title: Does clinical memory fMRI provide a comprehensive map of medial temporal lobe structures?
abstract: Successful clinical application of fMRI tasks requires reliable knowledge about the brain structures mapped by the task. With memory fMRI, diverging evidence exists concerning the location of major signal sources as well as hippocampal contributions. To clarify these issues, we investigated a frequently applied memory test (home town walking) in 33 patients with unilateral medial temporal lobe pathology, comparing healthy and diseased hemispheres. We focused on a detailed investigation of individual fMRI maps on non-transformed high-resolution functional images. Results show a clear dominance of activations around the collateral sulcus, corresponding to parahippocampal and entorhinal cortex activities. Hippocampus activity was absent in the vast majority of patients. The diseased hemispheres showed lower activation than the healthy hemispheres. We conclude that (1) the investigated memory test may be successfully applied for evaluation of the parahippocampal cortex, (2) the hippocampus is not reliably mapped by the task, and (3) the methods described for investigation of individual high-resolution functional images allow generation of application profiles for clinical fMRI tasks.
authors.affiliation: Study Group Clinical fMRI, MR Center of Excellence, Medical University of Vienna, Vienna, Austria. roland.beisteiner@meduniwien.ac.at
authors.forename: Roland
authors.initials: R
authors.lastname: Beisteiner
authors.forename: Kay
authors.initials: K
authors.lastname: Drabeck
authors.forename: Thomas
authors.initials: T
authors.lastname: Foki
authors.forename: Alexander
authors.initials: A
authors.lastname: Geissler
authors.forename: Andreas
authors.initials: A
authors.lastname: Gartus
authors.forename: Eva
authors.initials: E
authors.lastname: Lehner-Baumgartner
authors.forename: Christoph
authors.initials: C
authors.lastname: Baumgartner
mesh_terms: D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods; D018728:Entorhinal Cortex / Q000473:pathology* / Q000503:physiopathology; D004833:Epilepsy, Temporal Lobe / Q000473:pathology* / Q000503:physiopathology; D005260:Female; D007839:Functional Laterality; D006624:Hippocampus / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008568:Memory; D008875:Middle Aged; D009483:Neuropsychological Tests; D020534:Parahippocampal Gyrus / Q000473:pathology* / Q000503:physiopathology; D011237:Predictive Value of Tests; D011379:Prognosis; D013702:Temporal Lobe / Q000473:pathology* / Q000503:physiopathology