Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study

C. Rosazza, F. Ghielmetti, L. Minati, P. Vitali, A. R. Giovagnoli, F. Deleo, G. Didato, A. Parente, C. Marras, M. G. Bruzzone, L. D'Incerti, R. Spreafico, F. Villani

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31 Citations (Scopus)

Abstract

In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:Both left and right TLE patients show decreased left lateralization compared to controls.Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.Left lateralization correlates with peri-ictal aphasia in left TLE patients.Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.

Original languageEnglish
Pages (from-to)73-83
Number of pages11
JournalNeuroImage: Clinical
Volume3
DOIs
Publication statusPublished - 2013

Fingerprint

Temporal Lobe Epilepsy
Language
Stroke
Magnetic Resonance Imaging
Aphasia
Anterior Temporal Lobectomy

Keywords

  • Functional MRI
  • Language lateralization
  • Temporal lobe epilepsy
  • Temporal lobectomy

ASJC Scopus subject areas

  • Clinical Neurology
  • Radiology Nuclear Medicine and imaging
  • Cognitive Neuroscience
  • Neurology

Cite this

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title = "Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study",
abstract = "In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:Both left and right TLE patients show decreased left lateralization compared to controls.Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.Left lateralization correlates with peri-ictal aphasia in left TLE patients.Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.",
keywords = "Functional MRI, Language lateralization, Temporal lobe epilepsy, Temporal lobectomy",
author = "C. Rosazza and F. Ghielmetti and L. Minati and P. Vitali and Giovagnoli, {A. R.} and F. Deleo and G. Didato and A. Parente and C. Marras and Bruzzone, {M. G.} and L. D'Incerti and R. Spreafico and F. Villani",
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T1 - Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance

T2 - An fMRI study

AU - Rosazza, C.

AU - Ghielmetti, F.

AU - Minati, L.

AU - Vitali, P.

AU - Giovagnoli, A. R.

AU - Deleo, F.

AU - Didato, G.

AU - Parente, A.

AU - Marras, C.

AU - Bruzzone, M. G.

AU - D'Incerti, L.

AU - Spreafico, R.

AU - Villani, F.

PY - 2013

Y1 - 2013

N2 - In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:Both left and right TLE patients show decreased left lateralization compared to controls.Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.Left lateralization correlates with peri-ictal aphasia in left TLE patients.Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.

AB - In patients with temporal lobe epilepsy (TLE), assessment of language lateralization is important as anterior temporal lobectomy may lead to language impairments. Despite the widespread use of fMRI, evidence of its usefulness in predicting postsurgical language performance is scant. We investigated whether preoperative functional lateralization is related to the preoperative language performance, peri-ictal aphasia, and can predict language outcome one year post-surgery. We studied a total of 72 TLE patients (42 left, 30 right), by using three fMRI tasks: Naming, Verb Generation and Fluency. Functional lateralization indices were analyzed with neuropsychological scores and presence of peri-ictal aphasia. The key findings are:Both left and right TLE patients show decreased left lateralization compared to controls.Lateralization correlates with language performance before surgery. In left TLE, decreased left lateralization correlates with better fluency performance. In right TLE, increased left lateralization during the Naming task correlates with better naming.Left lateralization correlates with peri-ictal aphasia in left TLE patients.Lateralization correlates with language performance after surgery. In a subgroup of left TLE who underwent surgery (17 left), decreased left lateralization is predictive of better naming performance at 6 and 12 months after surgery. The present study highlights the clinical relevance of fMRI language lateralization in TLE, especially to predict language outcome one year post-surgery. We also underline the importance of using fMRI tasks eliciting frontal and anterior temporal activations, when studying left and right TLE patients.

KW - Functional MRI

KW - Language lateralization

KW - Temporal lobe epilepsy

KW - Temporal lobectomy

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