title: Neuroimaging correlates of language network impairment and reorganization in temporal lobe epilepsy.
abstract: Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.
authors.affiliation: Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States.
authors.forename: S
authors.initials: S
authors.lastname: Balter
authors.affiliation: Palo Alto University, Palo Alto, CA, United States.
authors.forename: G
authors.initials: G
authors.lastname: Lin
authors.affiliation: Multimodal Imaging Laboratory, University of California, San Diego, CA, United States.
authors.forename: K M
authors.initials: KM
authors.lastname: Leyden
authors.affiliation: Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States.
authors.forename: B M
authors.initials: BM
authors.lastname: Paul
authors.affiliation: Multimodal Imaging Laboratory, University of California, San Diego, CA, United States; Department of Psychiatry, University of California, San Diego, CA, United States. Electronic address: camcdonald@ucsd.edu.
authors.forename: C R
authors.initials: CR
authors.lastname: McDonald
mesh_terms: D000328:Adult; D001921:Brain / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods; D056324:Diffusion Tensor Imaging / Q000379:methods; D004833:Epilepsy, Temporal Lobe / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D007802:Language; D007806:Language Disorders / Q000000981:diagnostic imaging* / Q000503:physiopathology; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D009415:Nerve Net / Q000000981:diagnostic imaging* / Q000503:physiopathology; D059906:Neuroimaging / Q000379:methods*