Karin Trimmel1,2,3, Louis A van Graan1,2, Gloria G Gonzálvez1,2, Anja Haag1,2, Lorenzo Caciagli1,2, Sjoerd B Vos1,2,4, Silvia Bonelli1,2,3, Meneka Sidhu1,2, Pamela J Thompson1,2, Matthias J Koepp1,2, John S Duncan1,2. 1. Epilepsy Society MRI Unit, Chalfont Centre for Epilepsy, Chalfont St Peter, SL9 0LR, United Kingdom. 2. Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, Queen Square, London, WC1N 3BG, United Kingdom. 3. Department of Neurology, Medical University of Vienna, A-1090, Vienna, Austria. 4. Centre for Medical Image Computing, University College London, London, United Kingdom.
Abstract
OBJECTIVE: To develop language functional MRI (fMRI) methods that accurately predict postsurgical naming decline in temporal lobe epilepsy (TLE). METHODS: Forty-six patients with TLE (25 left) and 19 controls underwent two overt fMRI paradigms (auditory naming and picture naming, both with active baseline conditions) and one covert task (verbal fluency). Clinical naming performance was assessed preoperatively and 4 months following anterior temporal lobe resection. Preoperative fMRI activations were correlated with postoperative naming decline. Individual laterality indices (LI) were calculated for temporal (auditory and picture naming) and frontal regions (verbal fluency) and were considered as predictors of naming decline in multiple regression models, along with other clinical variables (age at onset of seizures, preoperative naming scores, hippocampal volume, age). RESULTS: In left TLE patients, activation of the left posterior inferior temporal gyrus during auditory naming and activation of left fusiform gyrus during picture naming were related to greater postoperative naming decline. Activation LI were the best individual predictors of naming decline in a multivariate regression model. For picture naming, an LI of higher than 0.34 gave 100% sensitivity and 92% specificity (positive predictive value (PPV) 91.6%). For auditory naming, a temporal lobe LI higher than 0.18 identified all patients with a clinically significant naming decline with 100% sensitivity and 58% specificity (PPV: 58.3%). No effect was seen for verbal fluency. INTERPRETATION: Auditory and picture naming fMRI are clinically applicable to predict postoperative naming decline after left temporal lobe resection in individual patients, with picture naming being more specific.
OBJECTIVE: To develop language functional MRI (fMRI) methods that accurately predict postsurgical naming decline in temporal lobe epilepsy (TLE). METHODS: Forty-six patients with TLE (25 left) and 19 controls underwent two overt fMRI paradigms (auditory naming and picture naming, both with active baseline conditions) and one covert task (verbal fluency). Clinical naming performance was assessed preoperatively and 4 months following anterior temporal lobe resection. Preoperative fMRI activations were correlated with postoperative naming decline. Individual laterality indices (LI) were calculated for temporal (auditory and picture naming) and frontal regions (verbal fluency) and were considered as predictors of naming decline in multiple regression models, along with other clinical variables (age at onset of seizures, preoperative naming scores, hippocampal volume, age). RESULTS: In left TLEpatients, activation of the left posterior inferior temporal gyrus during auditory naming and activation of left fusiform gyrus during picture naming were related to greater postoperative naming decline. Activation LI were the best individual predictors of naming decline in a multivariate regression model. For picture naming, an LI of higher than 0.34 gave 100% sensitivity and 92% specificity (positive predictive value (PPV) 91.6%). For auditory naming, a temporal lobe LI higher than 0.18 identified all patients with a clinically significant naming decline with 100% sensitivity and 58% specificity (PPV: 58.3%). No effect was seen for verbal fluency. INTERPRETATION: Auditory and picture naming fMRI are clinically applicable to predict postoperative naming decline after left temporal lobe resection in individual patients, with picture naming being more specific.
Authors: Karin Trimmel; Sjoerd B Vos; Lorenzo Caciagli; Fenglai Xiao; Louis A van Graan; Gavin P Winston; Matthias J Koepp; Pamela J Thompson; John S Duncan Journal: Epilepsia Date: 2021-10-12 Impact factor: 5.864
Authors: Caroline Reindl; Anna-Lena Allgäuer; Benedict A Kleiser; Müjgan Dogan Onugoren; Johannes D Lang; Tamara M Welte; Jenny Stritzelberger; Klemens Winder; Michael Schwarz; Stephanie Gollwitzer; Regina Trollmann; Julie Rösch; Arnd Doerfler; Karl Rössler; Sebastian Brandner; Dominik Madžar; Frank Seifert; Stefan Rampp; Hajo M Hamer; Katrin Walther Journal: Neuroimage Clin Date: 2022-07-29 Impact factor: 4.891
Authors: Karin Trimmel; Lorenzo Caciagli; Fenglai Xiao; Louis A van Graan; Matthias J Koepp; Pamela J Thompson; John S Duncan Journal: J Neurol Date: 2020-08-03 Impact factor: 4.849