Reorganization of verbal and nonverbal memory in temporal lobe epilepsy due to unilateral hippocampal sclerosis.
OBJECTIVE
Patients with temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) often suffer from material-specific memory impairments. The purpose of this study was to use functional magnetic resonance imaging (fMRI) to study the organization of specific memory functions in these patients.


METHODS
We report 14 patients with unilateral TLE and HS, and 10 controls, performing an fMRI memory paradigm of word, picture, and face encoding.


RESULTS
Compared with controls, patients with left TLE demonstrated less left MTL and greater right MTL activation and patients with right TLE demonstrated less right MTL and greater left MTL activation. Correlations between fMRI activation and memory performance revealed greater activation in the damaged left hippocampus to be correlated with better verbal memory performance in left TLE patients and greater right hippocampal activation to be correlated with better nonverbal memory in right TLE patients. Conversely, greater fMRI activation in the contralateral hippocampus correlated with worse memory performance.


CONCLUSIONS
Our findings suggest that memory function in unilateral TLE is better when it is sustained by activation within the damaged hippocampus and that reorganization to the undamaged MTL is an inefficient process, incapable of preserving memory function.
Powell
H W Robert
HW
Department of Clinical and Experimental Epilepsy, Institute of Neurology, University College London, Queen Square, London, UK.
Richardson
Mark P
MP
Symms
Mark R
MR
Boulby
Philip A
PA
Thompson
Pam J
PJ
Duncan
John S
JS
Koepp
Matthias J
MJ
D000328:Adult; D001931:Brain Mapping; D004833:Epilepsy, Temporal Lobe / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology*; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006624:Hippocampus / Q000473:pathology / Q000502:physiology / Q000503:physiopathology*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008568:Memory / Q000502:physiology; D008569:Memory Disorders / Q000503:physiopathology*; D011939:Mental Recall / Q000502:physiology; D008875:Middle Aged; D009483:Neuropsychological Tests; D009633:Nonverbal Communication / Q000502:physiology*; D011300:Preoperative Care; D021641:Recognition, Psychology / Q000502:physiology; D012598:Sclerosis; D014705:Verbal Behavior / Q000502:physiology*; D014796:Visual Perception / Q000502:physiology