Use of preoperative functional neuroimaging to predict language deficits from epilepsy surgery. Neurology 2003 Jun 10;60(11):1788-92
Date
06/11/2003Pubmed ID
12796532DOI
10.1212/01.wnl.0000068022.05644.01Scopus ID
2-s2.0-0038115332 (requires institutional sign-in at Scopus site) 265 CitationsAbstract
BACKGROUND: Left anterior temporal lobectomy (L-ATL) may be complicated by confrontation naming deficits.
OBJECTIVE: To determine whether preoperative fMRI predicts such deficits in patients with epilepsy undergoing L-ATL.
METHODS: Twenty-four patients with L-ATL underwent preoperative language mapping with fMRI, preoperative intracarotid amobarbital (Wada) testing for language dominance, and pre- and postoperative neuropsychological testing. fMRI laterality indexes (LIs), reflecting the interhemispheric difference between activated volumes in left and right homologous regions of interest, were calculated for each patient. Relationships between the fMRI LI, Wada language dominance, and naming outcome were examined.
RESULTS: Both the fMRI LI (p < 0.001) and the Wada test (p < 0.05) were predictive of naming outcome. fMRI showed 100% sensitivity and 73% specificity in predicting significant naming decline. Both fMRI and the Wada test were more predictive than age at seizure onset or preoperative naming performance.
CONCLUSIONS: Preoperative fMRI predicted naming decline in patients undergoing left anterior temporal lobectomy surgery.
Author List
Sabsevitz DS, Swanson SJ, Hammeke TA, Spanaki MV, Possing ET, Morris GL 3rd, Mueller WM, Binder JRAuthors
Jeffrey R. Binder MD Professor in the Neurology department at Medical College of WisconsinWade M. Mueller MD Professor in the Neurosurgery department at Medical College of Wisconsin
Sara J. Swanson PhD Chief, Professor in the Neurology department at Medical College of Wisconsin
MESH terms used to index this publication - Major topics in bold
AdultAnterior Temporal Lobectomy
Epilepsy, Temporal Lobe
Female
Humans
Language Disorders
Language Tests
Magnetic Resonance Imaging
Male
Prognosis
Risk Factors