A Functional MRI-Based Model for Individual Memory Assessment in Patients Eligible for Anterior Temporal Lobe Resection.

Q4 Medicine
Open Neuroimaging Journal Pub Date : 2017-03-31 eCollection Date: 2017-01-01 DOI:10.2174/1874440001711010001
Maria Strandberg, Peter Mannfolk, Lars Stenberg, Hanna Ljung, Ia Rorsman, Elna-Marie Larsson, Danielle van Westen, Kristina Källén
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引用次数: 6

Abstract

Title: A functional (f) MRI-based model for individual memory assessment in patients eligible for temporal lobe resection.

Aim: To investigate if pre-operative fMRI memory paradigms, add predictive information with regard to post-surgical memory deficits.

Methods: Fourteen pharmacoresistant Temporal Lobe Epilepsy (TLE) patients accepted for Anterior Temporal Lobe Resection (ATLR) were included. A clinical risk assessment score (RAS 0-3) was constructed from structural MRI, neuropsychological testing and hemisphere dominance. fMRI lateralization indices (LIs) over frontal language and medial temporal regions were calculated. Predictive value from clinical risk scoring and added value from fMRI LIs were correlated to post-surgical memory change scores (significant decline -1 SD). Verbal memory outcome was classified either as expected (RAS 2-3 and post-operative decline; RAS 0-1 and intact post-operative verbal memory) or as unexpected (RAS 2-3 and intact post-operative verbal memory post-surgery; RAS 0-1 and post-operative decline).

Results: RAS for verbal memory decline exhibited a specificity of 67% and a sensitivity of 75%. Significant correlations were found between frontal language LIs and post-operative verbal memory (r = -0.802; p = 0.017) for left (L) TLE and between medial temporal lobe LIs and visuospatial memory (r = 0.829; p = 0.021), as well as verbal memory (r = 0.714; p = 0.055) for right (R) TLE. Ten patients had expected outcome and four patients had an unexpected outcome. In two MRI-negative RTLE patients that suffered significant verbal memory decline post-operatively, fMRI identified bilateral language and right lateralized medial temporal verbal encoding. In two LTLE patients with MRI pathology and verbal memory dysfunction, neither RAS nor fMRI identified the risk for aggravated verbal memory decline following ATLR.

Conclusion: fMRI visualization of temporal-frontal network activation may add value to the pre-surgical work-up in epilepsy patients eligible for ATLR. Frontal language patterns are important for prediction in both L and RTLE. Strong left lateralized language in LTLE, as well as bilateral language combined with right lateralized encoding in RTLE, seems to indicate an increased risk for post-operative verbal memory decline.

Abstract Image

Abstract Image

Abstract Image

前颞叶切除患者个体记忆评估的功能性mri模型。
题目:一种基于功能(f) mri的模型,用于评估符合颞叶切除术条件的患者的个体记忆。目的:探讨术前fMRI记忆模式是否能增加术后记忆缺陷的预测信息。方法:对14例接受颞叶前部切除术(atr)治疗的耐药颞叶癫痫(TLE)患者进行分析。临床风险评估评分(RAS 0-3)由结构MRI、神经心理测试和半球优势度组成。计算额叶语言区和内侧颞区fMRI侧化指数(LIs)。临床风险评分的预测值和fMRI LIs的附加值与术后记忆改变评分相关(显著下降-1 SD)。言语记忆结果分为预期(RAS 2-3)和术后下降;RAS 0-1和完整的术后言语记忆)或意外(RAS 2-3和完整的术后言语记忆;RAS 0-1及术后下降)。结果:RAS对言语记忆衰退的特异性为67%,敏感性为75%。额叶语言LIs与术后言语记忆显著相关(r = -0.802;p = 0.017),以及内侧颞叶与视觉空间记忆之间的差异(r = 0.829;P = 0.021),以及言语记忆(r = 0.714;p = 0.055)为右(R) TLE。10例患者有预期结果,4例患者有意外结果。在两名mri阴性的RTLE患者中,术后言语记忆明显下降,fMRI发现了双侧语言和右侧内侧颞叶言语编码。在两例MRI病理和言语记忆功能障碍的LTLE患者中,RAS和fMRI均未发现ATLR后言语记忆功能衰退加剧的风险。结论:颞额叶网络激活的fMRI可视化对符合ATLR条件的癫痫患者的术前检查有一定的价值。额叶语言模式对左脑和右脑的预测都很重要。左颞叶颞叶中左侧语言能力强,以及右颞叶中双侧语言结合右侧编码能力强,似乎表明术后言语记忆衰退的风险增加。
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来源期刊
Open Neuroimaging Journal
Open Neuroimaging Journal Medicine-Radiology, Nuclear Medicine and Imaging
CiteScore
0.70
自引率
0.00%
发文量
3
期刊介绍: The Open Neuroimaging Journal is an Open Access online journal, which publishes research articles, reviews/mini-reviews, and letters in all important areas of brain function, structure and organization including neuroimaging, neuroradiology, analysis methods, functional MRI acquisition and physics, brain mapping, macroscopic level of brain organization, computational modeling and analysis, structure-function and brain-behavior relationships, anatomy and physiology, psychiatric diseases and disorders of the nervous system, use of imaging to the understanding of brain pathology and brain abnormalities, cognition and aging, social neuroscience, sensorimotor processing, communication and learning.
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