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Background and Purpose: Knowledge of the anatomic basis of aphasia after stroke has both theoretic and clinical implications by informing models of cortical connectivity and providing data for diagnosis and prognosis. In this study we use diffusion tensor imaging to address the relationship between damage to specific white matter tracts and linguistic deficits after left hemisphere stroke., Materials and Methods: Twenty patients aged 38-77 years with a history of stroke in the left hemisphere underwent diffusion tensor imaging, structural MR imaging, and language testing. All of the patients were premorbidly right handed and underwent imaging and language testing at least 1 month after stroke., Results: Lower fractional anisotropy (FA) values in the superior longitudinal and arcuate fasciculi of the left hemisphere, an indication of greater damage to these tracts, were correlated with decreased ability to repeat spoken language. Comprehension deficits after stroke were associated with lower FA values in the arcuate fasciculus of the left hemisphere. The findings for repetition were independent of MR imaging ratings of the degree of damage to cortical areas of the left hemisphere involved in language function. There were no findings for homotopic tracts in the right hemisphere., Conclusion: This study provides support for a specific role for damage to the superior longitudinal and arcuate fasciculi in the left hemisphere in patients with deficits in repetition of speech in aphasia after stroke.

Hemodynamic brain imaging and lesion studies have suggested differential involvement of expressive language-related cortical regions based on the phonemic versus semantic characteristics of verbal cues. The aims of this study were: 1) to elucidate the relative timing of the activity of inferior frontal and anterior insular versus motor and supplementary motor cortex during a fluency task and 2) to assess potential differences in the location or timing of activity in anterior and posterior language areas based on letter versus category cues. Using magnetic source imaging (MSI), we found significantly earlier onset latencies and a greater number of activity sources in motor and supplementary motor compared with inferior frontal and anterior insular regions. We also observed greater left versus right hemispheric asymmetry of activation for letter compared with category cues. This study provides new insights into cortico-cortical interactions during expressive language tasks.

Objective: Impulsivity is a hallmark of attention deficit/hyperactivity disorder (ADHD). Various auditory masking procedures can quantify the impulsivity caused by distracting background sounds. This study compares the impulsiveness and distraction caused by informational masking (unpredictable tones) with previously published data on central masking (contralateral noise) in children with and without ADHD., Methods: Twenty-six normal and 14 children diagnosed as having ADHD (combined type), all between the ages of 7 and 13, indicated whether they heard a 512-ms, 500-Hz pure tone in a single-interval task under conditions of informational masking and in quiet. The masker consisted of 10 randomly selected frequencies between 1,000 and 2,500 Hz presented simultaneously at an overall level of 60 dB SPL. A maximum-likelihood method estimated thresholds and false alarm rates., Results: There were no differences due to ADHD in thresholds or false alarm rates either with informational masking or in quiet. With informational masking, normal children had high false alarm rates, similar to those from children with ADHD under central masking. With informational masking, all children tended to say a stimulus was present when it was not., Conclusions: All children behave impulsively under some conditions. Pediatric patients with attention disorders can thus be reassured that impulsiveness with unpredictable background sounds is normal, to some extent. Response biases of children with ADHD may only diverge from normal in situations where distracting external stimuli have an intermediate level of predictability. A previous study showed that with central masking, children with ADHD are more impulsive than normal. There appears to be a limit to the uncertainty in auditory masking that can be tolerated by children. Children with ADHD become impulsive at lower levels of uncertainty than normal. Increasing the predictability of distracting background sounds may thus improve the performance of children with ADHD. Informational masking may, for normal listeners, mimic something of what it is like to have an attention deficit. ADHD can be profitably studied with auditory tasks.

Introduction and Development: The paper presents a brief outline of the rationale behind the use of non invasive functional imaging and of the features that any imaging technique should display in order to make a substantial contribution to the search of the brain mechanisms responsible for cognitive functions. One such technique, magnetic source imaging (MSI), that meets these specifications, is described in more detail. Advantages of MSI include the capacity to provide direct measures of regional neurophysiological activity, a millisecond range temporal resolution, and the capacity to provide images of brain activity on an individual basis. We then describe applications of MSI to the study of brain mechanisms involved in various language functions such as oral comprehension and reading. Among these applications, the accuracy of MSI protocols in determining hemispheric dominance for language functions and in identifying the precise location and extent language specific cortex (Wernicke s area) has been verified through comparison with standard invasive techniques (Wada procedure and electrocortical stimulation mapping) in over 60 consecutive cases. In another series of studies we combined data from MSI and direct cortical stimulation to determine the role of temporoparietal areas in phonological analysis of spoken language and in phonological decoding of print. Finally, we have used MSI to gain unique insights into the brain mechanisms that support reading in developmental reading disability., Conclusion: Results from over 21 children diagnosed with this disorder suggest that impaired reading is associated with aberrant functional connections between temporal and temporoparietal areas of the left hemisphere that are normally engaged in reading.

Tasks assessing perception of a phonemic contrast based on voice onset time (VOT) and a nonspeech analog of a VOT contrast using tone onset time (TOT) were administered to children (ages 7.5 to 15.9 years) identified as having reading disability (RD; n = 21), attention deficit/hyperactivity disorder (ADHD; n = 22), comorbid RD and ADHD (n = 26), or no impairment (NI; n = 26). Children with RD, whether they had been identified as having ADHD or not, exhibited reduced perceptual skills on both tasks as indicated by shallower slopes on category labeling functions and reduced accuracy even at the endpoints of the series where cues are most salient. Correlations between performance on the VOT task and measures of single word decoding and phonemic awareness were significant only in the groups without ADHD. These findings suggest that (a) children with RD have difficulty in processing speech and nonspeech stimuli containing similar auditory temporal cues, (b) phoneme perception is related to phonemic awareness and decoding skills, and (c) the potential presence of ADHD needs to be taken into account in studies of perception in children with RD., (Copyright 2001 Academic Press.)

Object: There are conflicting claims in the functional imaging literature concerning whether different languages are represented by distinct brain mechanisms in individuals who are proficient in more than one language. This interesting theoretical issue has practical implications when functional imaging methods are used for presurgical language mapping. To address this issue the authors compared the location and extent of receptive language cortex specific to English and Spanish in neurologically intact bilingual volunteers by using magnetic source imaging., Methods: Areas of the cortex that were specialized for receptive language functions were identified separately for each language in 11 healthy adults who were bilingual in English and Spanish. The authors performed exactly the same procedures used routinely for presurgical receptive language mapping. In each bilingual individual, the receptive language-specific map always encompassed the posterior portion of the superior temporal gyrus. In every case, however, substantial differences in the receptive language maps were also observed for the two languages, regardless of whether each participant's first language was English or Spanish., Conclusions: Although the reasons for such differences and their ultimate significance in identifying the cerebral mechanisms of language are subject to continuing investigation, their presence is noteworthy and has practical implications for the surgical management of patients with lesions in the temporal and parietal regions of the dominant hemisphere.

In this report, the newest of the functional imaging methods, magnetoencephalography, is described, and its use in addressing the issue of brain reorganization for basic sensory and linguistic functions is documented in a series of 10 children and young adults. These patients presented with a wide variety of conditions, ranging from tumors and focal epilepsy to reading disability. In all cases, clear evidence of reorganization of the brain mechanisms of either somatosensory or linguistic functions or both was obtained, demonstrating the utility of magnetoencephalography in studying, completely noninvasively, the issue of plasticity in the developing brain.

This study evaluated the validity of data derived from magnetic source imaging regarding hemispheric dominance for language in children and adolescents with intractable seizure disorder by comparison with results of the intracarotid amobarbital procedure. Functional imaging of the receptive language cortex using a whole-head neuromagnetometer was performed in 19 consecutive epilepsy patients, ages 8 to 18 years, who also underwent the intracarotid amobarbital procedure. During magnetic source imaging recordings, patients engaged in a continuous recognition memory task for words in visual and auditory modalities. This task has previously been shown to be valid for the purpose of lateralization and localization of language cortex in adult epilepsy patients who undergo the intracarotid amobarbital procedure and intraoperative language mapping allowing confirmation of magnetic source imaging findings. Results indicated that language laterality indices formed for the intracarotid amobarbital procedure and magnetic source imaging procedures were highly correlated (R = .87). In addition, clinical judgments regarding cerebral dominance for language made by independent raters using the two methods were in excellent agreement. We conclude that magnetic source imaging is a promising method for determination of cerebral dominance for language in children and adults.

Using magnetic source imaging, age-related changes in spatiotemporal brain activation profiles associated with printed word recognition and phonological decoding (pseudoword reading) were examined in 27 adults and 22 children without reading problems. Adults showed a distinct spatiotemporal profile during reading of both types of print consisting of bilateral activation of occipital cortices, followed by strongly left-predominant activation of basal temporal regions, and, finally, left hemisphere temporoparietal (including the angular gyrus) and inferior frontal activation. Children lacked the clear temporal distinction in the engagement of basal and temporoparietal areas and displayed significantly weaker activation of the left inferior frontal gyrus. In addition, the consistent hemispheric asymmetries in the degree of activation of basal temporal regions that were present in the adult readers were not apparent in the children. In contrast, the strong left hemisphere preponderance in the degree of activation of temporoparietal areas was present in children as well as adults, regardless of the type of print they were asked to read. The data suggest that the degree of specialization of cortical regions for reading, as well as the pattern of regional interactions that supports this specialization, may change with age.

92 patients with temporal lobe epilepsy (TLE) were classified into reading deficient (RD; N = 41) and non-reading deficient (no-RD; N = 51) groups. A cutoff of 80 was used to further classify patients as having low average or better (AVG: IQ > 79) or below average (LOW: 69 < IQ < 80) intellectual ability. Differences between RD-AVG and no-RD-AVG patients in profiles of performance on cognitive tests were specific to verbal and non-verbal memory and verbal abilities, but not visuoconstructional and executive abilities. RD-LOW patients exhibited globally reduced abilities. Profiles of performance on cognitive tests were sensitive to side of seizure onset in the no-RD AVG group, but not the RD-AVG or RD-LOW groups. These data suggest that a group of patients with TLE and reduced academic achievement exhibit cognitive deficits suggestive of a language learning disability, and that cognitive tests are less sensitive to side of seizure onset in this group.

This study was conducted to investigate the reliability of magnetoencephalography in lateralizing and localizing brain activity associated with receptive language function. Sixteen right-handed adults with no history of neurologic disorder engaged in a continuous recognition memory task for visually presented words in two separate sessions. The magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer during task performance. Using the total number of acceptable activity sources as an index, overall activation was greater in the left compared with the right hemisphere for all 16 subjects in both sessions. Sources of activity were consistently found in the temporoparietal areas of the left hemisphere in all subjects. Moreover, clusters of activity sources in this region either overlapped spatially or were found in close proximity across sessions. Medial and basal temporal lobe activity was also observed in most subjects during at least one session, and tended to be lateralized to left hemisphere. These results suggest that magnetoencephalography is a promising tool for determination of cerebral dominance for language and localization of temporal lobe language areas.

The purpose of this study was to test the neurological validity of a dual-route model of reading by asking patients, who were undergoing electrocortical stimulation mapping, to read words with irregular print-to-sound correspondences and pseudowords. Brain activation profiles were also obtained from these patients during an auditory and a visual word recognition task using whole-head magnetic source imaging. We demonstrated that reading is subserved by at least two brain mechanisms that are anatomically dissociable. One mechanism subserves assembled phonology and depends on the activity of the posterior part of the left superior temporal gyrus (STGp), whereas the second is responsible for addressed phonology and does not necessarily involve this region. The contribution of STGp to reading appears to be based on its specialization for phonological analysis operations, involved in the processing of both spoken and written language.

The purpose of the present investigation was to describe spatiotemporal brain activation profiles during word reading using magnetic source imaging (MSI). Ten right-handed dyslexic children with severe phonological decoding problems and eight age-matched non-impaired readers were tested in two recognition tasks, one involving spoken and the other printed words. Dyslexic children's activation profiles during the printed word recognition task consistently featured activation of the left basal temporal cortices followed by activation of the right temporoparietal areas (including the angular gyrus). Non-impaired readers showed predominant activation of left basal followed by left temporoparietal activation. In addition, we were able to rule out the hypothesis that hypoactivation of left temporoparietal areas in dyslexics was due to a more general cerebral dysfunction in these areas. Rather, it seems likely that reading difficulties in developmental dyslexia are associated with an aberrant pattern of functional connectivity between brain areas normally involved in reading, namely ventral visual association cortex and temporoparietal areas in the left hemisphere. The interindividual consistency of activation profiles characteristic of children with dyslexia underlines the potential utility of this technique for examining neurophysiological changes in response to specific educational intervention approaches.

This review outlines the rationale for the use of magnetoencephalography (MEG) or magnetic source imaging (MSI), a noninvasive functional imaging technique, and the features that any imaging method should display to make a substantial contribution to cognitive neuroscience. After a brief discussion of the basic experimental approach used in the authors' studies, the use of early sensory components of brain magnetic responses is reviewed to address issues of the functional organization of the primary sensory cortices, followed by a comment on the clinical use of these components. Second, normative studies focusing on the late components of magnetic responses for establishing the validity and reliability of MSI maps of the language-specific cortex in normal subjects are reviewed. Third, the authors' investigations of fine spatiotemporal features of brain activation maps, specific to receptive language and to reading, are reviewed. Fourth, experience with presurgical mapping of the language-specific cortex in neurosurgery candidates and in patients undergoing the "Wada" procedure is summarized followed by a comment on the perfect agreement of the MSI maps with those derived by more direct invasive brain mapping procedures. Fifth. MSI-derived evidence of often dramatic, functional reorganization of brain areas subserving both simple sensory and linguistic functions is summarized along with comments on the use of MSI as a means for investigating brain plasticity. Finally, in the sixth section of this review, the authors relate their experience with the use of MSI in deriving brain activation profiles during silent reading of real words and pseudowords that are specific to dyslexic children. The review concludes with a discussion on the further use of MSI in assessing, among other issues, the effectiveness of intervention strategies designed to improve reading fluency in dyslexic children.

The magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer while right-handed subjects (N = 15) were engaged in either an auditory word- or a tone-recognition task. Sources of the recorded magnetic fields were modeled as equivalent current dipoles at 4 ms intervals and the number of sources in the later portion of the magnetic response was used as an index of the degree of brain activation. Significantly more sources were found in the left as compared to the right hemisphere in the word but not the tone task on a group basis. On an individual basis, 13/15 subjects had more sources in the left as compared to the right hemisphere during the word task, while in the tone task 3/10 subjects showed this pattern. Sources of activity were found in the left superior and middle temporal gyri in all subjects with available MRI scans. Sources were also found in the supramarginal gyrus and in medial temporal areas, including the hippocampus, in the majority of cases. MEG appears to be a promising tool for detecting activity in cerebral areas specialized for language and memory function.

Object: In this paper the authors demonstrate the concordance between magnetic source (MS) imaging and direct cortical stimulation for mapping receptive language cortex., Methods: In 13 consecutive surgical patients, cortex specialized for receptive language functions was identified noninvasively by obtaining activation maps aided by MS imaging in the context of visual and auditory word-recognition tasks. Surgery was then performed for treatment of medically intractable seizure disorder (eight patients), and for resection of tumor (four), or angioma (one). Mapping of language areas with cortical stimulation was performed intraoperatively in 10 patients and extraoperatively in three. Cortical stimulation mapping verified the accuracy of the MS imaging-based localization in all cases., Conclusions: Information provided by MS imaging can be especially helpful in cases of atypical language representation, including bihemispheric representation, and location of language in areas other than those expected within the dominant hemisphere, such as the anterior portion of the superior temporal gyrus, the posteroinferior portion of the middle temporal gyrus, the basal temporal cortex, and the lateral temporooccipital cortex.

Spatiotemporal maps of brain activity were obtained from nine normal volunteers engaged in a pseudoword rhyme-matching task using Magnetic Source Imaging. Following bilateral occipital activity there was a clear temporal progression of activity in the left hemisphere beginning with basal temporal areas followed closely by activity in the angular gyrus and inferior frontal lobe. Medial temporal and posterior superior temporal lobe became active last. There was a strong interhemispheric asymmetry in activity favoring the left hemisphere in all areas. A control, pattern-matching task, with no verbal demands, exhibited a different spatiotemporal pattern of activity. These results agree anatomically with previous studies in other imaging modalities. In addition, the relative timing of activity in basal temporal areas of the left hemisphere supports hypotheses regarding a role for this area in early processing of visually presented verbal material.

Background: Although schizophrenic and control subjects differ on a variety of neuroanatomical measures, the specificity and sensitivity of any one measure for differentiating between groups are low. This study investigated the cumulative effect of deviant brain structure on diagnosis., Methods: Hemisphere and third ventricle volume and the normalized (Talairach) location of three association cortex sulcal landmarks were measured on high-resolution MRI scans in 37 male patients with schizophrenia and 33 male control subjects matched on age, handedness, and parental socioeconomic status., Results: While there were few group differences on individual anatomical measures, the 10 variables reliably discriminated between the two groups when used in concert in a discriminant function analysis (F[10.59] = 3.6, p < .0009) with 77% of the subjects correctly classified. Five of the measures (left posterior cingulate, left inferior frontal sulcus, right sylvian fissure, and left and right halves of the third ventricle) correlated significantly with the discriminant function (p < .005)., Conclusions: This is the first study to demonstrate that schizophrenics can be distinguished from matched controls on the basis of brain anatomy alone. The risk of schizophrenia may depend on the total amount of neural deviance, rather than on anomalies in a single structure or circuit.

Functional brain imaging techniques hold many promises as the methods of choice for identifying areas involved in the execution of language functions. The success of any of these techniques in fulfilling this goal depends upon their ability to produce maps of activated areas that overlap with those obtained through standard invasive procedures such as electrocortical stimulation. This need is particularly acute in cases where active areas are found outside of traditionally defined language areas. In the present report we present two patients who underwent mapping of receptive language areas preoperatively through magnetoencephalography (MEG) and intraoperatively through electrocortical stimulation. Language areas identified by both methods were located in temporoparietal regions as well as in less traditional regions (anterior portion of the superior temporal gyrus and basal temporal cortex). Importantly there was a perfect overlap between the two sets of maps. This clearly demonstrates the validity of MEG-derived maps for identifying cortical areas critically involved in receptive language functions.

Object: In this paper the authors introduce a novel use of magnetoencephalography (MEG) for noninvasive mapping of language-specific cortex in individual patients and in healthy volunteers., Methods: The authors describe a series of six experiments in which normative MEG data were collected and the reliability, validity, and topographical accuracy of the data were assessed in patients who had also undergone the Wada procedure or language mapping through intraoperative cortical stimulation., Conclusions: Findings include: 1) receptive language-specific areas can be reliably activated by simple language tasks and this activation can be readily recorded in short MEG sessions; 2) MEG-derived maps of each individual are reliable because they remain stable over time and are independent of whether auditory or visual stimuli are used to activate the brain; and 3) these maps are also valid because they concur with results of the Wada procedure in assessing hemispheric dominance for language and with the results of cortical stimulation in identifying the precise topography of receptive language regions within the dominant hemisphere. Although the MEG mapping technique should be further refined, it has been shown to be efficacious by correctly identifying the language-dominant hemisphere and specific language-related regions within this hemisphere. Further development of the technique may render it a valuable adjunct for routine presurgical planning in many patients who harbor tumors or have epilepsy.

Nine neurologically normal volunteers engaged in a recognition memory task for visually presented words while the magnetic flux normal to the scalp surface was measured with a whole-head neuromagnetometer. The relative timing of activity occurring during the task in different brain areas was determined. Occipital lobe areas became active first, followed by basal temporal areas. Temporoparietal and medial temporal areas became active next, during later portions of the recorded epoch, and appeared to activate in concert. Except for the occipital lobe, activity was predominantly in the left hemisphere. This pattern was consistent across participants. Results suggest that MEG, in capturing temporal as well as spatial aspects of brain activity, has a promising role as an adjunct to other functional imaging modalities.

Event-related magnetic fields (ERFs) were recorded from the left hemisphere in nine normal volunteers in response to four consonant-vowel (CV) syllables varying in voice-onset time (VOT). CVs with VOT values of 0 and +20 ms were perceived as /ga/ and those with VOT values of +40 and +60 ms as /ka/. Results showed: (1) a displacement of the N1m peak equivalent current dipole toward more medial locations; and (2) an abrupt reduction in peak magnetic flux strength, as VOT values increased from +20 to +40 ms. No systematic differences were noted between the 0 and +20 ms stimuli or between the +40 and +60 ms CVs. The findings are in agreement with the results of multiunit invasive recordings in non-human primates regarding the spatial and temporal pattern of neuronal population responses in the human auditory cortex which could serve as neural cues for the perception of voicing contrasts., (Copyright 1998 Elsevier Science B.V.)

We used magnetoencephalography (MEG) to assess the degree of hemispheric activation in eleven normal, right-handed subjects with no history of neurological disorder or learning disability during performance of a word- and a face-recognition tasks. Neuromagnetic activity was recorded using a whole-head system, and the sources of the recorded magnetic fields were modeled as single equivalent current dipoles. Early (<200 msec) cerebral activation, defined by the number of dipoles identified by the data-fitting algorithm, was localized in the occipital cortex during both tasks, as expected. During the language task, the extent of the later (>200 msec) cerebral activation was approximately double in the left hemisphere in almost all subjects, involving temporal and temporoparietal areas. In contrast, during the face-recognition task, the corresponding activation was mostly symmetrical across the two occipital lobes, also involving the posterior-inferior aspect of the right temporal lobe. Our results suggest that the MEG is a suitable method of assessing noninvasively hemispheric specialization for language.

The purpose of this study was to extend previous findings of changes in magnetic flux amplitude associated with neuronal currents in the human auditory cortex in response to two-tone stimuli selected from a tone-onset time (TOT) continuum. The results replicated previous findings by indicating a close correspondence between N1m field strength functions and individual perceptual identification curves. In a second experiment event-related fields were recorded in response to two-tone stimuli in which the two sinusoid components always started simultaneously, yet they showed the same energy envelope as the TOT stimuli (amplitude modulated (AM) tokens). The results showed that N1m modulation as a function of TOT could not be accounted for by an effect of AM. The findings suggest that discontinuities in N1m field amplitude functions were the result of interactions between two populations of active neurons each displaying distinct average sound frequency preferences.

Objectives: To contrast and compare self-reported quality of life in patients with intractable epilepsy and pseudoseizures and to examine the relationship between self-reports and objective measures of cognitive functioning in both of these groups., Design: Case series using profile analysis and analysis of covariance., Setting: University epilepsy surgery program., Participants: Forty-three patients with intractable complex partial seizures of unilateral temporal lobe origin and 25 patients with pseudoseizures., Measures: Quality of Life in Epilepsy Inventory-89; neuropsychological tests assessing verbal memory, nonverbal memory, naming, and attention; and the Depression Scale (2) of the MMPI-2 (Minnesota Multiphasic Personality Inventory)., Results: Patients with pseudoseizures described themselves as more limited in the physical health domain than patients with complex partial seizures. Self-perceptions of cognitive functioning were similar between groups, despite the superior performance of patients with pseudoseizures on objective measures. Self-perception of cognitive dysfunction was related to mood disorder in the pseudoseizure group only, and there were no relationships between subjective and objective measurements of cognitive status within this group independent of mood disorder. For the complex partial seizures group, relationships between subjective and objective measures of cognitive function were dependent on the side of seizure onset., Conclusions: Results are consistent with hypotheses that suggest that patients with pseudoseizures focus on physical rather than psychological explanations for stress, and that this focus is related, at least in a subgroup of patients, to mood disorder. Results also provide support for the validity of the Quality of Life in Epilepsy Inventory-89 in populations with intractable seizure disorder, although there is evidence for a possible floor effect on some of the subscales.

Event-related Fields (ERFs) were recorded in eleven normal volunteers in response to four two-tone stimuli selected from a tone onset time (TOT) continuum. The latter has been used extensively in the past as an analog of voice onset-time, an important cue for making voicing distinctions (e.g., ¿pa¿ versus ¿ba¿). TOT values ranged from 0 to 60 ms in 20-ms steps. Three components of the ERF (P50m, N1m, and P2m) in the hemisphere contralateral to the stimulated ear were analyzed. The most significant finding was an abrupt reduction in the peak field amplitude of N1m (bilaterally) as TOT values increased from +20 to +40 ms. No systematic differences were noted between the 0 and +20 ms stimuli or between the +40 and +60 ms tokens. On the other hand, peak component latencies rose steadily with increasing TOT values. The discontinuity in the change of peak RMS as a function of TOT is in close agreement with behavioral evidence of categorical perception of similar non-speech as well as speech stimuli., (Copyright 1998 Elsevier Science B.V.)

Sixty patients with temporal lobe epilepsy were classified into reading deficient (RD; n = 21) and non-reading deficient (non-RD; n = 39) groups. Selective deficits in verbal or nonverbal memory, consistent with side of seizure onset, were evident in the non-RD patients. Both verbal and nonverbal memory performance were reduced equivalently in individuals with RD, regardless of side of seizure onset. As a result, memory tests that were accurate in identifying side of seizure onset in the non-RD group were not as accurate in the RD group. When individual cases were classified using a clinically applicable decision rule, significantly more RD patients were either unclassifiable or incorrectly classified than were non-RD patients. Findings suggest that preoperative memory data obtained from individuals with epilepsy and evidence of RD may not be as valid an indicator of side of seizure onset as are those obtained from patients without RD.