1016/j.yebeh.2021.108041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/29/2022]
Abstract
Identification of the language dominant hemisphere is an essential part of the evaluation of potential pediatric epilepsy surgery patients. Historically, language dominance has been determined using the intracarotid amobarbitol procedure (IAP), but use of functional Magnetic Resonance Imaging (fMRI) scanning is becoming more common. Few studies examine the correspondence between fMRI and IAP in pediatric samples. The current study examined the agreement of hemispheric lateralization as determined by fMRI and IAP in a consecutive sample of 10 pediatric patients with epilepsy evaluated for epilepsy surgery. Data showed a strong correlation between IAP and fMRI lateralilty indices (r=.91) and 70% agreement in determination of hemispheric dominance, despite increased demonstration of bilateral or atypical language representation in this pediatric sample. Clinical implications and interpretation challenges are discussed.
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Affiliation(s)
- Jennifer I Koop
- Department of Neurology (Neuropsychology), Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Kevin Credille
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Michelle Loman
- Department of Neurology (Neuropsychology), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ahmad Marashly
- Division of Pediatric Neurology, University of Washington/Seattle Children's Hospital, Seattle, WA, United States
| | - Irene Kim
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sean M Lew
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mohit Maheshwari
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
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Leon-Rojas J, Cornell I, Rojas-Garcia A, D’Arco F, Panovska-Griffiths J, Cross H, Bisdas S. The role of preoperative diffusion tensor imaging in predicting and improving functional outcome in pediatric patients undergoing epilepsy surgery: a systematic review. BJR Open 2021; 3:20200002. [PMID: 34381942 PMCID: PMC8320117 DOI: 10.1259/bjro.20200002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 03/19/2021] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVE Diffusion tensor imaging (DTI) is a useful neuroimaging technique for surgical planning in adult patients. However, no systematic review has been conducted to determine its utility for pre-operative analysis and planning of Pediatric Epilepsy surgery. We sought to determine the benefit of pre-operative DTI in predicting and improving neurological functional outcome after epilepsy surgery in children with intractable epilepsy. METHODS A systematic review of articles in English using PubMed, EMBASE and Scopus databases, from inception to January 10, 2020 was conducted. All studies that used DTI as either predictor or direct influencer of functional neurological outcome (motor, sensory, language and/or visual) in pediatric epilepsy surgical candidates were included. Data extraction was performed by two blinded reviewers. Risk of bias of each study was determined using the QUADAS 2 Scoring System. RESULTS 13 studies were included (6 case reports/series, 5 retrospective cohorts, and 2 prospective cohorts) with a total of 229 patients. Seven studies reported motor outcome; three reported motor outcome prediction with a sensitivity and specificity ranging from 80 to 85.7 and 69.6 to 100%, respectively; four studies reported visual outcome. In general, the use of DTI was associated with a high degree of favorable neurological outcomes after epilepsy surgery. CONCLUSION Multiple studies show that DTI helps to create a tailored plan that results in improved functional outcome. However, more studies are required in order to fully assess its utility in pediatric patients. This is a desirable field of study because DTI offers a non-invasive technique more suitable for children. ADVANCES IN KNOWLEDGE This systematic review analyses, exclusively, studies of pediatric patients with drug-resistant epilepsy and provides an update of the evidence regarding the role of DTI, as part of the pre-operative armamentarium, in improving post-surgical neurological sequels and its potential for outcome prediction.
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Affiliation(s)
| | - Isabel Cornell
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK
| | | | - Felice D’Arco
- Department of Pediatric Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London, UK
| | | | - Helen Cross
- Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, University College London Hospitals NHS Trust, London, UK
- NeurALL Research Group, Universidad Internacional del Ecuador, Medical School, Quito, Ecuador
- Department of Applied Health Research, University College London, London, UK
- Department of Pediatric Neuroradiology, Great Ormond Street Hospital for Children NHS Trust, London, UK
- Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
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8
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Prediction of baseline expressive and receptive language function in children with focal epilepsy using diffusion tractography-based deep learning network. Epilepsy Behav 2021; 117:107909. [PMID: 33740493 PMCID: PMC8035310 DOI: 10.1016/j.yebeh.2021.107909] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 02/23/2021] [Accepted: 02/25/2021] [Indexed: 11/21/2022]
Abstract
PURPOSE Focal epilepsy is a risk factor for language impairment in children. We investigated whether the current state-of-the-art deep learning network on diffusion tractography connectome can accurately predict expressive and receptive language scores of children with epilepsy. METHODS We studied 37 children with a diagnosis of drug-resistant focal epilepsy (age: 11.8 ± 3.1 years) using 3 T MRI and diffusion tractography connectome: G = (S, Ω), where S is an adjacency matrix of edges representing the connectivity strength (number of white-matter tract streamlines) between each pair of brain regions, and Ω reflects a set of brain regions. A convolutional neural network (CNN) was trained to learn the nonlinear relationship between 'S (input)' and 'language score (output)'. Repeated hold-out validation was then employed to measure the Pearson correlation and mean absolute error (MAE) between CNN-predicted and actual language scores. RESULTS We found that CNN-predicted and actual scores were significantly correlated (i.e., Pearson's R/p-value: 0.82/<0.001 and 0.75/<0.001), yielding MAE: 7.77 and 7.40 for expressive and receptive scores, respectively. Specifically, sparse connectivity not only within the left cortico-cortical network but also involving the right subcortical structures was predictive of language impairment of expressive or receptive domain. Subsequent subgroup analyses inferred that the effectiveness of diffusion tractography-based prediction of language outcome was independent of clinical variables. Intrinsic diffusion tractography connectome properties may be useful for predicting the severity of baseline language dysfunction and possibly provide a better understanding of the biological mechanisms of epilepsy-related language impairment in children.
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9
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Pur DR, Eagleson R, Lo M, Jurkiewicz MT, Andrade A, de Ribaupierre S. Presurgical brain mapping of the language network in pediatric patients with epilepsy using resting-state fMRI. J Neurosurg Pediatr 2021; 27:259-268. [PMID: 33418528 DOI: 10.3171/2020.8.peds20517] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Accepted: 08/17/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Epilepsy affects neural processing and often causes intra- or interhemispheric language reorganization, rendering localization solely based on anatomical landmarks (e.g., Broca's area) unreliable. Preoperative brain mapping is necessary to weigh the risk of resection with the risk of postoperative deficit. However, the use of conventional mapping methods (e.g., somatosensory stimulation, task-based functional MRI [fMRI]) in pediatric patients is technically difficult due to low compliance and their unique neurophysiology. Resting-state fMRI (rs-fMRI), a "task-free" technique based on the neural activity of the brain at rest, has the potential to overcome these limitations. The authors hypothesized that language networks can be identified from rs-fMRI by applying functional connectivity analyses. METHODS Cases in which both task-based fMRI and rs-fMRI were acquired as part of the preoperative clinical protocol for epilepsy surgery were reviewed. Task-based fMRI consisted of 2 language tasks and 1 motor task. Resting-state fMRI data were acquired while the patients watched an animated movie and were analyzed using independent component analysis (i.e., data-driven method). The authors extracted language networks from rs-fMRI data by performing a similarity analysis with functionally defined language network templates via a template-matching procedure. The Dice coefficient was used to quantify the overlap. RESULTS Thirteen children underwent conventional task-based fMRI (e.g., verb generation, object naming), rs-fMRI, and structural imaging at 1.5T. The language components with the highest overlap with the language templates were identified for each patient. Language lateralization results from task-based fMRI and rs-fMRI mapping were comparable, with good concordance in most cases. Resting-state fMRI-derived language maps indicated that language was on the left in 4 patients (31%), on the right in 5 patients (38%), and bilateral in 4 patients (31%). In some cases, rs-fMRI indicated a more extensive language representation. CONCLUSIONS Resting-state fMRI-derived language network data were identified at the patient level using a template-matching method. More than half of the patients in this study presented with atypical language lateralization, emphasizing the need for mapping. Overall, these data suggest that this technique may be used to preoperatively identify language networks in pediatric patients. It may also optimize presurgical planning of electrode placement and thereby guide the surgeon's approach to the epileptogenic zone.
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Affiliation(s)
| | - Roy Eagleson
- 2Department of Electrical and Computer Engineering, Brain and Mind Institute, University of Western Ontario, London
| | - Marcus Lo
- 3Lawson Health Research Institute, London
| | - Michael T Jurkiewicz
- 4Department of Medical Imaging, Children's Hospital at London Health Sciences Centre, London; and
| | | | - Sandrine de Ribaupierre
- 6Clinical Neurological Sciences, London Health Sciences Centre, University of Western Ontario, London, Ontario, Canada
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10
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Jouravlev O, Mineroff Z, Blank IA, Fedorenko E. The Small and Efficient Language Network of Polyglots and Hyper-polyglots. Cereb Cortex 2021; 31:62-76. [PMID: 32820332 DOI: 10.1093/cercor/bhaa205] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 07/06/2020] [Accepted: 07/06/2020] [Indexed: 11/13/2022] Open
Abstract
Acquiring a foreign language is challenging for many adults. Yet certain individuals choose to acquire sometimes dozens of languages and often just for fun. Is there something special about the minds and brains of such polyglots? Using robust individual-level markers of language activity, measured with fMRI, we compared native language processing in polyglots versus matched controls. Polyglots (n = 17, including nine "hyper-polyglots" with proficiency in 10-55 languages) used fewer neural resources to process language: Their activations were smaller in both magnitude and extent. This difference was spatially and functionally selective: The groups were similar in their activation of two other brain networks-the multiple demand network and the default mode network. We hypothesize that the activation reduction in the language network is experientially driven, such that the acquisition and use of multiple languages makes language processing generally more efficient. However, genetic and longitudinal studies will be critical to distinguish this hypothesis from the one whereby polyglots' brains already differ at birth or early in development. This initial characterization of polyglots' language network opens the door to future investigations of the cognitive and neural architecture of individuals who gain mastery of multiple languages, including changes in this architecture with linguistic experiences.
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Affiliation(s)
- Olessia Jouravlev
- Brain & Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Department of Cognitive Science, Carleton University, Ottawa, ON K1S5B6, Canada
| | - Zachary Mineroff
- Brain & Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
| | - Idan A Blank
- Brain & Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,Department of Psychology, University of California Los Angeles, Los Angeles, CA 90095, USA
| | - Evelina Fedorenko
- Brain & Cognitive Sciences Department, Massachusetts Institute of Technology, Cambridge, MA 02139, USA.,McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA 02139, USA
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11
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Hildesheim FE, Debus I, Kessler R, Thome I, Zimmermann KM, Steinsträter O, Sommer J, Kamp-Becker I, Stark R, Jansen A. The Trajectory of Hemispheric Lateralization in the Core System of Face Processing: A Cross-Sectional Functional Magnetic Resonance Imaging Pilot Study. Front Psychol 2020; 11:507199. [PMID: 33123034 PMCID: PMC7566903 DOI: 10.3389/fpsyg.2020.507199] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Accepted: 09/10/2020] [Indexed: 12/12/2022] Open
Abstract
Face processing is mediated by a distributed neural network commonly divided into a “core system” and an “extended system.” The core system consists of several, typically right-lateralized brain regions in the occipito-temporal cortex, including the occipital face area (OFA), the fusiform face area (FFA) and the posterior superior temporal sulcus (pSTS). It was recently proposed that the face processing network is initially bilateral and becomes right-specialized in the course of the development of reading abilities due to the competition between language-related regions in the left occipito-temporal cortex (e.g., the visual word form area, VWFA) and the FFA for common neural resources. In the present pilot study, we assessed the neural face processing network in 12 children (aged 7–9 years) and 10 adults with functional magnetic resonance imaging (fMRI). The hemispheric lateralization of the core face regions was compared between both groups. The study had two goals: First, we aimed to establish an fMRI paradigm suitable for assessing activation in the core system of face processing in young children at the single subject level. Second, we planned to collect data for a power analysis to calculate the necessary group size for a large-scale cross-sectional imaging study assessing the ontogenetic development of the lateralization of the face processing network, with focus on the FFA. It was possible to detect brain activity in the core system of 75% of children at the single subject level. The average scan-to-scan motion of the included children was comparable to adults, ruling out that potential activation differences between groups are caused by unequal motion artifacts. Hemispheric lateralization of the FFA was 0.07 ± 0.48 in children (indicating bilateral activation) and −0.32 ± 0.52 in adults (indicating right-hemispheric dominance). These results thus showed, as expected, a trend for increased lateralization in adults. The estimated effect size for the FFA lateralization difference was d = 0.78 (indicating medium to large effects). An adequately powered follow-up study (sensitivity 0.8) testing developmental changes of FFA lateralization would therefore require the inclusion of 18 children and 26 adults.
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Affiliation(s)
- Franziska E Hildesheim
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany
| | - Isabell Debus
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany
| | - Roman Kessler
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany
| | - Ina Thome
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany
| | - Kristin M Zimmermann
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany
| | - Olaf Steinsträter
- Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany.,Core-Facility Brainimaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
| | - Jens Sommer
- Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany.,Core-Facility Brainimaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
| | - Inge Kamp-Becker
- Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Rudolf Stark
- Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany.,Bender Institute of Neuroimaging, Justus-Liebig University Giessen, Giessen, Germany
| | - Andreas Jansen
- Laboratory for Multimodal Neuroimaging, Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany.,Center for Mind, Brain and Behavior, Philipps-University Marburg, Marburg and Justus-Liebig University Giessen, Giessen, Germany.,Core-Facility Brainimaging, Faculty of Medicine, Philipps-University Marburg, Marburg, Germany
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12
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Jouravlev O, Kell AJE, Mineroff Z, Haskins AJ, Ayyash D, Kanwisher N, Fedorenko E. Reduced Language Lateralization in Autism and the Broader Autism Phenotype as Assessed with Robust Individual-Subjects Analyses. Autism Res 2020; 13:1746-1761. [PMID: 32935455 DOI: 10.1002/aur.2393] [Citation(s) in RCA: 34] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 07/28/2020] [Accepted: 08/25/2020] [Indexed: 12/13/2022]
Abstract
One of the few replicated functional brain differences between individuals with autism spectrum disorders (ASD) and neurotypical (NT) controls is reduced language lateralization. However, most prior reports relied on comparisons of group-level activation maps or functional markers that had not been validated at the individual-subject level, and/or used tasks that do not isolate language processing from other cognitive processes, complicating interpretation. Furthermore, few prior studies have examined functional responses in other brain networks, as needed to determine the spatial selectivity of the effect. Using functional magnetic resonance imaging (fMRI), we compared language lateralization between 28 adult ASD participants and carefully pairwise-matched controls, with the language regions defined individually using a well-validated language "localizer" task. Across two language comprehension paradigms, ASD participants showed less lateralized responses due to stronger right hemisphere activity. Furthermore, this effect did not stem from a ubiquitous reduction in lateralization of function across the brain: ASD participants did not differ from controls in the lateralization of two other large-scale networks-the Theory of Mind network and the Multiple Demand network. Finally, in an exploratory study, we tested whether reduced language lateralization may also be present in NT individuals with high autism-like traits. Indeed, autistic trait load in a large set of NT participants (n = 189) was associated with less lateralized language responses. These results suggest that reduced language lateralization is robustly associated with autism and, to some extent, with autism-like traits in the general population, and this lateralization reduction appears to be restricted to the language system. LAY SUMMARY: How do brains of individuals with autism spectrum disorders (ASD) differ from those of neurotypical (NT) controls? One of the most consistently reported differences is the reduction of lateralization during language processing in individuals with ASD. However, most prior studies have used methods that made this finding difficult to interpret, and perhaps even artifactual. Using robust individual-level markers of lateralization, we found that indeed, ASD individuals show reduced lateralization for language due to stronger right-hemisphere activity. We further show that this reduction is not due to a general reduction of lateralization of function across the brain. Finally, we show that greater autistic trait load is associated with less lateralized language responses in the NT population. These results suggest that reduced language lateralization is robustly associated with autism and, to some extent, with autism-like traits in the general population. Autism Res 2020, 13: 1746-1761. © 2020 International Society for Autism Research and Wiley Periodicals LLC.
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Affiliation(s)
- Olessia Jouravlev
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,Department of Cognitive Science, Carleton University, Ottawa, Ontario, Canada
| | - Alexander J E Kell
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,Zuckerman Institute, Columbia University, New York, New York, USA
| | - Zachary Mineroff
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,Eberly Center, Carnegie Mellon University, Pittsburgh, Pennsylvania, USA
| | - Amanda J Haskins
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,Department of Psychological and Brain Sciences, Dartmouth College, Hanover, New Hampshire, USA
| | - Dima Ayyash
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,McGovern Institute for Brain Research, MIT, Cambridge, Massachusetts, USA
| | - Nancy Kanwisher
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,McGovern Institute for Brain Research, MIT, Cambridge, Massachusetts, USA
| | - Evelina Fedorenko
- Brain and Cognitive Sciences Department, MIT, Cambridge, Massachusetts, USA.,McGovern Institute for Brain Research, MIT, Cambridge, Massachusetts, USA
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13
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Patterns and predictors of language representation and the influence of epilepsy surgery on language reorganization in children and young adults with focal lesional epilepsy. PLoS One 2020; 15:e0238389. [PMID: 32898166 PMCID: PMC7478845 DOI: 10.1371/journal.pone.0238389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 08/14/2020] [Indexed: 11/19/2022] Open
Abstract
Mapping brain functions is crucial for neurosurgical planning in patients with drug-resistant seizures. However, presurgical language mapping using either functional or structural networks can be challenging, especially in children. In fact, most of the evidence on this topic derives from cross-sectional or retrospective studies in adults submitted to anterior temporal lobectomy. In this prospective study, we used fMRI and DTI to explore patterns of language representation, their predictors and impact on cognitive performances in 29 children and young adults (mean age at surgery: 14.6 ± 4.5 years) with focal lesional epilepsy. In 20 of them, we also assessed the influence of epilepsy surgery on language lateralization. All patients were consecutively enrolled at a single epilepsy surgery center between 2009 and 2015 and assessed with preoperative structural and functional 3T brain MRI during three language tasks: Word Generation (WG), Rhyme Generation (RG) and a comprehension task. We also acquired DTI data on arcuate fasciculus in 24 patients. We first assessed patterns of language representation (relationship of activations with the epileptogenic lesion and Laterality Index (LI)) and then hypothesized a causal model to test whether selected clinical variables would influence the patterns of language representation and the ensuing impact of the latter on cognitive performances. Twenty out of 29 patients also underwent postoperative language fMRI. We analyzed possible changes of fMRI and DTI LIs and their clinical predictors. Preoperatively, we found atypical language lateralization in four patients during WG task, in one patient during RG task and in seven patients during the comprehension task. Diffuse interictal EEG abnormalities predicted a more atypical language representation on fMRI (p = 0.012), which in turn correlated with lower attention (p = 0.036) and IQ/GDQ scores (p = 0.014). Postoperative language reorganization implied shifting towards atypical language representation. Abnormal postoperative EEG (p = 0.003) and surgical failures (p = 0.015) were associated with more atypical language lateralization, in turn correlating with worsened fluency. Neither preoperative asymmetry nor postoperative DTI LI changes in the arcuate fasciculus were observed. Focal lesional epilepsy associated with diffuse EEG abnormalities may favor atypical language lateralization and worse cognitive performances, which are potentially reversible after successful surgery.
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14
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Guerin JB, Greiner HM, Mangano FT, Leach JL. Functional MRI in Children: Current Clinical Applications. Semin Pediatr Neurol 2020; 33:100800. [PMID: 32331615 DOI: 10.1016/j.spen.2020.100800] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Functional magnetic resonance imaging has become a critical research tool for evaluating brain function during active tasks and resting states. This has improved our understanding of developmental trajectories in children as well as the plasticity of neural networks in disease states. In the clinical setting, functional maps of eloquent cortex in patients with brain lesions and/or epilepsy provides crucial information for presurgical planning. Although children are inherently challenging to scan in this setting, preparing them appropriately and providing adequate resources can help achieve useful clinical data. This article will review the basic underlying physiologic aspects of functional magnetic resonance imaging, review clinically relevant research applications, describe known validation data compared to gold standard techniques and detail future directions of this technology.
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Affiliation(s)
- Julie B Guerin
- Department of Pediatric Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Radiology, Mayo Clinic, Rochester, MN
| | - Hansel M Greiner
- Division of Neurology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Francesco T Mangano
- Division of Pediatric Neurosurgery, University of Cincinnati College of Medicine Department of Neurosurgery, Cincinnati, OH
| | - James L Leach
- Department of Pediatric Radiology and Medical Imaging, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Radiology, Mayo Clinic, Rochester, MN.
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15
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Nair S, Szaflarski JP. Neuroimaging of memory in frontal lobe epilepsy. Epilepsy Behav 2020; 103:106857. [PMID: 31937510 DOI: 10.1016/j.yebeh.2019.106857] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 12/04/2019] [Accepted: 12/13/2019] [Indexed: 10/25/2022]
Abstract
In a large percentage of epilepsies, seizures have focal onset. These epilepsies are associated with a wide range of behavioral and cognitive deficits sometimes limited to the functions encompassed within the ictal onset zone but, more frequently, expanding beyond it. The presence of impairments associated with neuroanatomical areas outside of the ictal onset zone suggests distal propagation of epileptic activity via brain networks and interconnected whole-brain neural circuitry. In patients with frontal lobe epilepsy (FLE), using functional magnetic resonance imaging (fMRI) to identify deficits in working, semantic, and episodic memory may provide a lens through which to understand typical and atypical network organization. A network approach to focal epilepsy is relevant in these patients because of the frequently noted early age of seizure onset. Early seizure-related disruption in healthy brain development may result in a significant brain reorganization, development of compensation-related mechanisms of dealing with function abnormalities and disruptions, and the propagation of epileptic activity from the focus to widespread brain areas (functional deficit zones). Benefits of a network approach in the study of focal epilepsy are discussed along with considerations for future neuroimaging studies of patients with FLE.
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Affiliation(s)
- Sangeeta Nair
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA; Department of Neurosurgery, University of Alabama at Birmingham, Birmingham, AL, USA
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16
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Muh CR, Chou ND, Rahimpour S, Komisarow JM, Spears TG, Fuchs HE, Serafini S, Grant GA. Cortical stimulation mapping for localization of visual and auditory language in pediatric epilepsy patients. J Neurosurg Pediatr 2020; 25:168-177. [PMID: 31703207 DOI: 10.3171/2019.8.peds1922] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2019] [Accepted: 08/28/2019] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To determine resection margins near eloquent tissue, electrical cortical stimulation (ECS) mapping is often used with visual naming tasks. In recent years, auditory naming tasks have been found to provide a more comprehensive map. Differences in modality-specific language sites have been found in adult patients, but there is a paucity of research on ECS language studies in pediatric patients. The goals of this study were to evaluate word-finding distinctions between visual and auditory modalities and identify which cortical subregions most often contain critical language function in a pediatric population. METHODS Twenty-one pediatric patients with epilepsy or temporal lobe pathology underwent ECS mapping using visual (n = 21) and auditory (n = 14) tasks. Fisher's exact test was used to determine whether the frequency of errors in the stimulated trials was greater than the patient's baseline error rate for each tested modality and subregion. RESULTS While the medial superior temporal gyrus was a common language site for both visual and auditory language (43.8% and 46.2% of patients, respectively), other subregions showed significant differences between modalities, and there was significant variability between patients. Visual language was more likely to be located in the anterior temporal lobe than was auditory language. The pediatric patients exhibited fewer parietal language sites and a larger range of sites overall than did adult patients in previously published studies. CONCLUSIONS There was no single area critical for language in more than 50% of patients tested in either modality for which more than 1 patient was tested (n > 1), affirming that language function is plastic in the setting of dominant-hemisphere pathology. The high rates of language function throughout the left frontal, temporal, and anterior parietal regions with few areas of overlap between modalities suggest that ECS mapping with both visual and auditory testing is necessary to obtain a comprehensive language map prior to epileptic focus or tumor resection.
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Affiliation(s)
- Carrie R Muh
- 1Department of Neurosurgery, Duke University Hospital, and
- 2Department of Neurosurgery, Maria Fareri Children's Hospital, Westchester Medical Center, Valhalla, New York; and
| | - Naomi D Chou
- 1Department of Neurosurgery, Duke University Hospital, and
| | | | | | - Tracy G Spears
- 3Duke Clinical Research Institute, Durham, North Carolina
| | | | | | - Gerald A Grant
- 4Department of Neurosurgery, Stanford University Hospital, Stanford, California
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17
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Buck S, Bastos F, Baldeweg T, Vargha-Khadem F. A Functional MRI Paradigm Suitable for Language and Memory Mapping in Pediatric Temporal Lobe Epilepsy. Front Neurol 2020; 10:1384. [PMID: 31998226 PMCID: PMC6966885 DOI: 10.3389/fneur.2019.01384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2019] [Accepted: 12/16/2019] [Indexed: 11/13/2022] Open
Abstract
Functional Magnetic Resonance Imaging (fMRI) is a technique frequently used to determine the territories of eloquent tissue that serve critical functions, such as language. This can be particularly useful as part of the pre-surgical assessment for temporal lobe epilepsy (TLE) in order to predict cognitive outcome and guide surgical decision-making. Whereas language fMRI is widely used, memory fMRI is less frequently employed in adult TLE, and lacking in childhood TLE. We have developed a combined language/memory fMRI paradigm that is suitable for children, to provide clinically useful information for surgical planning in pediatric TLE. We evaluated this paradigm in 28 healthy children, aged 8 to 18 years. The advantages of this paradigm are: (a) it examines the functional mapping of language and memory networks within one scanning session, (b) provides assessment of both memory encoding- and retrieval-related neural networks, (c) examines recall-based retrieval to engage hippocampal involvement compared to recognition-based retrieval, and (d) provides overt verbal responses to monitor in-scanner memory performance. This novel fMRI paradigm was designed for language and memory mapping in pediatric TLE and could provide clinically useful information for surgical planning. Finally, parallel versions of the paradigm allow the comparison of brain activations pre- and post-surgical intervention.
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Affiliation(s)
- Sarah Buck
- Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom
| | - Filipa Bastos
- Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom
- Unit of Paediatric Neurology and Neurorehabilitation, Woman-Mother-Child Department, Lausanne University Hospital, Lausanne, Switzerland
| | - Torsten Baldeweg
- Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom
| | - Faraneh Vargha-Khadem
- Cognitive Neuroscience and Neuropsychiatry Section, Developmental Neurosciences Research and Teaching Department, UCL Great Ormond Street Institute of Child Health, London, United Kingdom
- Great Ormond Street Hospital for Children National Health Service Trust, London, United Kingdom
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18
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Karami M, Nilipour R, Barekatain M, Gaillard WD. Language representation and presurgical language mapping in pediatric epilepsy: A narrative review. IRANIAN JOURNAL OF CHILD NEUROLOGY 2020; 14:7-18. [PMID: 32952578 PMCID: PMC7468084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 01/09/2020] [Accepted: 01/14/2020] [Indexed: 11/25/2022]
Abstract
As one of the most common neurological diseases in children, epilepsy affects 0.9-2% of children. Complex interactions among the etiologies of epilepsy, interictal discharges, seizures, and antiepileptic drugs lead to cognitive impairments in children with epilepsy. Since epilepsy is considered as a network disorder, in which seizures have a widespread impact on many parts of the brain, childhood epilepsy can even affect the normal development of language. About 25% of children with epilepsy do not respond to medications; therefore, brain surgery is considered as a treatment option for some of them. Presurgical neuropsychological evaluations including language mapping are recommended to preserve cognitive and language abilities of patients after surgery. Functional magnetic resonance imaging as a non-invasive technique for presurgical language mapping has been widely recommended in many epileptic centers. The present study reviewed language representation and presurgical language mapping in children with epilepsy. Mapping language in children with epilepsy helps to localize the epileptogenic zone, and also, to predict the cognitive outcome of epilepsy surgery and possible cognitive rehabilitation. This review collected information about language representation and language mapping in pediatric epilepsy settings.
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Affiliation(s)
- Mahdieh Karami
- PhD of Cognitive Science of Language, ICSS, Tehran, Iran
| | - Reza Nilipour
- Emeritus Professor of Neurolinguistics and Clinical Linguistics, Department of Speech Therapy, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Majid Barekatain
- Professor of Neuropsychiatry, Department of Psychiatry, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - William D Gaillard
- Professor of Neurology and Pediatrics, George Washington University, Center for Neuroscience and Behavioral Health, Children's National Medical Center, Washington DC. USA
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19
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Right-hemispheric Dominance in Self-body Recognition is Altered in Left-handed Individuals. Neuroscience 2020; 425:68-89. [DOI: 10.1016/j.neuroscience.2019.10.056] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/29/2019] [Accepted: 10/31/2019] [Indexed: 11/23/2022]
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20
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Oyegbile TO. The role of task-based neural activation research in understanding cognitive deficits in pediatric epilepsy. Epilepsy Behav 2019; 99:106332. [PMID: 31399340 DOI: 10.1016/j.yebeh.2019.05.028] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 05/15/2019] [Accepted: 05/19/2019] [Indexed: 11/29/2022]
Abstract
Children with epilepsy can experience significant cognitive dysfunction that can lead to academic underachievement. Traditionally believed to be primarily due to the effects of factors such as the chronicity of epilepsy, medication effects, or the location of the primary epileptogenic lesion;, recent evidence has indicated that disruption of cognition-specific distributed neural networks may play a significant role as well. Specifically, over the last decade, researchers have begun to characterize the mechanisms underlying disrupted cognitive substrates by evaluating neural network abnormalities observed during specific cognitive tasks, using task-based functional magnetic resonance imaging (fMRI). This targeted review assesses the current literature investigating the relationship between neural network abnormalities and cognitive deficits in pediatric epilepsy. The findings indicate that there are indeed neural network abnormalities associated with deficits in executive function, language, processing speed, and memory. Overall, cognitive dysfunction in pediatric epilepsy is associated with a decrease in neural network activation/deactivation as well as increased recruitment of brain regions not typically related to the specific cognitive task under investigation. The research to date has focused primarily on children with focal epilepsy syndromes with small sample sizes and differing research protocols. More extensive research in children with a wider representation of epilepsy syndromes (including generalized epilepsy syndromes) is necessary to fully understand these relationships and begin to identify underlying cognitive phenotypes that may account for the variability observed across children with epilepsy. Furthermore, more uniformity in fMRI protocols and neuropsychological tasks would be ideal to advance this literature.
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Affiliation(s)
- Temitayo O Oyegbile
- Georgetown University Medical Center, Washington, D.C., United States of America.
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21
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Duda BM, Owens MM, Hallowell ES, Sweet LH. Neurocompensatory Effects of the Default Network in Older Adults. Front Aging Neurosci 2019; 11:111. [PMID: 31214012 PMCID: PMC6558200 DOI: 10.3389/fnagi.2019.00111] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2018] [Accepted: 04/29/2019] [Indexed: 11/13/2022] Open
Abstract
The hemispheric asymmetry reduction in older adults (HAROLD) is a neurocompensatory process that has been observed across several cognitive functions but has not yet been examined in relation to task-induced relative deactivations of the default mode network. The present study investigated the presence of HAROLD effects specific to neural activations and deactivations using a functional magnetic resonance imaging (fMRI) n-back paradigm. It was hypothesized that HAROLD effects would be identified in relative activations and deactivations during the paradigm, and that they would be associated with better 2-back performance. Forty-five older adults (M age = 63.8; range = 53-83) were administered a verbal n-back paradigm during fMRI. For each participant, the volume of brain response was summarized by left and right frontal regions of interest, and laterality indices (LI; i.e., left/right) were calculated to assess HAROLD effects. Group level results indicated that age was significantly and negatively correlated with LI (i.e., reduced left lateralization) for deactivations, but positively correlated with LI (i.e., increased left lateralization) for activations. The relationship between age and LI for deactivation was significantly moderated by performance level, revealing a stronger relationship between age and LI at higher levels of 2-back performance. Findings suggest that older adults may employ neurocompensatory processes specific to deactivations, and task-independent processes may be particularly sensitive to age-related neurocompensation.
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Affiliation(s)
- Bryant M. Duda
- Department of Psychology, University of Georgia, Athens, GA, United States
| | - Max M. Owens
- Department of Psychology, University of Georgia, Athens, GA, United States
| | - Emily S. Hallowell
- Department of Psychology, University of Georgia, Athens, GA, United States
| | - Lawrence H. Sweet
- Department of Psychology, University of Georgia, Athens, GA, United States
- Department of Psychiatry & Human Behavior, The Warren Alpert Medical School of Brown University, Providence, RI, United States
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22
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Zavadenko NN, Kholin AA, Zavadenko AN, Michurina ES. [Speech and language neurodevelopmental disorders in epilepsy: pathophysiologic mechanisms and therapeutic approaches]. Zh Nevrol Psikhiatr Im S S Korsakova 2018; 118:118-125. [PMID: 30251989 DOI: 10.17116/jnevro2018118081118] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Speech and language development may be impaired in all forms of epilepsy involving specialized functional areas in the dominant cerebral hemisphere and their connections. The concept of epilepsy-aphasia clinical spectrum was recently proposed, but the notion of aphasia is quite conditional here as many of these patients demonstrate disorders of speech and language development from their infancy. Those forms of epilepsy are considered as continuum from the most severe Landau-Kleffner syndrome (LKS) and epilepsy with continuous spike-and-wave during sleep (CSWS) (also indicating as electrical status epilepticus during sleep - ESES) to intermediate epilepsy-aphasia disorders (with incomplete correspondence to diagnostic criteria of LKS and epilepsy with CSWS). The mild end of the spectrum is represented by benign childhood epilepsy with centrotemporal spikes (rolandic), which is often associated with speech and language disorders. The importance of genetic factors is discussed, including mutations in SRPX2, GRIN2A and other genes. The perspectives of individualized pharmacotherapy in epilepsy, co-morbid with neurodevelopmental disorders or impairments of speech and language development, are depending on the progress in genetic studies. In the new generation of antiepileptic drugs the positive influence on neuroplasticity mechanisms and higher cerebral functions are supposed for levetiracetam.
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Affiliation(s)
- N N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A A Kholin
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - A N Zavadenko
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E S Michurina
- Pirogov Russian National Research Medical University, Moscow, Russia
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23
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Ardila A, Bernal B, Rosselli M. Executive Functions Brain System: An Activation Likelihood Estimation Meta-analytic Study. Arch Clin Neuropsychol 2018; 33:379-405. [PMID: 28961762 DOI: 10.1093/arclin/acx066] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/01/2017] [Indexed: 01/05/2023] Open
Abstract
Background and objective To characterize commonalities and differences between two executive functions: reasoning and inhibitory control. Methods A total of 5,974 participants in 346 fMRI experiments of inhibition or reasoning were selected. First level analysis consisted of Analysis of Likelihood Estimation (ALE) studies performed in two pooled data groups: (a) brain areas involved in reasoning and (b) brain areas involved in inhibition. Second level analysis consisted of two contrasts: (i) brain areas involved in reasoning but not in inhibition and (ii) brain areas involved in inhibition but not in reasoning. Lateralization Indexes were calculated. Results Four brain areas appear as the most critical: the dorsolateral aspect of the frontal lobes, the superior parietal lobules, the mesial aspect of the premotor area (supplementary motor area), and some subcortical areas, particularly the putamen and the thalamus. ALE contrasts showed significant differentiation of the networks, with the reasoning > inhibition-contrast showing a predominantly leftward participation, and the inhibition > reasoning-contrast, a clear right advantage. Conclusion Executive functions are mediated by sizable brain areas including not only cortical, but also involving subcortical areas in both hemispheres. The strength of activation shows dissociation between the hemispheres for inhibition (rightward) and reasoning (leftward) functions.
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Affiliation(s)
- Alfredo Ardila
- Department of Communication Sciences and Disorders, Florida International University, Miami, FL, USA
| | - Byron Bernal
- Department of Radiology/Brain Institute, Nicklaus Children's Hospital, Miami, FL, USA
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
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24
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Naito E, Morita T, Saito DN, Ban M, Shimada K, Okamoto Y, Kosaka H, Okazawa H, Asada M. Development of Right-hemispheric Dominance of Inferior Parietal Lobule in Proprioceptive Illusion Task. Cereb Cortex 2018; 27:5385-5397. [PMID: 28968653 PMCID: PMC5939204 DOI: 10.1093/cercor/bhx223] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2017] [Indexed: 01/10/2023] Open
Abstract
Functional lateralization can be an indicator of brain maturation. We have consistently shown that, in the adult brain, proprioceptive processing of muscle spindle afferents generating illusory movement of the right hand activates inferior frontoparietal cortical regions in a right-side dominant manner in addition to the cerebrocerebellar motor network. Here we provide novel evidence regarding the development of the right-dominant use of the inferior frontoparietal cortical regions in humans using this task. We studied brain activity using functional magnetic resonance imaging while 60 right-handed blindfolded healthy children (8-11 years), adolescents (12-15 years), and young adults (18-23 years) (20 per group) experienced the illusion. Adult-like right-dominant use of the inferior parietal lobule (IPL) was observed in adolescents, while children used the IPL bilaterally. In contrast, adult-like lateralized cerebrocerebellar motor activation patterns were already observable in children. The right-side dominance progresses during adolescence along with the suppression of the left-sided IPL activity that emerges during childhood. Therefore, the neuronal processing implemented in the adult's right IPL during the proprioceptive illusion task is likely mediated bilaterally during childhood, and then becomes right-lateralized during adolescence at a substantially later time than the lateralized use of the cerebrocerebellar motor system for kinesthetic processing.
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Affiliation(s)
- Eiichi Naito
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka 565-0871, Japan.,Graduate School of Frontier Biosciences and Medicine, Osaka University, 1-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tomoyo Morita
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka 565-0871, Japan.,Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Daisuke N Saito
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Research Center for Child Mental Development, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa 920-0934, Japan
| | - Midori Ban
- Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan.,Faculty of Psychology, Doshisha University, 1-3 Tataramiyakodani, Kyotanabe, Kyoto 610-0394, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Yuko Okamoto
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Hidehiko Okazawa
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan.,Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-Shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui 910-1193, Japan
| | - Minoru Asada
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka 565-0871, Japan.,Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka 565-0871, Japan
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25
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Morita T, Saito DN, Ban M, Shimada K, Okamoto Y, Kosaka H, Okazawa H, Asada M, Naito E. Self-Face Recognition Begins to Share Active Region in Right Inferior Parietal Lobule with Proprioceptive Illusion During Adolescence. Cereb Cortex 2018; 28:1532-1548. [PMID: 29420750 PMCID: PMC6093481 DOI: 10.1093/cercor/bhy027] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2017] [Revised: 01/15/2018] [Indexed: 01/19/2023] Open
Abstract
We recently reported that right-side dominance of the inferior parietal lobule (IPL) in self-body recognition (proprioceptive illusion) task emerges during adolescence in typical human development. Here, we extend this finding by demonstrating that functional lateralization to the right IPL also develops during adolescence in another self-body (specifically a self-face) recognition task. We collected functional magnetic resonance imaging (fMRI) data from 60 right-handed healthy children (8-11 years), adolescents (12-15 years), and adults (18-23 years; 20 per group) while they judged whether a presented face was their own (Self) or that of somebody else (Other). We also analyzed fMRI data collected while they performed proprioceptive illusion task. All participants performed self-face recognition with high accuracy. Among brain regions where self-face-related activity (Self vs. Other) developed, only right IPL activity developed predominantly for self-face processing, with no substantial involvement in other-face processing. Adult-like right-dominant use of IPL emerged during adolescence, but was not yet present in childhood. Adult-like common activation between the tasks also emerged during adolescence. Adolescents showing stronger right-lateralized IPL activity during illusion also showed this during self-face recognition. Our results suggest the importance of the right IPL in neuronal processing of information associated with one's own body in typically developing humans.
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Affiliation(s)
- Tomoyo Morita
- Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka, Japan
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka, Japan
| | - Daisuke N Saito
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Research Center for Child Mental Development, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, Japan
| | - Midori Ban
- Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka, Japan
- Faculty of Psychology, Doshisha University, 1-3 Tataramiyakodani, Kyotanabe, Kyoto, Japan
| | - Koji Shimada
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Yuko Okamoto
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Hirotaka Kosaka
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Department of Neuropsychiatry, Faculty of Medical Sciences, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Hidehiko Okazawa
- Research Center for Child Mental Development, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
- Biomedical Imaging Research Center, University of Fukui, 23-3 Matsuoka-shimoaiduki, Eiheiji-cho, Yoshida-gun, Fukui, Japan
| | - Minoru Asada
- Graduate School of Engineering, Osaka University, 2-1 Yamadaoka, Suita, Osaka, Japan
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka, Japan
| | - Eiichi Naito
- Center for Information and Neural Networks (CiNet), National Institute of Information and Communications Technology (NICT), 2A6 1-4 Yamadaoka, Suita, Osaka, Japan
- Graduate School of Frontier Biosciences and Medicine, Osaka University, 1-1 Yamadaoka, Suita, Osaka, Japan
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26
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Chou N, Serafini S, Muh CR. Cortical Language Areas and Plasticity in Pediatric Patients With Epilepsy: A Review. Pediatr Neurol 2018; 78:3-12. [PMID: 29191650 DOI: 10.1016/j.pediatrneurol.2017.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2017] [Revised: 08/28/2017] [Accepted: 10/02/2017] [Indexed: 12/12/2022]
Abstract
Chronic injury to the brain from seizure activity is associated with decreased language skills in pediatric patients, as measured on neuropsychological tests for language function and academic achievement. This makes the study of language in patients with epilepsy clinically necessary. Functional magnetic resonance imaging and direct electrical cortical stimulation have been used to evaluate aspects of cortical language processing in healthy adults and in adults with epilepsy or other neurological insults. Results of these studies help to locate cortical language areas that are involved with modality-specific language processing (visual naming, auditory naming, sentence-completion, and repetition) and the neuroplasticity of language areas in the setting of neurological injury and reorganization. A better understanding of language processing contributes to a more efficient and efficacious electrical cortical stimulation mapping of language areas for patients with intractable epilepsy who are undergoing preresection evaluation. Most of the current literature on localization and reorganization of cortical language areas in the setting of epilepsy concerns the adult patient population, whereas the literature on pediatric patients is substantially lacking in comparison. This article reviews the conclusions drawn thus far from Wada, magnetoencephalography, functional magnetic resonance imaging, and electrical cortical stimulation language studies on types of language reorganization seen in pediatric patients with intractable temporal lobe epilepsy and the clinical factors associated with reorganization, and proposes future directions of research to further the academic and clinical understanding of language processing in pediatric patients.
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Affiliation(s)
- Naomi Chou
- Duke University School of Medicine, Durham, North Carolina
| | - Sandra Serafini
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina
| | - Carrie R Muh
- Department of Neurosurgery, Duke University Medical Center, Durham, North Carolina.
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27
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Kaye HL, Gersner R, Boes AD, Pascual-Leone A, Rotenberg A. Persistent uncrossed corticospinal connections in patients with intractable focal epilepsy. Epilepsy Behav 2017; 75:66-71. [PMID: 28830029 PMCID: PMC5882467 DOI: 10.1016/j.yebeh.2017.07.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2017] [Revised: 07/07/2017] [Accepted: 07/07/2017] [Indexed: 01/28/2023]
Abstract
Corticospinal connections may be bilateral at birth, but a predominantly unilateral and crossed pattern develops by the toddler years. Acquired injury can alter the normal development of laterality such that uncrossed corticospinal connections persist, particularly if the injury is early in life and involves the motor system. Whether other developmental insults, such as childhood epilepsy, affect the development of crossed laterality in the motor system is unknown, although this topic has relevance for understanding the broader impact of epilepsy on brain development. Accordingly, in a cohort of children with intractable focal epilepsy, we tested by neuronavigated transcranial magnetic stimulation (nTMS) whether childhood epilepsy is associated with persistent uncrossed corticospinal connections. Specifically, we hypothesized that in contrast to early-life neuroclastic corticospinal tract injury that induces preservation of uncrossed corticospinal connections in the contralesional hemisphere, uncrossed corticospinal connections will be preserved in the epileptic hemisphere where the corticospinal tract is intact, but overstimulated by ongoing seizures and epileptic interictal discharges. Motor cortex mapping was performed by nTMS as part of a clinical presurgical evaluation, and the analysis was limited to patients with radiographically intact motor cortices and corticospinal tracts. Given that foot motor cortex representation is often bilateral, we focused on the lateralization for the tibialis anterior muscle cortical motor representation and its relation to the seizure focus. We demonstrate preserved uncrossed corticospinal connections for the tibialis anterior region of the hemisphere affected by the epilepsy. These findings indicate a pathologically preserved immature motor lateralization in patients with epilepsy and suggest that developmental processes associated with hemispheric lateralization are affected by epilepsy.
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Affiliation(s)
- Harper L Kaye
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
| | - Roman Gersner
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA
| | - Aaron D Boes
- Neuromodulation Program, Division of Pediatric Neurology, Department of Pediatrics, University of Iowa, Iowa City, IA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Alexander Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Boston, MA, USA; F.M. Kirby Neurobiology Center, Boston Children's Hospital, Boston, MA, USA; Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Department of Neurology, Harvard Medical School and Beth Israel Deaconess Medical Center, Boston, MA, USA.
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28
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Age-related language lateralization assessed by fMRI: The effects of sex and handedness. Brain Res 2017; 1674:20-35. [PMID: 28830770 DOI: 10.1016/j.brainres.2017.08.021] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2017] [Revised: 08/14/2017] [Accepted: 08/16/2017] [Indexed: 11/21/2022]
Abstract
Previous studies focusing on the relationship between lateralization of language function and age suffer from lack of a balanced distribution of age and handedness among participants, especially in the extremes of age. This limits our understanding of the influence of these factors on lateralization of language circuitry. The hemispheric asymmetry reduction in older adults (HAROLD) model suggests that under similar circumstances, involvement in cognitive processes of prefrontal (and potentially other) cortical areas tends to be less lateralized with age. In this study, we aimed to investigate the link between age, gender, and language lateralization in a large group of healthy participants with a relatively even distribution of age and handedness in order to further test the HAROLD model. 99 healthy men (33 left-handed; age range 18-74years) and 125 women (44 left-handed; age range 19-76) were recruited. All participants underwent fMRI at 3T with a semantic decision and a verb generation tasks and received a battery of linguistic tests. Lateralization indexes (LI) were calculated for each participant based on fMRI results for each task separately. LIs were found to be significantly decreasing with age only in right-handed men and only in temporo-parietal cortical area. LIs did not change with age in other brain regions or in left-handed subjects. Our results do not support the HAROLD model and suggest a potentially different relationship between aging and lateralization of language functions.
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29
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Chang YHA, Kemmotsu N, Leyden KM, Kucukboyaci NE, Iragui VJ, Tecoma ES, Kansal L, Norman MA, Compton R, Ehrlich TJ, Uttarwar VS, Reyes A, Paul BM, McDonald CR. Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy. BRAIN AND LANGUAGE 2017; 170:82-92. [PMID: 28432987 PMCID: PMC5507363 DOI: 10.1016/j.bandl.2017.03.012] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 02/09/2017] [Accepted: 03/27/2017] [Indexed: 06/07/2023]
Abstract
This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for each imaging modality and a principal component (PC) was derived from language measures. Correlations were performed among imaging measures, as well as to the language PC. In controls, better language performance was associated with stronger left-lateralized temporo-parietal and temporo-occipital activations. In LTLE, better language performance was associated with stronger right-lateralized inferior frontal, temporo-parietal, and temporo-occipital activations. These right-lateralized activations in LTLE were associated with right-lateralized arcuate fasciculus fractional anisotropy. These data suggest that interhemispheric language reorganization in LTLE is associated with alterations to perisylvian white matter. These concurrent structural and functional shifts from left to right may help to mitigate language impairment in LTLE.
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Affiliation(s)
- Yu-Hsuan A Chang
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Nobuko Kemmotsu
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Kelly M Leyden
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - N Erkut Kucukboyaci
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Vicente J Iragui
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Evelyn S Tecoma
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Leena Kansal
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Marc A Norman
- Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Rachelle Compton
- Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Tobin J Ehrlich
- Palo Alto University, 1971 Arastradero Drive, Palo Alto, CA 94304, USA.
| | - Vedang S Uttarwar
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA.
| | - Anny Reyes
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
| | - Brianna M Paul
- Department of Neurology, University of California - San Francisco, San Francisco, CA, USA; UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA.
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA.
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Strandberg M, Mannfolk P, Stenberg L, Ljung H, Rorsman I, Larsson EM, van Westen D, Källén K. A Functional MRI-Based Model for Individual Memory Assessment in Patients Eligible for Anterior Temporal Lobe Resection. Open Neuroimag J 2017; 11:1-16. [PMID: 28567171 PMCID: PMC5420180 DOI: 10.2174/1874440001711010001] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Revised: 02/21/2017] [Accepted: 02/27/2017] [Indexed: 11/22/2022] Open
Abstract
Title: A functional (f) MRI-based model for individual memory assessment in patients eligible for temporal lobe resection. Aim: To investigate if pre-operative fMRI memory paradigms, add predictive information with regard to post-surgical memory deficits. Methods: Fourteen pharmacoresistant Temporal Lobe Epilepsy (TLE) patients accepted for Anterior Temporal Lobe Resection (ATLR) were included. A clinical risk assessment score (RAS 0-3) was constructed from structural MRI, neuropsychological testing and hemisphere dominance. fMRI lateralization indices (LIs) over frontal language and medial temporal regions were calculated. Predictive value from clinical risk scoring and added value from fMRI LIs were correlated to post-surgical memory change scores (significant decline -1 SD). Verbal memory outcome was classified either as expected (RAS 2-3 and post-operative decline; RAS 0-1 and intact post-operative verbal memory) or as unexpected (RAS 2-3 and intact post-operative verbal memory post-surgery; RAS 0-1 and post-operative decline). Results: RAS for verbal memory decline exhibited a specificity of 67% and a sensitivity of 75%. Significant correlations were found between frontal language LIs and post-operative verbal memory (r = -0.802; p = 0.017) for left (L) TLE and between medial temporal lobe LIs and visuospatial memory (r = 0.829; p = 0.021), as well as verbal memory (r = 0.714; p = 0.055) for right (R) TLE. Ten patients had expected outcome and four patients had an unexpected outcome. In two MRI-negative RTLE patients that suffered significant verbal memory decline post-operatively, fMRI identified bilateral language and right lateralized medial temporal verbal encoding. In two LTLE patients with MRI pathology and verbal memory dysfunction, neither RAS nor fMRI identified the risk for aggravated verbal memory decline following ATLR. Conclusion: fMRI visualization of temporal-frontal network activation may add value to the pre-surgical work-up in epilepsy patients eligible for ATLR. Frontal language patterns are important for prediction in both L and RTLE. Strong left lateralized language in LTLE, as well as bilateral language combined with right lateralized encoding in RTLE, seems to indicate an increased risk for post-operative verbal memory decline.
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Affiliation(s)
- Maria Strandberg
- Department of Neurology and Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Peter Mannfolk
- Diagnostic Radiology, Department of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Lars Stenberg
- Diagnostic Radiology, Department of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Hanna Ljung
- Department of Neurology and Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Ia Rorsman
- Department of Neurology and Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Elna-Marie Larsson
- Department of Radiology, Uppsala University Hospital, SE-75185, Uppsala, Sweden
| | - Danielle van Westen
- Diagnostic Radiology, Department of Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
| | - Kristina Källén
- Department of Neurology and Clinical Sciences, Lund University Hospital, SE-221 85 Lund, Sweden
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Multi-factorial modulation of hemispheric specialization and plasticity for language in healthy and pathological conditions: A review. Cortex 2017; 86:314-339. [DOI: 10.1016/j.cortex.2016.05.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/16/2016] [Accepted: 05/13/2016] [Indexed: 12/16/2022]
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Abstract
Atypical lateralization for language has been found in schizophrenia, suggesting that language and thought disorders on the schizophrenia spectrum may be due to left hemispheric dysfunction. However, research with those with non-clinical schizotypy has been inconsistent, with some studies finding reduced or reversed language laterality (particularly with positive schizotypal traits), and others finding typical left hemispheric specialization. The aim of the current study was to use both a behavioural (dual reading-finger tapping) task and an functional magnetic resonance imaging lexical decision task to investigate language laterality in a university sample of high- and low-schizotypal adults. Findings revealed no evidence for atypical lateralization in our sample for both overall schizotypy (measured by the Oxford-Liverpool Inventory of Feelings and Experiences) and positive schizotypy (measured by the Unusual Experiences subscale) groups. Our findings provide further evidence that non-clinical schizotypy is not associated with atypical language laterality.
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Affiliation(s)
- Haeme R P Park
- a School of Psychology and Centre for Brain Research , The University of Auckland , Auckland , New Zealand
| | - Karen E Waldie
- a School of Psychology and Centre for Brain Research , The University of Auckland , Auckland , New Zealand
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Vannasing P, Cornaggia I, Vanasse C, Tremblay J, Diadori P, Perreault S, Lassonde M, Gallagher A. Potential brain language reorganization in a boy with refractory epilepsy; an fNIRS-EEG and fMRI comparison. EPILEPSY & BEHAVIOR CASE REPORTS 2016; 5:34-7. [PMID: 26977406 PMCID: PMC4782003 DOI: 10.1016/j.ebcr.2016.01.006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Revised: 01/27/2016] [Accepted: 01/30/2016] [Indexed: 04/12/2023]
Abstract
As part of a presurgical investigation for a resection of a tumor located in the left temporal brain region, we evaluated pre- and postsurgical language lateralization in a right-handed boy with refractory epilepsy. In this study, we compared functional near infrared spectroscopy (fNIRS) results obtained while the participant performed expressive and receptive language tasks with those obtained using functional magnetic resonance imaging (fMRI). This case study illustrates the potential for NIRS to contribute favorably to the localization of language functions in children with epilepsy and cognitive or behavioral problems and its potential advantages over fMRI in presurgical assessment. Moreover, it suggests that fNIRS is sensitive in localizing an atypical language network or potential brain reorganization related to epilepsy in young patients.
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Affiliation(s)
| | | | - Catherine Vanasse
- Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Julie Tremblay
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
| | - Paola Diadori
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Sébastien Perreault
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Division of Child Neurology, CHU Sainte-Justine, Montreal, Quebec, Canada
| | - Maryse Lassonde
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Psychology Department, Centre de Recherche de Neuropsychologie et Cognition (CERNEC), Université de Montréal, Quebec, Canada
| | - Anne Gallagher
- CHU Sainte-Justine Research Center, Montreal, Quebec, Canada
- Psychology Department, Centre de Recherche de Neuropsychologie et Cognition (CERNEC), Université de Montréal, Quebec, Canada
- Corresponding author at: Département de Psychologie, Université de Montréal, P.O. Box 6128, Downtown Station, Montreal, QC, Canada H3C 3J7. Phone: 514-345-4931 ext. 6409 Fax: 514-343-5787.Département de PsychologieUniversité de MontréalP.O. Box 6128, Downtown StationMontrealQCH3C 3J7Canada
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Baciu M, Perrone-Bertolotti M. What do patients with epilepsy tell us about language dynamics? A review of fMRI studies. Rev Neurosci 2015; 26:323-41. [PMID: 25741734 DOI: 10.1515/revneuro-2014-0074] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/20/2014] [Indexed: 11/15/2022]
Abstract
The objective of this review is to resume major neuroimaging findings on language organization and plasticity in patients with focal and refractory epilepsy, to discuss the effect of modulatory variables that should be considered alongside patterns of reorganization, and to propose possible models of language reorganization. The focal and refractory epilepsy provides a real opportunity to investigate various types of language reorganization in different conditions. The 'chronic' condition (induced by the epileptogenic zone or EZ) is associated with either recruitment of homologous regions of the opposite hemisphere or recruitment of intrahemispheric, nonlinguistic regions. In the 'acute' condition (neurosurgery and EZ resection), the initial interhemispheric shift (induced by the chronic EZ) could follow a reverse direction, back to the initial hemisphere. These different patterns depend on several modulatory factors and are associated with various levels of language performance. As a neuroimaging tool, functional magnetic resonance imaging enables the detailed investigation of both hemispheres simultaneously and allows for comparison with healthy controls, potentially creating a more comprehensive and more realistic picture of brain-language relations. Importantly, functional neuroimaging approaches demonstrate a good degree of concordance on a theoretical level, but also a considerable degree of individual variability, attesting to the clinical importance with these methods to establish, empirically, language localization in individual patients. Overall, the unique features of epilepsy, combined with ongoing advances in technology, promise further improvement in understanding of language substrate.
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Caciagli L, Bernhardt BC, Hong SJ, Bernasconi A, Bernasconi N. Functional network alterations and their structural substrate in drug-resistant epilepsy. Front Neurosci 2014; 8:411. [PMID: 25565942 PMCID: PMC4263093 DOI: 10.3389/fnins.2014.00411] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 11/24/2014] [Indexed: 12/24/2022] Open
Abstract
The advent of MRI has revolutionized the evaluation and management of drug-resistant epilepsy by allowing the detection of the lesion associated with the region that gives rise to seizures. Recent evidence indicates marked chronic alterations in the functional organization of lesional tissue and large-scale cortico-subcortical networks. In this review, we focus on recent methodological developments in functional MRI (fMRI) analysis techniques and their application to the two most common drug-resistant focal epilepsies, i.e., temporal lobe epilepsy related to mesial temporal sclerosis and extra-temporal lobe epilepsy related to focal cortical dysplasia. We put particular emphasis on methodological developments in the analysis of task-free or “resting-state” fMRI to probe the integrity of intrinsic networks on a regional, inter-regional, and connectome-wide level. In temporal lobe epilepsy, these techniques have revealed disrupted connectivity of the ipsilateral mesiotemporal lobe, together with contralateral compensatory reorganization and striking reconfigurations of large-scale networks. In cortical dysplasia, initial observations indicate functional alterations in lesional, peri-lesional, and remote neocortical regions. While future research is needed to critically evaluate the reliability, sensitivity, and specificity, fMRI mapping promises to lend distinct biomarkers for diagnosis, presurgical planning, and outcome prediction.
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Affiliation(s)
- Lorenzo Caciagli
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Boris C Bernhardt
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Seok-Jun Hong
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Andrea Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
| | - Neda Bernasconi
- Neuroimaging of Epilepsy Laboratory, McConnell Brain Imaging Center, Montreal Neurological Institute and Hospital, McGill University Montreal, QC, Canada
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Chaudhary UJ, Duncan JS. Applications of blood-oxygen-level-dependent functional magnetic resonance imaging and diffusion tensor imaging in epilepsy. Neuroimaging Clin N Am 2014; 24:671-94. [PMID: 25441507 DOI: 10.1016/j.nic.2014.07.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The lifetime prevalence of epilepsy ranges from 2.7 to 12.4 per 1000 in Western countries. Around 30% of patients with epilepsy remain refractory to antiepileptic drugs and continue to have seizures. Noninvasive imaging techniques such as functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI) have helped to better understand mechanisms of seizure generation and propagation, and to localize epileptic, eloquent, and cognitive networks. In this review, the clinical applications of fMRI and DTI are discussed, for mapping cognitive and epileptic networks and organization of white matter tracts in individuals with epilepsy.
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Affiliation(s)
- Umair J Chaudhary
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; MRI Unit, Epilepsy Society, Chesham Lane, Chalfont St Peter, Buckinghamshire SL9 0RJ, UK.
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; MRI Unit, Epilepsy Society, Chesham Lane, Chalfont St Peter, Buckinghamshire SL9 0RJ, UK; Queen Square Division, UCLH NHS Foundation Trust, Queen Square, London WC1N 3BG, UK
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Hertz-Pannier L, Noulhiane M, Rodrigo S, Chiron C. Pretherapeutic functional magnetic resonance imaging in children. Neuroimaging Clin N Am 2014; 24:639-53. [PMID: 25441505 DOI: 10.1016/j.nic.2014.07.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
In this article, some specificities of functional magnetic resonance imaging (fMRI) in children (eg, blood-oxygen-level-dependent response and brain maturation, paradigm design, technical issues, feasibility, data analysis) are reviewed, the main knowledge on presurgical cortical mapping in children (motor, language, reading, memory) is summarized, and the emergence of resting state fMRI in presurgical cortical mapping is discussed.
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Affiliation(s)
- Lucie Hertz-Pannier
- UMR 1129, INSERM, Paris Descartes University, CEA-Saclay, Gif sur Yvette, France; UNIACT/Neurospin, I2BM, DSV, CEA-Saclay, Gif sur Yvette, France.
| | - Marion Noulhiane
- UMR 1129, INSERM, Paris Descartes University, CEA-Saclay, Gif sur Yvette, France; UNIACT/Neurospin, I2BM, DSV, CEA-Saclay, Gif sur Yvette, France
| | - Sebastian Rodrigo
- UMR 1129, INSERM, Paris Descartes University, CEA-Saclay, Gif sur Yvette, France; UNIACT/Neurospin, I2BM, DSV, CEA-Saclay, Gif sur Yvette, France
| | - Catherine Chiron
- UMR 1129, INSERM, Paris Descartes University, CEA-Saclay, Gif sur Yvette, France; UNIACT/Neurospin, I2BM, DSV, CEA-Saclay, Gif sur Yvette, France
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Gelinas JN, Fitzpatrick KPV, Kim HC, Bjornson BH. Cerebellar language mapping and cerebral language dominance in pediatric epilepsy surgery patients. NEUROIMAGE-CLINICAL 2014; 6:296-306. [PMID: 25379442 PMCID: PMC4215475 DOI: 10.1016/j.nicl.2014.06.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/06/2014] [Revised: 06/27/2014] [Accepted: 06/30/2014] [Indexed: 11/10/2022]
Abstract
Objective Children with epilepsy often have reorganization of language networks and abnormal brain anatomy, making determination of language lateralization difficult. We characterized the proportion and distribution of language task activation in the cerebellum to determine the relationship to cerebral language lateralization. Methods Forty-six pediatric epilepsy surgery candidates (aged 7–19 years) completed an fMRI auditory semantic decision language task. Distribution of activated voxels and language laterality indices were computed using: (a) Broca's and Wernicke's areas and their right cerebral homologues; and (b) left and right cerebellar hemispheres. Language task activation was anatomically localized in the cerebellum. Results Lateralized language task activation in either cerebral hemisphere was highly correlated with lateralized language task activation in the contralateral cerebellar hemisphere (Broca vs. cerebellar: ρ = −0.54, p < 0.01). Cerebellar language activation was located within Crus I/II, areas previously implicated in non-motor functional networks. Conclusions Cerebellar language activation occurs in homologous regions of Crus I/II contralateral to cerebral language activation in patients with both right and left cerebral language dominance. Cerebellar language laterality could contribute to comprehensive pre-operative evaluation of language lateralization in pediatric epilepsy surgery patients. Our data suggest that patients with atypical cerebellar language activation are at risk for having atypical cerebral language organization. We examine fMRI cerebellar language activation in pediatric epilepsy surgery patients. A semantic decision task is employed to lateralize cerebral and cerebellar language. Cerebral and contralateral cerebellar language activations are highly correlated. Cerebellar language activation is located in right or left Crus I/II. Cerebellar language laterality may aid pre-operative cerebral language localization.
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Affiliation(s)
- Jennifer N Gelinas
- Neurosciences and Physiology, New York University Langone Medical Center, 450 East 29th St, New York, NY 10016, USA
| | - Kevin P V Fitzpatrick
- Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada
| | - Hong Cheol Kim
- Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada
| | - Bruce H Bjornson
- Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada ; Child and Family Research Institute, University of British Columbia, 950 W. 28th Ave, Vancouver V6H 3V4, Canada
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Abstract
Surgical techniques have emerged as a viable therapeutic option in patients with drug refractory epilepsy. Pre-surgical evaluation of epilepsy requires a comprehensive, multiparametric, and multimodal approach for precise localization of the epileptogenic focus. Various non-invasive techniques are available at the disposal of the treating physician to detect the epileptogenic focus, which include electroencephalography (EEG), video-EEG, magnetic resonance imaging (MRI), functional MRI including blood oxygen level dependent (BOLD) techniques, single photon emission tomography (SPECT), and 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET). Currently, non-invasive high-resolution MR imaging techniques play pivotal roles in the preoperative detection of the seizure focus, and represent the foundation for successful epilepsy surgery. BOLD functional magnetic resonance imaging (fMRI) maps allow for precise localization of the eloquent cortex in relation to the seizure focus. This review article focuses on the clinical utility of BOLD (fMRI) in the pre-surgical work-up of epilepsy patients.
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Affiliation(s)
- Karthik Ganesan
- Department of 3T fMRI, SRL Diagnostics and Jankharia Imaging, Mumbai, Maharashtra, India
| | - Meher Ursekar
- Department of 3T fMRI, SRL Diagnostics and Jankharia Imaging, Mumbai, Maharashtra, India
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40
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Aberrant functional connectivity between motor and language networks in rolandic epilepsy. Epilepsy Res 2013; 107:253-62. [DOI: 10.1016/j.eplepsyres.2013.10.008] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2013] [Revised: 10/01/2013] [Accepted: 10/13/2013] [Indexed: 11/18/2022]
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A functional magnetic resonance imaging study of language function in international adoptees. J Pediatr 2013; 163:1458-64. [PMID: 23896183 PMCID: PMC3812411 DOI: 10.1016/j.jpeds.2013.06.026] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2012] [Revised: 03/26/2013] [Accepted: 06/13/2013] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To test the hypothesis that international adoption of Chinese and Eastern European girls after 9 months of age results in long-term changes in the neural circuitry supporting monolingual English in later childhood. STUDY DESIGN Functional magnetic resonance imaging was used to test this hypothesis by comparison with a control group of American-born English speakers (n = 13). Girls now aged 6-10 years adopted from China (n = 13) and Eastern Europe (n = 12) by English-speaking families were recruited through a pediatric hospital-based international adoption center after spending more than 6 months in an orphanage or other institution, a measure of early environmental deprivation. Functional magnetic resonance imaging scans were performed on a 3 Tesla MRI scanner using a verb generation language fluency task. Composite activation maps were computed for each group using a general linear model with random effects analysis. RESULTS Chinese born adoptees demonstrate atypical lateralization of language function with an apparent shift of temporal-parietal and frontal areas of brain activity toward the right hemisphere. Eastern European adoptees exhibited a rightward shift relative to controls in both frontal and temporal-parietal brain regions. CONCLUSIONS Significant differences in lateralization between the Chinese and American-born groups in temporal-parietal language areas highlight the possible impact of early tonal Asian language exposure on neural circuitry. Findings suggest that exposure to an Asian language during infancy can leave a long-term imprint on the neural circuitry supporting English language development.
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Rodin D, Bar-Yosef O, Smith ML, Kerr E, Morris D, Donner EJ. Language dominance in children with epilepsy: concordance of fMRI with intracarotid amytal testing and cortical stimulation. Epilepsy Behav 2013; 29:7-12. [PMID: 23911353 DOI: 10.1016/j.yebeh.2013.06.005] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2013] [Revised: 06/04/2013] [Accepted: 06/07/2013] [Indexed: 11/30/2022]
Abstract
Accurate localization of language function is critical in children undergoing epilepsy surgery. Functional magnetic resonance imaging (fMRI) is a noninvasive mapping method that has begun to replace electrocortical stimulation mapping (ESM) and the intracarotid amytal test (IAT). We used both quantitative and qualitative methods to evaluate the concordance of fMRI with ESM and IAT in 20 children using a panel of language tasks. In no cases did fMRI assessment of language hemisphere dominance identify the opposite hemisphere from assessment by IAT or ESM. Concordance with IAT and ESM was higher using fMRI visual inspection than an fMRI laterality index, which failed to lateralize language in a number of the subjects. We have demonstrated that fMRI has good concordance with more traditional methods of language mapping. When fMRI demonstrates bilateral language activations, however, we continue to recommend confirmatory testing by either IAT or ESM prior to resection in classic language regions.
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Affiliation(s)
- Danielle Rodin
- Division of Neurology, The Hospital for Sick Children, Department of Pediatrics, University of Toronto, Toronto, Ontario, Canada
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Vannest J, Szaflarski JP, Eaton KP, Henkel DM, Morita D, Glauser TA, Byars AW, Patel K, Holland SK. Functional magnetic resonance imaging reveals changes in language localization in children with benign childhood epilepsy with centrotemporal spikes. J Child Neurol 2013; 28:435-45. [PMID: 22761402 DOI: 10.1177/0883073812447682] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
In children with benign childhood epilepsy with centrotemporal spikes, centrotemporal spikes may cause language dysfunction via disruption of underlying functional neuroanatomy. Fifteen patients with benign childhood epilepsy with centrotemporal spikes and 15 healthy controls completed 3 functional magnetic resonance imaging (MRI) language paradigms; standardized cognitive and language assessments were also performed. For all paradigms, children with benign childhood epilepsy with centrotemporal spikes showed specific regional differences in activation compared to controls. Children with benign childhood epilepsy with centrotemporal spikes also differed from controls on neuropsychological testing. They did not differ in general intelligence, but children with benign childhood epilepsy with centrotemporal spikes scored significantly lower than controls on tests of language, visuomotor integration, and processing speed. These results extend previous findings of lower language and cognitive skills in patients with benign childhood epilepsy with centrotemporal spikes, and suggest epilepsy-related remodeling of language networks that may underlie these observed differences.
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Affiliation(s)
- Jennifer Vannest
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Medical Center, Cincinnati, OH 45229, USA.
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Besseling RM, Jansen JF, Overvliet GM, van der Kruijs SJ, Vles JS, Ebus SC, Hofman PA, Louw AD, Aldenkamp AP, Backes WH. Reduced functional integration of the sensorimotor and language network in rolandic epilepsy. NEUROIMAGE-CLINICAL 2013; 2:239-46. [PMID: 24179777 PMCID: PMC3777786 DOI: 10.1016/j.nicl.2013.01.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2012] [Revised: 12/17/2012] [Accepted: 01/10/2013] [Indexed: 12/31/2022]
Abstract
Introduction Over the last years, evidence has accumulated that rolandic epilepsy (RE) is associated with serious cognitive comorbidities, including language impairment. However, the cerebral mechanism through which epileptiform activity in the rolandic (sensorimotor) areas may affect the language system is unknown. To investigate this, the connectivity between rolandic areas and regions involved in language processing is studied using functional MRI (fMRI). Materials and methods fMRI data was acquired from 22 children with rolandic epilepsy and 22 age-matched controls (age range: 8–14 years), both at rest and using word-generation and reading tasks. Activation map analysis revealed no group differences (FWE-corrected, p < 0.05) and was therefore used to define regions of interest for pooled (patients and controls combined) language activation. Independent component analysis with dual regression was used to identify the sensorimotor resting-state network in all subjects. The associated functional connectivity maps were compared between groups at the regions of interest for language activation identified from the task data. In addition, neuropsychological language testing (Clinical Evaluation of Language Fundamentals, 4th edition) was performed. Results Functional connectivity with the sensorimotor network was reduced in patients compared to controls (p = 0.011) in the left inferior frontal gyrus, i.e. Broca's area as identified by the word-generation task. No aberrant functional connectivity values were found in the other regions of interest, nor were any associations found between functional connectivity and language performance. Neuropsychological testing confirmed language impairment in patients relative to controls (reductions in core language score, p = 0.03; language content index, p = 0.01; receptive language index, p = 0.005). Conclusion Reduced functional connectivity was demonstrated between the sensorimotor network and the left inferior frontal gyrus (Broca's area) in children with RE, which might link epileptiform activity/seizures originating from the sensorimotor cortex to language impairment, and is in line with the identified neuropsychological profile of anterior language dysfunction.
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Affiliation(s)
- René M.H. Besseling
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Jacobus F.A. Jansen
- Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Geke M. Overvliet
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sylvie J.M. van der Kruijs
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Johannes S.H. Vles
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | | | - Paul A.M. Hofman
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Anton de Louw
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
| | - Albert P. Aldenkamp
- Epilepsy center Kempenhaeghe, Heeze, the Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, the Netherlands
| | - Walter H. Backes
- Research School for Mental Health & Neuroscience, Maastricht University, Maastricht, the Netherlands
- Department of Radiology, Maastricht University Medical Center, Maastricht, the Netherlands
- Corresponding author at: Department of Radiology, Maastricht University Medical Center, PB 5800, 6202 AZ Maastricht, The Netherlands. Tel.: + 31 43 3874910; fax: + 31 43 3876909.
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Datta AN, Oser N, Bauder F, Maier O, Martin F, Ramelli GP, Steinlin M, Weber P, Penner IK. Cognitive impairment and cortical reorganization in children with benign epilepsy with centrotemporal spikes. Epilepsia 2013; 54:487-94. [PMID: 23297860 DOI: 10.1111/epi.12067] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/31/2012] [Indexed: 11/28/2022]
Affiliation(s)
- Alexandre N. Datta
- Division of Pediatric Neurology and Developmental Medicine; University Children's Hospital; Basel; Switzerland
| | | | - Florian Bauder
- Division of Pediatric Neurology and Developmental Medicine; Children's Hospital; Lucerne; Switzerland
| | - Oliver Maier
- Division of Pediatric Neurology, Developmental Medicine and Rehabilitation; Ostschweizer Children's Hospital; St. Gallen; Switzerland
| | - Florence Martin
- Division of Pediatric Neurology and Developmental Medicine; Children's Hospital; Aarau; Switzerland
| | - Gian Paolo Ramelli
- Pediatric Neurology; Department of Pediatrics; Ospedale Regionale di Bellinzona e valli; Bellinzona; Switzerland
| | - Maja Steinlin
- Divison of Pediatric Neurology, Developmental Medicine and Rehabilitation; University Children's Hospital; Bern; Switzerland
| | - Peter Weber
- Division of Pediatric Neurology and Developmental Medicine; University Children's Hospital; Basel; Switzerland
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Pau S, Jahn G, Sakreida K, Domin M, Lotze M. Encoding and recall of finger sequences in experienced pianists compared with musically naïve controls: A combined behavioral and functional imaging study. Neuroimage 2013; 64:379-87. [PMID: 22982586 DOI: 10.1016/j.neuroimage.2012.09.012] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Revised: 07/30/2012] [Accepted: 09/03/2012] [Indexed: 11/24/2022] Open
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Fakhri M, Oghabian MA, Vedaei F, Zandieh A, Masoom N, Sharifi G, Ghodsi M, Firouznia K. Atypical language lateralization: an fMRI study in patients with cerebral lesions. FUNCTIONAL NEUROLOGY 2013; 28:55-61. [PMID: 23731916 PMCID: PMC3812717] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
Differences in the lateralization of language processes between healthy subjects and patients with neurological complaints other than epilepsy have been less documented than those between healthy subjects and epilepsy patients. Moreover, the contribution of factors such as the location and type of lesion in determining interhemispheric shift of language function is poorly understood. Sixty-seven patients who underwent presurgical evaluations at the Medical Imaging Center of the Imam Khomeini University Hospital, Tehran, and the same number of healthy controls, were recruited. The laterality index (LI) of language activation, calculated from two separate functional magnetic resonance imaging tasks, was compared between the patients and the age-/gender-/handedness-matched controls. Chi square testing showed that the percentages of subjects with "typical" and "atypical" language dominance in the patient group were significantly different from the percentages recorded in the matched healthy controls for both tasks (p<0.005). Lesion type, lesion location, lesion hemisphere, presenting symptom and patient gender had no statistically significant effect on the hemispheric LI (p>0.05). In a logistic regression model including all potential determinants of atypical LI, age emerged as the only independent predictor (p<0.05, odds ratio=0.9). Abnormal language lateralization is found in patients with a variety of cerebral lesions and with a diversity of clinical manifestations. In our selected population, symptom duration, lesion hemisphere and anatomical site of the lesion were not found to impact significantly on the development of an abnormal LI while patient age can independently predict the presence of an atypical LI.
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Affiliation(s)
- Mohammad Fakhri
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Faeze Vedaei
- Neuroimaging and Analysis Group, Research Center for Molecular and Cellular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Zandieh
- Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Nina Masoom
- Iranian Center of Neurological Research, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Guive Sharifi
- Department of Neurosurgery, Loghman Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mohammad Ghodsi
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
| | - Kavous Firouznia
- Department of Neurosurgery, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran
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Epilepsy Surgery in Childhood. Can J Neurol Sci 2012. [DOI: 10.1017/s0317167100018163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Historically, epilepsy surgery has been considered a treatment of last resort. Advances in neuroimaging, particularly high resolution magnetic resonance imaging (MRI) techniques and functional neuroimaging, advances in neuroanesthesia and neurosurgery have all contributed to the development of safe and effective epilepsy surgery in infants and children. Furthermore, epilepsy surgery may prevent the chronic deleterious effects that uncontrolled epileptic seizures have on brain development. The main challenges that clinicians face are early identification of infants and children who have epilepsy which is amenable to epilepsy surgery, the timing of epilepsy surgery and the investigation of patients where no lesion is demonstrable on MRI. It is imperative that children be followed after epilepsy surgery to assess the long-term outcomes not only in relation to seizure control, but also to assess quality of life, psychoeducational achievement, and psychiatric co-morbidity.
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Language mapping in temporal lobe epilepsy in children: special considerations. EPILEPSY RESEARCH AND TREATMENT 2012; 2012:837036. [PMID: 22957246 PMCID: PMC3420711 DOI: 10.1155/2012/837036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2011] [Accepted: 11/06/2011] [Indexed: 02/01/2023]
Abstract
Temporal lobe epilepsy (TLE) in children is a slightly different entity than TLE in adults not only because of its semiology and pathology but also because of the different approach to surgical treatment. Presurgical investigations for eloquent cortex, especially language, must take these differences into account. Most diagnostic tests were created for adults, and many of the assessment tools need to be adapted for children because they are not just small adults. This paper will highlight the specific challenges and solutions in mapping language in a pediatric population with TLE.
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Wang Y, Holland SK, Vannest J. Concordance of MEG and fMRI patterns in adolescents during verb generation. Brain Res 2012; 1447:79-90. [PMID: 22365747 DOI: 10.1016/j.brainres.2012.02.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2011] [Revised: 01/31/2012] [Accepted: 02/01/2012] [Indexed: 10/14/2022]
Abstract
In this study we focused on direct comparison between the spatial distributions of activation detected by functional magnetic resonance imaging (fMRI) and localization of sources detected by magnetoencephalography (MEG) during identical language tasks. We examined the spatial concordance between MEG and fMRI results in 16 adolescents performing a three-phase verb generation task that involves repeating the auditorily presented concrete noun and generating verbs either overtly or covertly in response to the auditorily presented noun. MEG analysis was completed using a synthetic aperture magnetometry (SAM) technique, while the fMRI data were analyzed using the general linear model approach with random-effects. To quantify the agreement between the two modalities, we implemented voxel-wise concordance correlation coefficient (CCC) and identified the left inferior frontal gyrus and the bilateral motor cortex with high CCC values. At the group level, MEG and fMRI data showed spatial convergence in the left inferior frontal gyrus for covert or overt generation versus overt repetition, and the bilateral motor cortex when overt generation versus covert generation. These findings demonstrate the utility of the CCC as a quantitative measure of spatial convergence between two neuroimaging techniques.
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Affiliation(s)
- Yingying Wang
- Pediatric Neuroimaging Research Consortium, Cincinnati Children's Hospital Research Foundation, Cincinnati, OH 45229-3039, USA.
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