title: Memory fMRI predicts verbal memory decline after anterior temporal lobe resection.
abstract: OBJECTIVE
  To develop a clinically applicable memory functional MRI (fMRI) method of predicting postsurgical memory outcome in individual patients.
  
  
  METHODS
  In this prospective cohort study, 50 patients with temporal lobe epilepsy (23 left) and 26 controls underwent an fMRI memory encoding paradigm of words with a subsequent out-of-scanner recognition assessment. Neuropsychological assessment was performed preoperatively and 4 months after anterior temporal lobe resection, and at equal time intervals in controls. An event-related analysis was used to explore brain activations for words remembered and change in verbal memory scores 4 months after surgery was correlated with preoperative activations. Individual lateralization indices were calculated within a medial temporal and frontal region and compared with other clinical parameters (hippocampal volume, preoperative verbal memory, age at onset of epilepsy, and language lateralization) as a predictor of verbal memory outcome.
  
  
  RESULTS
  In left temporal lobe epilepsy patients, left frontal and anterior medial temporal activations correlated significantly with greater verbal memory decline, while bilateral posterior hippocampal activation correlated with less verbal memory decline postoperatively. In a multivariate regression model, left lateralized memory lateralization index (≥0.5) within a medial temporal and frontal mask was the best predictor of verbal memory outcome after surgery in the dominant hemisphere in individual patients. Neither clinical nor functional MRI parameters predicted verbal memory decline after nondominant temporal lobe resection.
  
  
  CONCLUSIONS
  We propose a clinically applicable memory fMRI paradigm to predict postoperative verbal memory decline after surgery in the language-dominant hemisphere in individual patients.
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Meneka K
authors.initials: MK
authors.lastname: Sidhu
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Jason
authors.initials: J
authors.lastname: Stretton
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Gavin P
authors.initials: GP
authors.lastname: Winston
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Mark
authors.initials: M
authors.lastname: Symms
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Pamela J
authors.initials: PJ
authors.lastname: Thompson
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK.
authors.forename: Matthias J
authors.initials: MJ
authors.lastname: Koepp
authors.affiliation: From the Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London; and the Epilepsy Society MRI Unit, Chalfont St. Peter, UK. j.duncan@ucl.ac.uk.
authors.forename: John S
authors.initials: JS
authors.lastname: Duncan
mesh_terms: D000328:Adult; D038481:Anterior Temporal Lobectomy / Q000009:adverse effects*; D001931:Brain Mapping; D002540:Cerebral Cortex / Q000503:physiopathology* / Q000601:surgery*; D004833:Epilepsy, Temporal Lobe / Q000601:surgery*; D005625:Frontal Lobe / Q000503:physiopathology; D007839:Functional Laterality / Q000502:physiology*; D006624:Hippocampus / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D008279:Magnetic Resonance Imaging; D008569:Memory Disorders / Q000209:etiology / Q000503:physiopathology*; D011183:Postoperative Complications / Q000503:physiopathology*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D013702:Temporal Lobe / Q000503:physiopathology / Q000601:surgery