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Functional MRI Predicts Memory Performance after Right Mesiotemporal Epilepsy Surgery
Author(s) -
Janszky Jozsef,
Jokeit Hennric,
Kontopoulou Konstantina,
Mertens Markus,
Ebner Alois,
PohlmannEden Bernd,
Woermann Friedrich G.
Publication year - 2005
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/j.0013-9580.2005.10804.x
Subject(s) - temporal lobe , epilepsy , magnetic resonance imaging , anterior temporal lobectomy , functional magnetic resonance imaging , epilepsy surgery , psychology , wada test , wechsler adult intelligence scale , medicine , audiology , neuroscience , cognition , radiology
Summary: Purpose: Anterior temporal lobe resection (ATR) is a treatment option in drug‐resistant epilepsy. An important risk of ATR is loss of memory because mesiotemporal structures contribute substantially to memory function. We investigated whether memory‐activated functional MRI ( f MRI) can predict postoperative memory loss after anterior temporal lobectomy in right‐sided medial temporal lobe epilepsy (MTLE). Methods: We included 16 patients (10 women) aged 16–54 years. The mean age at epilepsy onset was 12.5 years (range, 1–26 years). The patients' mean Wechsler IQ score was 95.2 (range, 62–125). The activation condition of f MRI consisted of retrieval from long‐term memory induced by self‐paced performance of an imaginative walk. All but one patient had left‐sided speech dominance according to speech‐activated f MRI. Outside the scanner, we evaluated the pre‐ and postoperative visual memory retention by using Rey Visual Design Learning Test. Results: We found a correlation between the preoperative asymmetry index of memory‐ f MRI and the change between pre‐ and postsurgical measures of memory retention. Reduced activation of the mesiotemporal region ipsilateral to the epileptogenic region correlated with a favorable memory outcome after right‐sided ATR. Conclusions: In light of the postoperative results, the theoretical implication of our study is that f MRI based on a simple introspective retrieval task measures memory functions. The main clinical implication of our study is that memory‐ f MRI might replace the invasive Wada test in MTLE by using a simple f MRI paradigm. Predictive power, however, will be studied in larger patient samples. Other studies are required for left‐sided MTLE and neocortical epilepsies to assess the clinical usefulness of memory‐ f MRI.