title: Lateralized anterior mesiotemporal lobe activation: semirandom functional MR imaging encoding paradigm in patients with temporal lobe epilepsy--initial experience.
abstract: OBJECTIVE
  To prospectively demonstrate anterior mesiotemporal lobe (MTL) activation in healthy volunteers by using a semirandom memory-encoding paradigm and to prospectively compare lateralized functional magnetic resonance (MR) imaging activation with intracarotid amobarbital procedure (IAP) memory test results in patients with temporal lobe epilepsy (TLE) who were scheduled to undergo surgery.
  
  
  METHODS
  The study was approved by a local ethics committee, and written informed consent was obtained from all subjects. Eight healthy volunteers and 18 patients with TLE who were scheduled for surgery were included in the functional MR imaging study involving the use of a memory-encoding paradigm with variable epoch lengths. Subjects were instructed to memorize new pictures that were mixed among pictures that they had seen before. Data analysis entailed computations of the contrast between the MTL activation induced by the new pictures and the MTL activation induced by the old pictures and of the lateralization index, defined as the relative difference in the number of activated voxels between the left and right MTLs. Lateralization indexes were compared between the patients and the volunteers and statistically correlated with the patients' IAP memory test results. To study deviations from perfect correspondence between the functional MR imaging- and IAP-derived lateralization indexes, orthogonal regression analysis was applied. Proportional relations for the patients with left-sided TLE and for those with right-sided TLE were calculated separately.
  
  
  RESULTS
  The memory paradigm consistently activated the posterior and anterior MTL structures in both the healthy volunteers and the patients. Regression analysis revealed that functional MR imaging activation was stronger than the IAP results when it was lateralized to the contralateral MTL. This analysis also revealed a significant (P < .001) correlation between the functional MR imaging results and the IAP results in the patients with right-sided TLE but not in those with left-sided TLE (P > .1).
  
  
  CONCLUSIONS
  The functional MR imaging memory-encoding paradigm consistently yielded MTL activation in the volunteers and the patients with TLE, but lateralized functional MR imaging activation was in concordance with the IAP results in only those patients with right-sided TLE.
authors.affiliation: Dept of Neuroradiology, Ghent Univ Hosp, MR Dept 1 K12, De Pintelaan 185, 9000 Ghent, Belgium. karen.deblaere@ugent.be
authors.forename: Karel
authors.initials: K
authors.lastname: Deblaere
authors.forename: Walter H
authors.initials: WH
authors.lastname: Backes
authors.forename: Ann
authors.initials: A
authors.lastname: Tieleman
authors.forename: Pieter
authors.initials: P
authors.lastname: Vandemaele
authors.forename: Luc
authors.initials: L
authors.lastname: Defreyne
authors.forename: Kristl
authors.initials: K
authors.lastname: Vonck
authors.forename: Paul
authors.initials: P
authors.lastname: Hofman
authors.forename: Peter
authors.initials: P
authors.lastname: Boon
authors.forename: Jan
authors.initials: J
authors.lastname: Vermeulen
authors.forename: Jan
authors.initials: J
authors.lastname: Wilmink
authors.forename: Albert
authors.initials: A
authors.lastname: Aldenkamp
authors.forename: Paul A J M
authors.initials: PA
authors.lastname: Boon
authors.forename: Guy
authors.initials: G
authors.lastname: Vingerhoets
authors.forename: Eric
authors.initials: E
authors.lastname: Achten
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D004833:Epilepsy, Temporal Lobe / Q000503:physiopathology*; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008568:Memory / Q000502:physiology*; D008875:Middle Aged; D011446:Prospective Studies; D012044:Regression Analysis; D013702:Temporal Lobe / Q000502:physiology