Brain network plasticity and verbal memory outcomes following temporal lobe resection

2021 ◽  
Author(s):  
Carolina Deifelt Streese
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Brain Network ◽  
Temporal Lobe Resection ◽  
Network Plasticity

scholarly journals Superior Verbal Memory Outcome After Stereotactic Laser Amygdalohippocampotomy

2021 ◽  
Vol 12 ◽  
Author(s):  
Daniel L. Drane ◽  
Jon T. Willie ◽  
Nigel P. Pedersen ◽  
Deqiang Qiu ◽  
Natalie L. Voets ◽  
...  
Keyword(s):  
Laser Ablation ◽  
Temporal Lobe ◽  
Verbal Memory ◽  
Mesial Temporal Sclerosis ◽  
Open Resection ◽  
Memory Decline ◽  
Exact Test ◽  
Fisher's Exact Test ◽  
Fisher’S Exact Test ◽  
Temporal Lobe Resection

Objective: To evaluate declarative memory outcomes in medically refractory epilepsy patients who underwent either a highly selective laser ablation of the amygdalohippocampal complex or a conventional open temporal lobe resection.Methods: Post-operative change scores were examined for verbal memory outcome in epilepsy patients who underwent stereotactic laser amygdalohippocampotomy (SLAH: n = 40) or open resection procedures (n = 40) using both reliable change index (RCI) scores and a 1-SD change metric.Results: Using RCI scores, patients undergoing open resection (12/40, 30.0%) were more likely to decline on verbal memory than those undergoing SLAH (2/40 [5.0%], p = 0.0064, Fisher's exact test). Patients with language dominant procedures were much more likely to experience a significant verbal memory decline following open resection (9/19 [47.4%]) compared to laser ablation (2/19 [10.5%], p = 0.0293, Fisher's exact test). 1 SD verbal memory decline frequently occurred in the open resection sample of language dominant temporal lobe patients with mesial temporal sclerosis (8/10 [80.0%]), although it rarely occurred in such patients after SLAH (2/14, 14.3%) (p = 0.0027, Fisher's exact test). Memory improvement occurred significantly more frequently following SLAH than after open resection.Interpretation: These findings suggest that while verbal memory function can decline after laser ablation of the amygdalohippocampal complex, it is better preserved when compared to open temporal lobe resection. Our findings also highlight that the dominant hippocampus is not uniquely responsible for verbal memory. While this is at odds with our simple and common heuristic of the hippocampus in memory, it supports the findings of non-human primate studies showing that memory depends on broader medial and lateral TL regions.

Predicting verbal memory decline following temporal lobe resection for epilepsy

2019 ◽  
Vol 140 (5) ◽  
pp. 312-319 ◽  
Author(s):  
Sofia Ljunggren ◽  
Lena Andersson‐Roswall ◽  
Henrik Imberg ◽  
Hans Samuelsson ◽  
Kristina Malmgren
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Memory Decline ◽  
Temporal Lobe Resection

scholarly journals What’s in Your Nomogram? Personalized Prognostication of Verbal Memory Decline after Temporal Lobe Resection in Adults With Epilepsy

2021 ◽  
pp. 153575972110582
Author(s):  
Tracey A. Milligan
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Validation Cohort ◽  
Predictive Accuracy ◽  
Verbal Learning ◽  
Cleveland Clinic ◽  
The United States ◽  
Clinical Predictors ◽  
Memory Decline ◽  
Temporal Lobe Resection

Objective This study aims to develop and externally validate models to predict the probability of postoperative verbal memory decline in adults following temporal lobe resection (TLR) for epilepsy using easily accessible preoperative clinical predictors. Methods Multivariable models were developed to predict delayed verbal memory outcome on 3 commonly used measures: Rey Auditory Verbal Learning Test (RAVLT), and Logical Memory (LM), and Verbal Paired Associates (VPA) subtests from Wechsler Memory Scale-Third Edition. Using Harrell’s step-down procedure for variable selection, models were developed in 359 adults who underwent TLR at Cleveland Clinic and validated in 290 adults at 1 of 5 epilepsy surgery centers in the United States or Canada. Results Twenty-nine percent of the development cohort and 26% of the validation cohort demonstrated significant decline on at least 1 verbal memory measure. Initial models had good-to-excellent predictive accuracy (calibration (c) statistic range = .77–.80) in identifying patients with memory decline; however, models slightly underestimated decline in the validation cohort. Model coefficients were updated using data from both cohorts to improve stability. The model for RAVLT included surgery side, baseline memory score, and hippocampal resection. The models for LM and VPA included surgery side, baseline score, and education. Updated model performance was good to excellent (RAVLT c = .81, LM c = .76, VPA c = .78). Model calibration was very good, indicating no systematic over- or under-estimation of risk. Conclusions Nomograms are provided in 2 easy-to-use formats to assist clinicians in estimating the probability of verbal memory decline in adults considering TLR for treatment of epilepsy.

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

2017 ◽  
Vol 11 (1) ◽  
pp. 1-16 ◽  
Author(s):  
Maria Strandberg ◽  
Peter Mannfolk ◽  
Lars Stenberg ◽  
Hanna Ljung ◽  
Ia Rorsman ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Anterior Temporal Lobe ◽  
Memory Decline ◽  
Memory Assessment ◽  
Clinical Risk ◽  
Post Surgery ◽  
Increased Risk ◽  
Individual Memory ◽  
Temporal Lobe Resection

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.

scholarly journals Memory fMRI predicts verbal memory decline after anterior temporal lobe resection

Neurology ◽  
2015 ◽  
Vol 84 (15) ◽  
pp. 1512-1519 ◽  
Author(s):  
M. K. Sidhu ◽  
J. Stretton ◽  
G. P. Winston ◽  
M. Symms ◽  
P. J. Thompson ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Anterior Temporal Lobe ◽  
Memory Decline ◽  
Temporal Lobe Resection

scholarly journals Practice guideline summary: Use of fMRI in the presurgical evaluation of patients with epilepsy

Neurology ◽  
2017 ◽  
Vol 88 (4) ◽  
pp. 395-402 ◽  
Author(s):  
Jerzy P. Szaflarski ◽  
David Gloss ◽  
Jeffrey R. Binder ◽  
William D. Gaillard ◽  
Alexandra J. Golby ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Verbal Memory ◽  
Medial Temporal Lobe ◽  
Case Reports ◽  
Data Extraction ◽  
General Level ◽  
Temporal Epilepsy ◽  
Language Functions ◽  
Temporal Lobe Resection ◽  
Meta Analyses

Objective:To assess the diagnostic accuracy and prognostic value of functional MRI (fMRI) in determining lateralization and predicting postsurgical language and memory outcomes.Methods:An 11-member panel evaluated and rated available evidence according to the 2004 American Academy of Neurology process. At least 2 panelists reviewed the full text of 172 articles and selected 37 for data extraction. Case reports, reports with <15 cases, meta-analyses, and editorials were excluded.Results and recommendations:The use of fMRI may be considered an option for lateralizing language functions in place of intracarotid amobarbital procedure (IAP) in patients with medial temporal lobe epilepsy (MTLE; Level C), temporal epilepsy in general (Level C), or extratemporal epilepsy (Level C). For patients with temporal neocortical epilepsy or temporal tumors, the evidence is insufficient (Level U). fMRI may be considered to predict postsurgical language deficits after anterior temporal lobe resection (Level C). The use of fMRI may be considered for lateralizing memory functions in place of IAP in patients with MTLE (Level C) but is of unclear utility in other epilepsy types (Level U). fMRI of verbal memory or language encoding should be considered for predicting verbal memory outcome (Level B). fMRI using nonverbal memory encoding may be considered for predicting visuospatial memory outcomes (Level C). Presurgical fMRI could be an adequate alternative to IAP memory testing for predicting verbal memory outcome (Level C). Clinicians should carefully advise patients of the risks and benefits of fMRI vs IAP during discussions concerning choice of specific modality in each case.

scholarly journals Memory network plasticity after temporal lobe resection: a longitudinal functional imaging study

Brain ◽  
2016 ◽  
Vol 139 (2) ◽  
pp. 415-430 ◽  
Author(s):  
Meneka K. Sidhu ◽  
Jason Stretton ◽  
Gavin P. Winston ◽  
Andrew W. McEvoy ◽  
Mark Symms ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Functional Imaging ◽  
Imaging Study ◽  
Functional Imaging Study ◽  
Temporal Lobe Resection ◽  
Memory Network ◽  
Network Plasticity

scholarly journals Node abnormality predicts seizure outcome and relates to long-term relapse after epilepsy surgery

2019 ◽  
Author(s):  
Nishant Sinha ◽  
Yujiang Wang ◽  
Nádia Moreira da Silva ◽  
Anna Miserocchi ◽  
Andrew W. McEvoy ◽  
...  
Keyword(s):  
Temporal Lobe ◽  
Clinical Data ◽  
Structural Mri ◽  
Brain Network ◽  
Patient Specific ◽  
Seizure Outcome ◽  
Seizure Freedom ◽  
Post Surgery ◽  
Seizure Relapse ◽  
Temporal Lobe Resection

AbstractObjectiveWe assessed pre-operative structural brain networks and clinical characteristics of patients with drug resistant temporal lobe epilepsy (TLE) to identify correlates of post-surgical seizure outcome at 1 year and seizure relapses up to 5 years.MethodsWe retrospectively examined data from 51 TLE patients who underwent anterior temporal lobe resection (ATLR) and 29 healthy controls. For each patient, using the pre-operative structural, diffusion, and post-operative structural MRI, we generated two networks: ‘pre-surgery’ network and ‘surgically-spared’ network. The pre-surgery network is the whole-brain network before surgery and the surgically-spared network is a subnetwork of the pre-surgery network which is expected to remain unaffected by surgery and hence present post-operatively. Standardising these networks with respect to controls, we determined the number of abnormal nodes before surgery and expected to remain after surgery. We incorporated these 2 abnormality measures and 13 commonly acquired clinical data from each patient in a robust machine learning framework to estimate patient-specific chances of seizures persisting after surgery.ResultsPatients with more abnormal nodes had lower chance of seizure freedom at 1 year and even if seizure free at 1 year, were more likely to relapse within five years. In the surgically-spared networks of poor outcome patients, the number of abnormal nodes was greater and their locations more widespread than in good outcome patients. We achieved 0.84 ± 0.06 AUC and 0.89 ± 0.09 specificity in detecting unsuccessful seizure outcomes at 1-year. Moreover, the model-predicted likelihood of seizure relapse was significantly correlated with the grade of surgical outcome at year-one and associated with relapses up-to five years post-surgery.ConclusionNode abnormality offers a personalised non-invasive marker, that can be combined with clinical data, to better estimate the chances of seizure freedom at 1 year, and subsequent relapse up to 5 years after ATLR.

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