Pre-operative verbal memory fMRI predicts post-operative memory decline after left temporal lobe resection.
Functional MRI (fMRI) of cognitive tasks depends on technology widely available in the clinical sphere, but has yet to show a role in the investigation of patients. We report here the first demonstration of a clinically valuable role for cognitive fMRI. Temporal lobe epilepsy (TLE) is commonly caused by hippocampal sclerosis and is frequently resistant to drug treatment. Surgical resection of the left hippocampus in this setting can cure seizures, but may produce significant verbal memory decline, which is hard to predict. We report 10 right-handed TLE patients with left hippocampal sclerosis who underwent left hippocampal resection. We compared currently used data for the prediction of post-operative verbal memory decline in such patients with a novel fMRI assessment of verbal memory encoding. Multiple regression analyses showed that fMRI provided the strongest independent predictor of memory outcome after surgery. At the individual subject level, the fMRI data had high positive predictive value for memory decline.
Richardson
Mark P
MP
Department of Clinical and Experimental Epilepsy , Institute of Neurology, University College London, UK. m.richardson@ion.ucl.ac.uk
Strange
Bryan A
BA
Thompson
Pamela J
PJ
Baxendale
Sallie A
SA
Duncan
John S
JS
Dolan
Raymond J
RJ
D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D004833:Epilepsy, Temporal Lobe / Q000209:etiology / Q000523:psychology / Q000601:surgery*; D005260:Female; D006624:Hippocampus / Q000473:pathology / Q000601:surgery; D006801:Humans; D016014:Linear Models; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008568:Memory; D008569:Memory Disorders / Q000209:etiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D011300:Preoperative Care; D011379:Prognosis; D011446:Prospective Studies; D012598:Sclerosis