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Mankinen K, Ipatti P, Harila M, Nikkinen J, Paakki JJ, Rytky S, Starck T, Remes J, Tokariev M, Carlson S, Tervonen O, Rantala H, Kiviniemi V. Reading, listening and memory-related brain activity in children with early-stage temporal lobe epilepsy of unknown cause-an fMRI study. Eur J Paediatr Neurol 2015; 19:561-71. [PMID: 26026490 DOI: 10.1016/j.ejpn.2015.05.001] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Revised: 01/25/2015] [Accepted: 05/05/2015] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS The changes in functional brain organization associated with paediatric epilepsy are largely unknown. Since children with epilepsy are at risk of developing learning difficulties even before or shortly after the onset of epilepsy, we assessed the functional organization of memory and language in paediatric patients with temporal lobe epilepsy (TLE) at an early stage in epilepsy. METHODS Functional magnetic resonance imaging was used to measure the blood oxygenation level-dependent (BOLD) response to four cognitive tasks measuring reading, story listening, memory encoding and retrieval in a population-based group of children with TLE of unknown cause (n = 21) and of normal intelligence and a healthy age and gender-matched control group (n = 21). RESULTS Significant BOLD response differences were found only in one of the four tasks. In the story listening task, significant differences were found in the right hemispheric temporal structures, thalamus and basal ganglia. Both activation and deactivation differed significantly between the groups, activation being increased and deactivation decreased in the TLE group. Furthermore, the patients with abnormal electroencephalograms (EEGs) showed significantly increased activation bilaterally in the temporal structures, basal ganglia and thalamus relative to those with normal EEGs. The patients with normal interictal EEGs had a significantly stronger deactivation than those with abnormal EEGs or the controls, the differences being located outside the temporal structures. CONCLUSIONS Our results suggest that TLE entails a widespread disruption of brain networks. This needs to be taken into consideration when evaluating learning abilities in patients with TLE. The thalamus seems to play an active role in TLE. The changes in deactivation may reflect neuronal inhibition.
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Affiliation(s)
- Katariina Mankinen
- Department of Paediatrics, Oulu University Hospital, PB 29, 90014 Oulu, Finland.
| | - Pieta Ipatti
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Marika Harila
- Department of Neurology, Oulu University Hospital, Finland
| | - Juha Nikkinen
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
| | | | - Seppo Rytky
- Department of Clinical Neurophysiology, Oulu University Hospital, Finland
| | - Tuomo Starck
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Jukka Remes
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Maksym Tokariev
- Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, P.B. 15100, 00076 Aalto, Finland; Neuroscience Unit, Institute of Biomedicine/Physiology, University of Helsinki, P.B. 63, 00014 University of Helsinki, Finland
| | - Synnöve Carlson
- Brain Research Unit, O.V. Lounasmaa Laboratory, Aalto University School of Science, P.B. 15100, 00076 Aalto, Finland; Neuroscience Unit, Institute of Biomedicine/Physiology, University of Helsinki, P.B. 63, 00014 University of Helsinki, Finland
| | - Osmo Tervonen
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
| | - Heikki Rantala
- Department of Paediatrics, Oulu University Hospital, PB 29, 90014 Oulu, Finland
| | - Vesa Kiviniemi
- Clinic of Diagnostic Radiology, Oulu University Hospital, Finland
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Połczyńska M, Curtiss S, Walshaw P, Siddarth P, Benjamin C, Moseley BD, Vigil C, Jones M, Eliashiv D, Bookheimer S. Grammar tests increase the ability to lateralize language function in the Wada test. Epilepsy Res 2014; 108:1864-73. [DOI: 10.1016/j.eplepsyres.2014.09.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Revised: 08/12/2014] [Accepted: 09/13/2014] [Indexed: 10/24/2022]
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Wilson SJ, Abbott DF, Tailby C, Gentle EC, Merrett DL, Jackson GD. Changes in singing performance and fMRI activation following right temporal lobe surgery. Cortex 2013; 49:2512-24. [DOI: 10.1016/j.cortex.2012.12.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 12/05/2012] [Accepted: 12/24/2012] [Indexed: 10/27/2022]
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Enatsu R, Kubota Y, Kakisaka Y, Bulacio J, Piao Z, O’Connor T, Horning K, Mosher J, Burgess RC, Bingaman W, Nair DR. Reorganization of posterior language area in temporal lobe epilepsy: A cortico-cortical evoked potential study. Epilepsy Res 2013; 103:73-82. [DOI: 10.1016/j.eplepsyres.2012.07.008] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Revised: 06/15/2012] [Accepted: 07/03/2012] [Indexed: 11/25/2022]
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Abstract
Our understanding of epileptogenesis is still limited. Knowledge is increasing with regard to structural and functional changes in chronic stages of epilepsy. At the same time, we have to appreciate that there is a significant lack of such information in new-onset epilepsy. The First Halifax International Epilepsy Conference tried to fill this gap, focusing on the contribution of advanced neuroimaging in early stages of epilepsy. The following article aims to synthesize the themes that emerged from this meeting. Participants agreed that (1) there is a need for a unified theory of epileptogenesis, addressing the interplay of functional and structural brain changes; (2) neuroimaging reveals widespread brain alterations in epilepsy; (3) advances in neuroimaging challenge the concept of "MRI-negative" (magnetic resonance imaging negative) focal epilepsy; (4) methodologic limitations and potential confounders must be considered in the translation of innovative imaging approaches to clinical practice; and (5) there is an urgent need for longitudinal studies that begin early in the disease process.
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Affiliation(s)
- Matthias H Schmidt
- Department of Radiology Medicine, Neurology, Dalhousie University, Halifax, Nova Scotia, Canada.
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