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Trimmel K, Vos SB, Binding L, Caciagli L, Xiao F, van Graan LA, Koepp MJ, Thompson PJ, Duncan JS. Naming fMRI-guided white matter language tract volumes influence naming decline after temporal lobe resection. J Neurol 2024; 271:4158-4167. [PMID: 38583105 PMCID: PMC11233363 DOI: 10.1007/s00415-024-12315-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 03/08/2024] [Accepted: 03/08/2024] [Indexed: 04/08/2024]
Abstract
OBJECTIVE The aim of this study was to explore the relation of language functional MRI (fMRI)-guided tractography with postsurgical naming decline in people with temporal lobe epilepsy (TLE). METHODS Twenty patients with unilateral TLE (9 left) were studied with auditory and picture naming functional MRI tasks. Activation maxima in the left posterobasal temporal lobe were used as seed regions for whole-brain fibre tractography. Clinical naming performance was assessed preoperatively, 4 months, and 12 months following temporal lobe resection. Volumes of white matter language tracts in both hemispheres as well as tract volume laterality indices were explored as moderators of postoperative naming decline using Pearson correlations and multiple linear regression with other clinical variables. RESULTS Larger volumes of white matter language tracts derived from auditory and picture naming maxima in the hemisphere of subsequent surgery as well as stronger lateralization of picture naming tract volumes to the side of surgery correlated with greater language decline, which was independent of fMRI lateralization status. Multiple regression for picture naming tract volumes was associated with a significant decline of naming function with 100% sensitivity and 93% specificity at both short-term and long-term follow-up. INTERPRETATION Naming fMRI-guided white matter language tract volumes relate to postoperative naming decline after temporal lobe resection in people with TLE. This can assist stratification of surgical outcome and minimize risk of postoperative language deficits in TLE.
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Affiliation(s)
- Karin Trimmel
- Department of Neurology, Medical University of Vienna, Vienna, Austria.
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK.
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK.
| | - Sjoerd B Vos
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
- Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, London, UK
- Centre for Microscopy Characterisation and Analysis, University of Western Australia, Nedlands, Australia
| | - Lawrence Binding
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Centre for Medical Image Computing, Department of Computer Science, University College London, London, UK
| | - Lorenzo Caciagli
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Department of Neurology, Inselspital, Sleep-Wake-Epilepsy-Center, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Fenglai Xiao
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Louis A van Graan
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Matthias J Koepp
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Pamela J Thompson
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - John S Duncan
- Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, UK
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
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Matoba K, Matsumoto R, Shimotake A, Nakae T, Imamura H, Togo M, Yamao Y, Usami K, Kikuchi T, Yoshida K, Matsuhashi M, Kunieda T, Miyamoto S, Takahashi R, Ikeda A. Basal temporal language area revisited in Japanese language with a language function density map. Cereb Cortex 2024; 34:bhae218. [PMID: 38858838 DOI: 10.1093/cercor/bhae218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
We revisited the anatomo-functional characteristics of the basal temporal language area (BTLA), first described by Lüders et al. (1986), using electrical cortical stimulation (ECS) in the context of Japanese language and semantic networks. We recruited 11 patients with focal epilepsy who underwent chronic subdural electrode implantation and ECS mapping with multiple language tasks for presurgical evaluation. A semiquantitative language function density map delineated the anatomo-functional characteristics of the BTLA (66 electrodes, mean 3.8 cm from the temporal tip). The ECS-induced impairment probability was higher in the following tasks, listed in a descending order: spoken-word picture matching, picture naming, Kanji word reading, paragraph reading, spoken-verbal command, and Kana word reading. The anterior fusiform gyrus (FG), adjacent anterior inferior temporal gyrus (ITG), and the anterior end where FG and ITG fuse, were characterized by stimulation-induced impairment during visual and auditory tasks requiring verbal output or not, whereas the middle FG was characterized mainly by visual input. The parahippocampal gyrus was the least impaired of the three gyri in the basal temporal area. We propose that the BTLA has a functional gradient, with the anterior part involved in amodal semantic processing and the posterior part, especially the middle FG in unimodal semantic processing.
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Affiliation(s)
- Kento Matoba
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takuro Nakae
- Department of Neurosurgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga 524-0022, Japan
| | - Hisaji Imamura
- Department of Neurology, Fukui Red Cross Hospital, 2-4-1, Tsukimi, Fukui, 918-8011, Japan
| | - Masaya Togo
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kiyohide Usami
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Volfart A, Rossion B, Brissart H, Busigny T, Colnat-Coulbois S, Maillard L, Jonas J. Stability of face recognition abilities after left or right anterior temporal lobectomy. J Neuropsychol 2024; 18 Suppl 1:115-133. [PMID: 37391874 DOI: 10.1111/jnp.12337] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/08/2023] [Accepted: 06/20/2023] [Indexed: 07/02/2023]
Abstract
Patients with anterior temporal lobe (ATL) resection due to mesial temporal lobe epilepsy (MTLE) have difficulties at identifying familiar faces and explicitly remembering newly learned faces but their ability to individuate unfamiliar faces remains largely unknown. Moreover, the extent to which their difficulties with familiar face identity recognition and learning is truly due to the ATL resection remains unknown. Here, we report a study of 24 MTLE patients and matched healthy controls tested with an extensive set of seven face and visual object recognition tasks (including three tasks evaluating unfamiliar face individuation) before and about 6 months after unilateral (nine left, 15 right) ATL resection. We found that ATL resection has little or no effect on the patients' preserved pre-surgical ability to perform unfamiliar face individuation, both at the group and individual levels. More surprisingly, ATL resection also has little effect on the patients' performance at recognizing and naming famous faces as well as at learning new faces. A substantial proportion of right MTLE patients (33%) even improved their response times on several tasks, which may indicate a functional release of visuo-spatial processing after resection in the right ATL. Altogether this study shows that face recognition abilities are mainly unaffected by ATL resection in MTLE, either because the critical regions for face recognition are spared or because performance at some tasks is already lower than normal preoperatively. Overall, these findings urge caution when interpreting the causal effect of brain lesions on face recognition ability in patients with ATL resection due to MTLE. They also illustrate the complexity of predicting cognitive outcomes after epilepsy surgery because of the influence of many different intertwined factors.
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Affiliation(s)
- Angélique Volfart
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- Institute of Research in Psychological Science, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
- School of Psychology and Counselling, Faculty of Health, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Bruno Rossion
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- Institute of Research in Psychological Science, Université Catholique de Louvain, Louvain-La-Neuve, Belgium
- CHRU-Nancy, Service de Neurologie, Université de Lorraine, Nancy, France
| | - Hélène Brissart
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- CHRU-Nancy, Service de Neurologie, Université de Lorraine, Nancy, France
| | - Thomas Busigny
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
| | - Sophie Colnat-Coulbois
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- CHRU-Nancy, Service de Neurochirurgie, Université de Lorraine, Nancy, France
| | - Louis Maillard
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- CHRU-Nancy, Service de Neurologie, Université de Lorraine, Nancy, France
| | - Jacques Jonas
- CNRS, CRAN UMR 7039, Université de Lorraine, Nancy, France
- CHRU-Nancy, Service de Neurologie, Université de Lorraine, Nancy, France
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Reindl C, Walther K, Allgäuer AL, Lang JD, Welte TM, Stritzelberger J, Gollwitzer S, Schwarz M, Trollmann R, Madzar D, Knott M, Doerfler A, Seifert F, Rössler K, Brandner S, Rampp S, Schwab S, Hamer HM. Age of epilepsy onset as modulating factor for naming deficit after epilepsy surgery: a voxel-based lesion-symptom mapping study. Sci Rep 2023; 13:14395. [PMID: 37658152 PMCID: PMC10474263 DOI: 10.1038/s41598-023-40722-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Accepted: 08/16/2023] [Indexed: 09/03/2023] Open
Abstract
Age at onset of epilepsy is an important predictor of deterioration in naming ability following epilepsy surgery. In 141 patients with left hemispheric epilepsy and language dominance who received epilepsy surgery at the Epilepsy Centre Erlangen, naming of objects (Boston naming test, BNT) was assessed preoperatively and 6 months postoperatively. Surgical lesions were plotted on postoperative MRI and normalized for statistical analysis using voxel-based lesion-symptom mapping (VBLSM). The correlation between lesion and presence of postoperative naming deterioration was examined varying the considered age range of epilepsy onsets. The VBLSM analysis showed that volumes of cortex areas in the left temporal lobe, which were associated with postoperative decline of naming, increased with each year of later epilepsy onset. In patients with later onset, an increasing left posterior temporobasal area was significantly associated with a postoperative deficit when included in the resection. For late epilepsy onset, the temporomesial expansion also included the left hippocampus. The results underline that early onset of epilepsy is a good prognostic factor for unchanged postoperative naming ability following epilepsy surgery. For later age of epilepsy onset, the extent of the area at risk of postoperative naming deficit at 6 months after surgery included an increasing left temporobasal area which finally also comprised the hippocampus.
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Affiliation(s)
- Caroline Reindl
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany.
| | - Katrin Walther
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Anna-Lena Allgäuer
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Johannes D Lang
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Tamara M Welte
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Jenny Stritzelberger
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Stephanie Gollwitzer
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Michael Schwarz
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
| | - Regina Trollmann
- Department of Neuropaediatrics, University Hospital Erlangen, Erlangen, Germany
| | - Dominik Madzar
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Knott
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Frank Seifert
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Karl Rössler
- Department of Neurosurgery, University Hospital Vienna (AKH), Vienna, Austria
| | - Sebastian Brandner
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle (Saale), Halle, Germany
| | - Stefan Schwab
- Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Hajo M Hamer
- Epilepsy Center Department of Neurology, University Hospital Erlangen, Schwabachanlage 6, 91054, Erlangen, Germany
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Cockle E, Rayner G, Malpas C, Alpitsis R, Rheims S, O'Brien TJ, Neal A. An international survey of SEEG cortical stimulation practices. Epilepsia Open 2023; 8:1084-1095. [PMID: 37437189 PMCID: PMC10472359 DOI: 10.1002/epi4.12790] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 07/02/2023] [Indexed: 07/14/2023] Open
Abstract
OBJECTIVE Cortical stimulation is an important component of stereoelectroencephalography (SEEG). Despite this, there is currently no standardized approach and significant heterogeneity in the literature regarding cortical stimulation practices. Via an international survey of SEEG clinicians, we sought to examine the spectrum of cortical stimulation practices to reveal areas of consensus and variability. METHODS A 68-item questionnaire was developed to understand cortical stimulation practices including neurostimulation parameters, interpretation of epileptogenicity, functional and cognitive assessment and subsequent surgical decisions. Multiple recruitment pathways were pursued, with the questionnaire distributed directly to 183 clinicians. RESULTS Responses were received from 56 clinicians across 17 countries with experience ranging from 2 to 60 years (M = 10.73, SD = 9.44). Neurostimulation parameters varied considerably, with maximum current ranging from 3 to 10 mA (M = 5.33, SD = 2.29) for 1 Hz and from 2 to 15 mA (M = 6.54, SD = 3.68) for 50 Hz stimulation. Charge density ranged from 8 to 200 μC/cm2 , with up to 43% of responders utilizing charge densities higher than recommended upper safety limits, i.e. 55 μC/cm2 . North American responders reported statistically significant higher maximum current (P < 0.001) for 1 Hz stimulation and lower pulse width for 1 and 50 Hz stimulation (P = 0.008, P < 0.001, respectively) compared to European responders. All clinicians evaluated language, speech, and motor function during cortical stimulation; in contrast, 42% assessed visuospatial or visual function, 29% memory, and 13% executive function. Striking differences were reported in approaches to assessment, classification of positive sites, and surgical decisions guided by cortical stimulation. Patterns of consistency were observed for interpretation of the localizing capacity of stimulated electroclinical seizures and auras, with habitual electroclinical seizures induced by 1 Hz stimulation considered the most localizing. SIGNIFICANCE SEEG cortical stimulation practices differed vastly across clinicians internationally, highlighting the need for consensus-based clinical guidelines. In particular, an internationally standardized approach to assessment, classification, and functional prognostication will provide a common clinical and research framework for optimizing outcomes for people with drug-resistant epilepsy.
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Affiliation(s)
- Emily Cockle
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Genevieve Rayner
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
| | - Charles Malpas
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
- Melbourne School of Psychological SciencesUniversity of MelbourneParkvilleVictoriaAustralia
- Department of Medicine, Royal Melbourne HospitalUniversity of MelbourneParkvilleVictoriaAustralia
| | - Rubina Alpitsis
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Sylvain Rheims
- Lyon Neurosciences Research Center (Inserm U1028, CNRS UMR5292, Lyon 1 University)LyonFrance
- Department of Functional Neurology and EpileptologyHospices Civils de Lyon and Lyon 1 UniversityLyonFrance
- Epilepsy Institute and member of the ERN EpiCARELyonFrance
| | - Terence J O'Brien
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
| | - Andrew Neal
- Department of NeurologyAlfred HospitalMelbourneVictoriaAustralia
- Department of NeuroscienceMonash UniversityMelbourneVictoriaAustralia
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Snyder KM, Forseth KJ, Donos C, Rollo PS, Fischer-Baum S, Breier J, Tandon N. Critical role of the ventral temporal lobe in naming. Epilepsia 2023; 64:1200-1213. [PMID: 36806185 DOI: 10.1111/epi.17555] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Lexical retrieval deficits are characteristic of a variety of different neurological disorders. However, the exact substrates responsible for this are not known. We studied a large cohort of patients undergoing surgery in the dominant temporal lobe for medically intractable epilepsy (n = 95) to localize brain regions that were associated with anomia. METHODS We performed a multivariate voxel-based lesion-symptom mapping analysis to correlate surgical lesions within the temporal lobe with changes in naming ability. Additionally, we used a surface-based mixed-effects multilevel analysis to estimate group-level broadband gamma activity during naming across a subset of patients with electrocorticographic recordings and integrated these results with lesion-deficit findings. RESULTS We observed that ventral temporal regions, centered around the middle fusiform gyrus, were significantly associated with a decline in naming. Furthermore, we found that the ventral aspect of temporal lobectomies was linearly correlated to a decline in naming, with a clinically significant decline occurring once the resection extended 6 cm from the anterior tip of the temporal lobe on the ventral surface. On electrocorticography, the majority of these cortical regions were functionally active following visual processing. These loci coincide with the sites of susceptibility artifacts during echoplanar imaging, which may explain why this region has been previously underappreciated as the locus responsible for postoperative naming deficits. SIGNIFICANCE Taken together, these data highlight the crucial contribution of the ventral temporal cortex in naming and its important role in the pathophysiology of anomia following temporal lobe resections. As such, surgical strategies should attempt to preserve this region to mitigate postoperative language deficits.
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Affiliation(s)
- Kathryn M Snyder
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kiefer J Forseth
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cristian Donos
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Faculty of Physics, University of Bucharest, Bucharest, Romania
| | - Patrick S Rollo
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Simon Fischer-Baum
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Joshua Breier
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, USA
| | - Nitin Tandon
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, USA
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Massot-Tarrús A, Mirsattari SM. Roles of fMRI and Wada tests in the presurgical evaluation of language functions in temporal lobe epilepsy. Front Neurol 2022; 13:884730. [PMID: 36247757 PMCID: PMC9562037 DOI: 10.3389/fneur.2022.884730] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022] Open
Abstract
Surgical treatment of pharmacoresistant temporal lobe epilepsy (TLE) carries risks for language function that can significantly affect the quality of life. Predicting the risks of decline in language functions before surgery is, consequently, just as important as predicting the chances of becoming seizure-free. The intracarotid amobarbital test, generally known as the Wada test (WT), has been traditionally used to determine language lateralization and to estimate their potential decline after surgery. However, the test is invasive and it does not localize the language functions. Therefore, other noninvasive methods have been proposed, of which functional magnetic resonance (fMRI) has the greatest potential. Functional MRI allows localization of language areas. It has good concordance with the WT for language lateralization, and it is of predictive value for postsurgical naming outcomes. Consequently, fMRI has progressively replaced WT for presurgical language evaluation. The objective of this manuscript is to review the most relevant aspects of language functions in TLE and the current role of fMRI and WT in the presurgical evaluation of language. First, we will provide context by revising the language network distribution and the effects of TLE on them. Then, we will assess the functional outcomes following various forms of TLE surgery and measures to reduce postoperative language decline. Finally, we will discuss the current indications for WT and fMRI and the potential usefulness of the resting-state fMRI technique.
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Affiliation(s)
| | - Seyed M. Mirsattari
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
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8
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Aron O, Krieg J, Brissart H, Abdallah C, Colnat-Coulbois S, Jonas J, Maillard L. Naming impairments evoked by focal cortical electrical stimulation in the ventral temporal cortex correlate with increased functional connectivity. Neurophysiol Clin 2022; 52:312-322. [PMID: 35777988 DOI: 10.1016/j.neucli.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND High-frequency cortical electrical stimulations (HF-CES) are the gold standard for presurgical functional mapping. In the dominant ventral temporal cortex (VTC) HF-CES can elicit transient naming impairment (eloquent sites), defining a basal temporal language area (BTLA). OBJECTIVE Whether naming impairments induced by HF-CES within the VTC are related to a specific pattern of connectivity of the BTLA within the temporal lobe remains unknown. We addressed this issue by comparing the connectivity of eloquent and non-eloquent sites from the VTC using cortico-cortical evoked potentials (CCEP). METHODS Low frequency cortical electrical stimulations (LF-CES) were used to evoke CCEP in nine individual brains explored with Stereo-Electroencephalography. We compared the connectivity of eloquent versus non eloquent sites within the VTC using Pearson's correlation matrix. RESULTS Overall, within the VTC, eloquent sites were associated with increased functional connectivity compared to non-eloquent sites. Among the VTC structures, this pattern holds true for the inferior temporal gyrus and the parahippocampal gyrus while the fusiform gyrus specifically showed a high connectivity in both non eloquent and eloquent sites. CONCLUSIONS Our findings suggest that the cognitive effects of focal HF-CES are related to the functional connectivity properties of the stimulated sites, and therefore to the disturbance of a wide cortical network. They further suggest that functional specialization of a cortical region emerges from its specific pattern of functional connectivity. Cortical electrical stimulation functional mapping protocols including LF coupled to HF-CES could provide valuable data characterizing both local and distant functional architecture.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France.
| | - Julien Krieg
- Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Helene Brissart
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France
| | - Chifaou Abdallah
- Neurology and Neurosurgery Department, Montreal Neurological Institute (C.A.) McGill University, Montreal, Quebec, Canada
| | - Sophie Colnat-Coulbois
- Department of Neurosurgery, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Jacques Jonas
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Louis Maillard
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
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Paredes-Aragon E, AlKhaldi NA, Ballesteros-Herrera D, Mirsattari SM. Stereo-Encephalographic Presurgical Evaluation of Temporal Lobe Epilepsy: An Evolving Science. Front Neurol 2022; 13:867458. [PMID: 35720095 PMCID: PMC9197919 DOI: 10.3389/fneur.2022.867458] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 04/25/2022] [Indexed: 11/15/2022] Open
Abstract
Drug-resistant epilepsy is present in nearly 30% of patients. Resection of the epileptogenic zone has been found to be the most effective in achieving seizure freedom. The study of temporal lobe epilepsy for surgical treatment is extensive and complex. It involves a multidisciplinary team in decision-making with initial non-invasive studies (Phase I), providing 70% of the required information to elaborate a hypothesis and treatment plans. Select cases present more complexity involving bilateral clinical or electrographic manifestations, have contradicting information, or may involve deeper structures as a part of the epileptogenic zone. These cases are discussed by a multidisciplinary team of experts with a hypothesis for invasive methods of study. Subdural electrodes were once the mainstay of invasive presurgical evaluation and in later years most Comprehensive Epilepsy Centers have shifted to intracranial recordings. The intracranial recording follows original concepts since its development by Bancaud and Talairach, but great advances have been made in the field. Stereo-electroencephalography is a growing field of study, treatment, and establishment of seizure pattern complexities. In this comprehensive review, we explore the indications, usefulness, discoveries in interictal and ictal findings, pitfalls, and advances in the science of presurgical stereo-encephalography for temporal lobe epilepsy.
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Affiliation(s)
- Elma Paredes-Aragon
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
| | - Norah A AlKhaldi
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Neurology Department, King Fahad Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Daniel Ballesteros-Herrera
- Neurosurgery Department, National Institute of Neurology and Neurosurgery "Dr. Manuel Velasco Suárez", Mexico City, Mexico
| | - Seyed M Mirsattari
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada.,Departments of Clinical Neurological Sciences, Diagnostic Imaging, Biomedical Imaging and Psychology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada
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Mezjan I, Brissart H, Masson D, Vignal JP, Aron O, Ferrand M, Civit T, Maillard L, Colnat-Coulbois S. Epilepsy surgery for drug-resistant temporal lobe epilepsy in over-50 year-olds: seizure outcome, surgical complications and neuropsychological outcome. Neurochirurgie 2022; 68:510-517. [DOI: 10.1016/j.neuchi.2022.04.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 02/19/2022] [Accepted: 04/07/2022] [Indexed: 10/18/2022]
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Kaestner E, Stasenko A, Ben-Haim S, Shih J, Paul BM, McDonald CR. The importance of basal-temporal white matter to pre- and post-surgical naming ability in temporal lobe epilepsy. Neuroimage Clin 2022; 34:102963. [PMID: 35220106 PMCID: PMC8888987 DOI: 10.1016/j.nicl.2022.102963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Emerging research highlights the importance of basal-temporal cortex, centered on the fusiform gyrus, to both pre-surgical naming ability and post-surgical naming outcomes in temporal lobe epilepsy (TLE). In this study, we investigate whether integrity of the white matter network that interconnects this basal region to the distributed language network affects naming ability and risk for post-surgical naming decline. METHODS Patients with drug-resistant TLE were recruited from two epilepsy centers in a prospective longitudinal study. The pre-surgical dataset included 50 healthy controls, 47 left TLE (L-TLE), and 41 right TLE (R-TLE) patients. All participants completed pre-surgical T1- and diffusion-weighted MRI (dMRI), as well as neuropsychological tests of auditory and visual naming. Nineteen L-TLE and 18 R-TLE patients underwent anterior temporal lobectomy (ATL) and also completed post-surgical neuropsychological testing. Pre-surgical fractional anisotropy (FA) of the white matter directly beneath the fusiform neocortex (i.e., superficial white matter; SWM) and of deep white matter tracts with connections to the basal-temporal cortex [inferior longitudinal fasciculus (ILF) and inferior frontal occipital fasciculus (IFOF)] was calculated. Clinical variables, hippocampal volume, and FA of each white matter tract or region were examined in linear regressions with naming scores, or change in naming scores, as the primary outcomes. RESULTS Pre-surgically, higher FA in the bilateral ILF, bilateral IFOF, and left fusiform SWM was associated with better visual and auditory naming scores (all ps < 0.05 with FDR correction). In L-TLE, higher pre-surgical FA was also associated with less naming decline post-surgically, but results varied across tracts. When including only patients with typical language dominance, only integrity of the right fusiform SWM was associated with less visual naming decline (p = .0018). DISCUSSION Although a broad network of white matter network matter may contribute to naming ability pre-surgically, the reserve capacity of the contralateral (right) fusiform SWM may be important for mitigating visual naming decline following ATL in L-TLE. This shows that the study of the structural network interconnecting the basal-temporal region to the wider language network has implications for understanding both pre- and post-surgical naming in TLE.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Alena Stasenko
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharona Ben-Haim
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Jerry Shih
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California -San Francisco, San Francisco, CA, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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Resection of dominant fusiform gyrus is associated with decline of naming function when temporal lobe epilepsy manifests after the age of five: A voxel-based lesion-symptom mapping study. NEUROIMAGE: CLINICAL 2022; 35:103129. [PMID: 36002957 PMCID: PMC9421498 DOI: 10.1016/j.nicl.2022.103129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/08/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Resection in the dominant fusiform gyrus is associated with an increased risk of postoperative decline in picture naming. More temporo-posterior resections in this area results in a greater degree of naming decline. Risk of significant naming decline after left temporal surgery increased by 5% with every year of later seizure onset.
Objective To determine patients’ characteristics and regions in the temporal lobe where resections lead to a decline in picture naming. Methods 311 patients with left hemispheric dominance for language were included who underwent epilepsy surgery at the Epilepsy Center of Erlangen and whose picture naming scores (Boston Naming Test, BNT) were available preoperatively and 6-months postoperatively. Surgical lesions were mapped to an averaged template based on preoperative and postoperative MRI using voxel-based lesion-symptom mapping (VBLSM). Postoperative brain shifts were corrected. The relationship between lesioned brain areas and the presence of a postoperative naming decline was examined voxel-wise while controlling for effects of overall lesion size at first in the total cohort and then restricted to temporal lobe resections. Results In VBLSM in the total sample, a decline in BNT score was significantly related to left temporal surgery. When only considering patients with left temporal lobe resections (n = 121), 40 (33.1%) significantly worsened in BNT postoperatively. VBLSM including all patients with left temporal resections generated no significant results within the temporal lobe. However, naming decline of patients with epilepsy onset after 5 years of age was significantly associated with resections in the left inferior temporal (extent of BNT decline range: 10.8− 14.4%) and fusiform gyrus (decline range: 12.1−18.4%). Significance Resections in the posterior part of the dominant fusiform and inferior temporal gyrus was associated with a risk of deterioration in naming performance at six months after surgery in patients with epilepsy onset after 5 years of age but not with earlier epilepsy onset.
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McDonald CR. Removing Basal Temporal Language Cortex in Epilepsy Surgery: Short-Term Disruption or Long-Lasting Problem? Epilepsy Curr 2021; 21:329-331. [PMID: 34924825 PMCID: PMC8655261 DOI: 10.1177/15357597211025134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Aron O, Jonas J, Colnat-Coulbois S, Maillard L. Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion. Front Hum Neurosci 2021; 15:619521. [PMID: 33776668 PMCID: PMC7987679 DOI: 10.3389/fnhum.2021.619521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Stereo-electroencephalography (sEEG) is a method that uses stereotactically implanted depth electrodes for extra-operative mapping of epileptogenic and functional networks. sEEG derived functional mapping is achieved using electrical cortical stimulations (ECS) that are currently the gold standard for delineating eloquent cortex. As this stands true especially for primary cortices (e.g., visual, sensitive, motor, etc.), ECS applied to higher order brain areas determine more subtle behavioral responses. While anterior and posterior language areas in the dorsal language stream seem to share characteristics with primary cortices, basal temporal language area (BTLA) in the ventral temporal cortex (VTC) behaves as a highly associative cortex. After a short introduction and considerations about methodological aspects of ECS using sEEG, we review the sEEG language mapping literature in this perspective. We first establish the validity of this technique to map indispensable language cortices in the dorsal language stream. Second, we highlight the contrast between the growing empirical ECS experience and the lack of understanding regarding the fundamental mechanisms underlying ECS behavioral effects, especially concerning the dispensable language cortex in the VTC. Evidences for considering network architecture as determinant for ECS behavioral response complexities are discussed. Further, we address the importance of designing new research in network organization of language as this could enhance ECS ability to map interindividual variability, pathology driven reorganization, and ultimately identify network resilience markers in order to better predict post-operative language deficit. Finally, based on a whole body of available studies, we believe there is strong evidence to consider sEEG as a valid, safe and reliable method for defining eloquent language cortices although there have been no proper comparisons between surgical resections with or without extra-operative or intra-operative language mapping.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | - Jacques Jonas
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | | | - Louis Maillard
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
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