title: Cortical reorganization following anterior temporal lobectomy in patients with temporal lobe epilepsy.
abstract: BACKGROUND
  Functional MRI was used to study the impact of temporal lobe epilepsy (TLE) and anterior temporal lobectomy (ATL) on the cortical language network in patients with medically refractory TLE.
  
  
  METHODS
  Nineteen patients with medically refractory TLE and 11 healthy control subjects were enrolled in this study. Ten patients underwent left ATL (mean age 35.2 +/- 3.8 years), and 9 underwent right ATL (mean age 35.9 +/- 2.6 years). The subjects silently generated verbs in response to a series of visually presented nouns inside the scanner. Correlation analysis was performed between the subjects' performance on the clinical language tests and their neural response in the a priori cortical regions.
  
  
  RESULTS
  Preoperative data revealed that the patients with TLE showed increased neural activity in the right inferior frontal gyri (IFG) and middle frontal gyri (MFG). The right TLE patients demonstrated strong correlation between their language performance and the level of cortical activation within the typical language areas. However, such a correlation was absent in the left TLE patients. After the ATL surgery, the left TLE patients showed reduced activation in the left MFG and right IFG, whereas no difference was observed in the right TLE patients. In the right TLE patients, the correlation between language performance and neural response shifted from the typical language areas to the anterior cingulate cortex.
  
  
  CONCLUSIONS
  This study demonstrates that the cortical language network is affected differently by the left and right temporal lobe epilepsy and is reorganized after anterior temporal lobectomy.
authors.affiliation: Brain and Creativity Institute, University of Southern California, Los Angeles, USA.
authors.forename: S W H
authors.initials: SW
authors.lastname: Wong
authors.forename: L
authors.initials: L
authors.lastname: Jong
authors.forename: D
authors.initials: D
authors.lastname: Bandur
authors.forename: F
authors.initials: F
authors.lastname: Bihari
authors.forename: Y-F
authors.initials: YF
authors.lastname: Yen
authors.forename: A M
authors.initials: AM
authors.lastname: Takahashi
authors.forename: D H
authors.initials: DH
authors.lastname: Lee
authors.forename: D A
authors.initials: DA
authors.lastname: Steven
authors.forename: A G
authors.initials: AG
authors.lastname: Parrent
authors.forename: S E
authors.initials: SE
authors.lastname: Pigott
authors.forename: S M
authors.initials: SM
authors.lastname: Mirsattari
mesh_terms: D000328:Adult; D001931:Brain Mapping; D004833:Epilepsy, Temporal Lobe / Q000150:complications* / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D005625:Frontal Lobe / Q000033:anatomy & histology / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology; D006179:Gyrus Cinguli / Q000033:anatomy & histology / Q000502:physiology; D006801:Humans; D007806:Language Disorders / Q000209:etiology* / Q000473:pathology / Q000503:physiopathology; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D009415:Nerve Net / Q000503:physiopathology / Q000601:surgery*; D009434:Neural Pathways / Q000033:anatomy & histology / Q000503:physiopathology; D009473:Neuronal Plasticity / Q000502:physiology*; D019635:Neurosurgical Procedures / Q000009:adverse effects / Q000379:methods; D020127:Recovery of Function / Q000502:physiology; D013060:Speech / Q000502:physiology; D013067:Speech Perception / Q000502:physiology; D013702:Temporal Lobe / Q000033:anatomy & histology / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D016896:Treatment Outcome
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