1. Temporal lobe surgery and memory: Lessons, risks, and opportunities
- Author
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Orrin Devinsky, Kristie Bauman, and Anli Liu
- Subjects
Hippocampus ,Amnesia ,Article ,Lateralization of brain function ,Temporal lobe ,03 medical and health sciences ,Behavioral Neuroscience ,Cognition ,0302 clinical medicine ,Visual memory ,Neuroimaging ,Memory ,Seizures ,Functional neuroimaging ,Humans ,Medicine ,Epilepsy surgery ,Longitudinal Studies ,030212 general & internal medicine ,Cerebral Cortex ,Tomography, Emission-Computed, Single-Photon ,Memory Disorders ,business.industry ,Magnetic Resonance Imaging ,Temporal Lobe ,Epilepsy, Temporal Lobe ,Neurology ,Neurology (clinical) ,medicine.symptom ,business ,Neuroscience ,030217 neurology & neurosurgery - Abstract
Careful study of the clinical outcomes of temporal lobe epilepsy (TLE) surgery has greatly advanced our knowledge of the neuroanatomy of human memory. After early cases resulted in profound amnesia, the critical role of the hippocampus and associated medial temporal lobe (MTL) structures to declarative memory became evident. Surgical approaches quickly changed to become unilateral and later, to be more precise, potentially reducing cognitive morbidity. Neuropsychological studies following unilateral temporal lobe resection (TLR) have challenged early models, which simplified the lateralization of verbal and visual memory function. Diagnostic tests, including intracarotid sodium amobarbital procedure (WADA), structural magnetic resonance imaging (MRI), and functional neuroimaging (functional MRI (fMRI), positron emission tomography (PET), and single-photon emission computed tomography (SPECT)), can more accurately lateralize and localize epileptogenic cortex and predict memory outcomes from surgery. Longitudinal studies have shown that memory may even improve in seizure-free patients. From 70 years of experience with epilepsy surgery, we now have a richer understanding of the clinical, neuroimaging, and surgical predictors of memory decline—and improvement—after TLR. "Special Issue: Epilepsy & Behavior's 20th Anniversary"
- Published
- 2019