Pre-operative verbal memory fMRI predicts post-operative memory decline after left temporal lobe resection

Functional MRI (fMRI) of cognitive tasks depends on technology widely available in the clinical sphere, but has yet to show a role in the investigation of patients. We report here the first demonstration of a clinically valuable role for cognitive fMRI. Temporal lobe epilepsy (TLE) is commonly cause...

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Bibliographic Details
Published in:Brain (London, England : 1878) England : 1878), 2004-11, Vol.127 (11), p.2419-2426
Main Authors: Richardson, Mark P., Strange, Bryan A., Thompson, Pamela J., Baxendale, Sallie A., Duncan, John S., Dolan, Raymond J.
Format: Article
Language:English
Subjects:
Adult
Anterior Temporal Lobectomy - adverse effects
Biological and medical sciences
epilepsy
Epilepsy, Temporal Lobe - etiology
Epilepsy, Temporal Lobe - psychology
Epilepsy, Temporal Lobe - surgery
Female
fMRI
fMRI = functional MRI
Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy
hippocampus
Hippocampus - pathology
Hippocampus - surgery
Humans
IAP = intracarotid amytal procedure
Linear Models
Magnetic Resonance Imaging - methods
Male
Medical sciences
Memory
Memory Disorders - etiology
Middle Aged
MTLE = mesial temporal lobe epilepsy
Nervous system (semeiology, syndromes)
Neurology
Neuropsychological Tests
Preoperative Care
Prognosis
Prospective Studies
Sclerosis
surgery
Vascular diseases and vascular malformations of the nervous system
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Summary:Functional MRI (fMRI) of cognitive tasks depends on technology widely available in the clinical sphere, but has yet to show a role in the investigation of patients. We report here the first demonstration of a clinically valuable role for cognitive fMRI. Temporal lobe epilepsy (TLE) is commonly caused by hippocampal sclerosis and is frequently resistant to drug treatment. Surgical resection of the left hippocampus in this setting can cure seizures, but may produce significant verbal memory decline, which is hard to predict. We report 10 right-handed TLE patients with left hippocampal sclerosis who underwent left hippocampal resection. We compared currently used data for the prediction of post-operative verbal memory decline in such patients with a novel fMRI assessment of verbal memory encoding. Multiple regression analyses showed that fMRI provided the strongest independent predictor of memory outcome after surgery. At the individual subject level, the fMRI data had high positive predictive value for memory decline.
ISSN:0006-8950
1460-2156
1460-2156
DOI:10.1093/brain/awh293