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Temporal lobe regions essential for preserved picture naming after left temporal epilepsy surgery
Author(s) -
Binder Jeffrey R.,
Tong JiaQing,
Pillay Sara B.,
Conant Lisa L.,
Humphries Colin J.,
Raghavan Manoj,
Mueller Wade M.,
Busch Robyn M.,
Allen Linda,
Gross William L.,
Anderson Christopher T.,
Carlson Chad E.,
Lowe Mark J.,
Langfitt John T.,
Tivarus Madalina E.,
Drane Daniel L.,
Loring David W.,
Jacobs Monica,
Morgan Victoria L.,
Allendorfer Jane B.,
Szaflarski Jerzy P.,
Bonilha Leonardo,
Bookheimer Susan,
Grabowski Thomas,
Vannest Jennifer,
Swanson Sara J.
Publication year - 2020
Publication title -
epilepsia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.687
H-Index - 191
eISSN - 1528-1167
pISSN - 0013-9580
DOI - 10.1111/epi.16643
Subject(s) - temporal lobe , lesion , anterior temporal lobectomy , epilepsy surgery , superior temporal gyrus , epilepsy , psychology , lateralization of brain function , temporal cortex , medicine , surgery , neuroscience , functional magnetic resonance imaging
Abstract Objective To define left temporal lobe regions where surgical resection produces a persistent postoperative decline in naming visual objects. Methods Pre‐ and postoperative brain magnetic resonance imaging data and picture naming (Boston Naming Test) scores were obtained prospectively from 59 people with drug‐resistant left temporal lobe epilepsy. All patients had left hemisphere language dominance at baseline and underwent surgical resection or ablation in the left temporal lobe. Postoperative naming assessment occurred approximately 7 months after surgery. Surgical lesions were mapped to a standard template, and the relationship between presence or absence of a lesion and the degree of naming decline was tested at each template voxel while controlling for effects of overall lesion size. Results Patients declined by an average of 15% in their naming score, with wide variation across individuals. Decline was significantly related to damage in a cluster of voxels in the ventral temporal lobe, located mainly in the fusiform gyrus approximately 4‐6 cm posterior to the temporal tip. Extent of damage to this region explained roughly 50% of the variance in outcome. Picture naming decline was not related to hippocampal or temporal pole damage. Significance The results provide the first statistical map relating lesion location in left temporal lobe epilepsy surgery to picture naming decline, and they support previous observations of transient naming deficits from electrical stimulation in the basal temporal cortex. The critical lesion is relatively posterior and could be avoided in many patients undergoing left temporal lobe surgery for intractable epilepsy.