Back to Search
Start Over
fMRI prediction of naming change after adult temporal lobe epilepsy surgery: Activation matters
- Source :
- Epilepsia. 60(3)
- Publication Year :
- 2018
-
Abstract
- Objective We aimed to predict language deficits after epilepsy surgery. In addition to evaluating surgical factors examined previously, we determined the impact of the extent of functional magnetic resonance imaging (fMRI) activation that was resected on naming ability. Method Thirty-five adults (mean age 37.5 ± 10.9 years, 13 male) with temporal lobe epilepsy completed a preoperative fMRI auditory description decision task, which reliably activates frontal and temporal language networks. Patients underwent temporal lobe resections (20 left resection). The Boston Naming Test (BNT) was used to determine language functioning before and after surgery. Language dominance was determined for Broca and Wernicke area (WA) by calculating a laterality index following statistical parametric mapping processing. We used an innovative method to generate anatomic resection masks automatically from pre- and postoperative MRI tissue map comparison. This mask provided the following: (a) resection volume; (b) overlap between resection and preoperative activation; and (c) overlap between resection and WA. We examined postoperative language change predictors using stepwise linear regression. Predictors included parameters described above as well as age at seizure onset (ASO), preoperative BNT score, and resection side and its relationship to language dominance. Results Seven of 35 adults had significant naming decline (6 dominant-side resections). The final regression model predicted 38% of the naming score change variance (adjusted r2 = 0.28, P = 0.012). The percentage of top 10% fMRI activation resected (P = 0.017) was the most significant contributor. Other factors in the model included WA LI, ASO, volume of WA resected, and WA LI absolute value (extent of laterality). Significance Resection of fMRI activation during a word-definition decision task is an important factor for postoperative change in naming ability, along with other previously reported predictors. Currently, many centers establish language dominance using fMRI. Our results suggest that the amount of the top 10% of language fMRI activation in the intended resection area provides additional predictive power and should be considered when planning surgical resection.
- Subjects :
- 0301 basic medicine
Adult
Male
medicine.medical_specialty
Adolescent
Statistical parametric mapping
Article
Temporal lobe
03 medical and health sciences
Epilepsy
Young Adult
0302 clinical medicine
Predictive Value of Tests
Risk Factors
Medicine
Humans
Epilepsy surgery
Age of Onset
Language Disorders
Language Tests
medicine.diagnostic_test
business.industry
Wernicke Area
Functional Neuroimaging
Middle Aged
medicine.disease
Magnetic Resonance Imaging
030104 developmental biology
Boston Naming Test
Neurology
Epilepsy, Temporal Lobe
Laterality
Female
Neurology (clinical)
Radiology
business
Functional magnetic resonance imaging
030217 neurology & neurosurgery
Subjects
Details
- ISSN :
- 15281167
- Volume :
- 60
- Issue :
- 3
- Database :
- OpenAIRE
- Journal :
- Epilepsia
- Accession number :
- edsair.doi.dedup.....09aab1267699b5409faa8eded7304d89