Sidhu, MK;
Stretton, J;
Winston, GP;
Thompson, PJ;
Symms, M;
Koepp, MJ;
Duncan, JS;
(2014)
Preoperative memory fMRI predicts verbal memory decline after left anterior temporal lobe resection.
Neurology
, 84
(15)
pp. 1512-1519.
10.1212/WNL.0000000000001461.
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Abstract
Objective: To develop a clinically applicable memory fMRI method of predicting post-surgical memory outcome in individual patients. Methods: A prospective cohort study where 50 patients with temporal lobe epilepsy (23 left) and 26 controls performed an fMRI memory encoding paradigm of words with a subsequent out of scanner recognition assessment was performed. Neuropsychological assessment was performed pre-operatively and 4 months after anterior temporal lobe resection, and at equal time-intervals in controls. An event related analysis was used to explore brain activations for words remembered and change in verbal memory scores 4 months after surgery was correlated with pre-operative activations. Individual lateralisation indices were calculated within a medial temporal and frontal region and compared with other clinical parameters (hippocampal volume, pre-operative verbal memory, age at onset of epilepsy and language lateralisation) as a predictor of verbal memory outcome. Results: In left temporal lobe epilepsy patients, left frontal and anterior medial temporal activations correlated significantly with greater verbal memory decline whilst bilateral posterior hippocampal activation correlated with less verbal memory decline post-operatively. In a multivariate regression model, left lateralised memory lateralisation index (≥0.5) within a medial temporal and frontal mask was the best predictor of verbal memory outcome after surgery in the dominant hemisphere in individual patients. Neither clinical nor functional MRI parameters predicted verbal memory decline after non-dominant temporal lobe resection. Conclusion: We propose a clinically applicable memory fMRI paradigm to predict post-operative verbal memory decline after surgery in the language dominant hemisphere in individual patients.
| Type: | Article |
|---|---|
| Title: | Preoperative memory fMRI predicts verbal memory decline after left anterior temporal lobe resection |
| Open access status: | An open access version is available from UCL Discovery |
| DOI: | 10.1212/WNL.0000000000001461 |
| Publisher version: | https://doi.org/10.1212/WNL.0000000000001461 |
| Language: | English |
| Additional information: | © 2015 American Academy of Neurology This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| Keywords: | Prediction, Memory fMRI, Anterior temporal lobe resection, Verbal memory |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Experimental Epilepsy |
| URI: | https://discovery-pp.ucl.ac.uk/id/eprint/1435759 |
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