CC BY-NC-ND 4.0 · Indian J Radiol Imaging 2014; 24(01): 51-56
DOI: 10.4103/0971-3026.130694
fMRI-MINI SYMPOSIA

Mapping of cognitive functions in chronic intractable epilepsy: Role of fMRI

Kapil Chaudhary
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
,
S Senthil Kumaran
Department of Nuclear Magnetic Resonance, All India Institute of Medical Sciences, New Delhi, India
,
Sarat P Chandra
Department of Neuro-Surgery, All India Institute of Medical Sciences, New Delhi, India
,
Ashima Nehra Wadhawan
Department of Clinical Neuro Psychology, All India Institute of Medical Sciences, New Delhi, India
,
Manjari Tripathi
Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations

Abstract

Background: Functional magnetic resonance imaging (fMRI), a non-invasive technique with high spatial resolution and blood oxygen level dependent (BOLD) contrast, has been applied to localize and map cognitive functions in the clinical condition of chronic intractable epilepsy. Purpose: fMRI was used to map the language and memory network in patients of chronic intractable epilepsy pre- and post-surgery. Materials and Methods: After obtaining approval from the institutional ethics committee, six patients with intractable epilepsy with an equal number of age-matched controls were recruited in the study. A 1.5 T MR scanner with 12-channel head coil, integrated with audio-visual fMRI accessories was used. Echo planar imaging sequence was used for BOLD studies. There were two sessions in TLE (pre- and post-surgery). Results: In TLE patients, BOLD activation increased post-surgery in comparison of pre-surgery in inferior frontal gyrus (IFG), middle frontal gyrus (MFG), and superior temporal gyrus (STG), during semantic lexical, judgment, comprehension, and semantic memory tasks. Conclusion: Functional MRI is useful to study the basic concepts related to language and memory lateralization in TLE and guide surgeons for preservation of important brain areas during ATLR. This will help in understanding future directions for the diagnosis and treatment of such disease.



Publication History

Article published online:
02 August 2021

© 2014. Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

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  • References

  • 1 Bell B, Lin JJ, Seidenberg M, Hermann B. The neurobiology of cognitive disorders in temporal lobe epilepsy. Nat Rev Neurol 2011;7:154-64.
  • 2 Chen CC, Chen LS, Yen MF, Chen HH, Liou HH. Geographic variation in the age- and gender-specific prevalence and incidence of epilepsy: Analysis of Taiwanese National Health Insurance-based data. Epilepsia 2012;53:283-90.
  • 3 Sridharan R, Murthy BN. Prevalence and pattern of epilepsy in India. Epilepsia 1999;40:631-6.
  • 4 Koul R, Razdan S, Mott A. Prevalence and patterns of epilepsy in rural Kashmir in India. Epilepsia 1988;29:116-22.
  • 5 Wieser HG. ILAE Commission Report. Mesial temporal lobe epilepsy with hippocampal sclerosis. Epilepsia 2004;45:695-714.
  • 6 Thom M. Recent advances in the neuropathology of focal lesions in epilepsy. Expert Rev Neurother 2004;4:973-84.
  • 7 Chandra SP, Bal CS, Sarkar C, Tripathi M. Intraoperative coregistration of magnetic resonance imaging, positron emission tomography, and electrocorticographic data for neocortical lesional epilepsies may improve the localization of the epileptogenic focus: A pilot study. World Neurosurg 2013;pii: S1878-8750(13):00343-4.
  • 8 Lippincott CE. An investigation of extra-temporal deficits in temporal lobe epilepsy. Ph.D Thesis, 2010.
  • 9 Detre A. fMRI Applications in Epilepsy. Epilepsia 2004;45:26-31.
  • 10 Smith K. fMRI 2.0. Nature 2012;484:24-6.
  • 11 Herholz K, Heiss W. Functional imaging correlates of recovery after stroke in humans. J Cereb Blood Flow Metab 2000;20:1619-31.
  • 12 Yetkin FZ, Swanson S, Fischer M, Akansel G, Morris G, Mueller W, et al. Functional MR of Frontal Lobe Activation: Comparison with Wada Language Results. AJNR Am J Neuroradiol 1998;19:1095-8.
  • 13 Cousin E, Baciu M, Pichat C, Kahane P, Le Bas JF. Functional MRI evidence for language plasticity in adult epileptic patients: Preliminary results. Neuropsychiatr Dis Treat 2008;4:235-46.
  • 14 Oldfield RC. The assessment and analysis of handedness: The Edinburgh inventory. Neuropsychologia 1971;9:97-113.
  • 15 Mukundan CR, Rao SL, Jain VK, Jayakumar PN, Shailaja K. Neuropsychological assessment: a cross validation study with neuroradiological/operative findings in patients with cerebral hemisphere lesions. Pharmacopsychoecologia 1991;4:33-9.
  • 16 Feydy A, Carlier R, Brami AR, Bussel B, Cazalis F, Pierot L, et al. Longitudinal study of motor recovery after stroke recruitment and focusing of brain activation. Stroke 2002;33:1610-7.
  • 17 Wong SW, Jong L, Bandur D, Bihari F, Yen YF, Takahashi AM, et al. Cortical reorganization following anterior temporal lobectomy in patients with temporal lobe epilepsy. Neurology 2009;73:518-25.
  • 18 Kim JH, Lee JM, Kang E, Kim JS, Song IC, Chung CK. Functional reorganization associated with semantic language processing in temporal lobe epilepsy patients after anterior temporal lobectomy: A longitudinal functional magnetic resonance image study. J Korean Neurosurg Soc 2010;47:17-25.
  • 19 Saur D, Kreher BW, Schnell S, Kümmerer D, Kellmeyer P, Vry MS, et al. Ventral and dorsal pathways for language. Proc Natl Acad Sci U S A 2008;105:46.
  • 20 Hickok G, Poeppel D. Dorsal and ventral streams: A framework for understanding aspects of the functional anatomy of language. Cognition 2004;92:67-99.
  • 21 Weber B, Wellmer J, Schür S, Dinkelacker V, Ruhlmann J, Mormann F, et al. Presurgical language fMRI in patients with drug-resistant epilepsy: Effects of task performance. Epilepsia 2006;47:880-6.
  • 22 Rosazza C, Ghielmetti F, Minati L, Vitali P, Giovagnoli AR, Deleo F, et al. Preoperative language lateralization in temporal lobe epilepsy (TLE) predicts peri-ictal, pre- and post-operative language performance: An fMRI study. Neuroimage Clin 2013;3:73-83.
  • 23 Dronkers NF, Wilkins DP, Van Valin RD Jr, Redfern BB, Jaeger JJ. Lesion analysis of the brain areas involved in language comprehension. Cognition 2004;92:145-51.
  • 24 Oh YM, Koh EJ. Language lateralization in patients with temporal lobe epilepsy: A comparison between volumetric analysis and the Wada test. J Korean Neurosurg Soc 2009;45:329-35.
  • 25 Benke T, Visa P, Willmes K. Language lateralization in TLE: A comparison between FMRI and the Wada test. Epilepsia 2006;47:1308-19.
  • 26 Appel S, Duke ES, Martinez AR, Khan OI, Dustin IM, Reeves-Tyer P, et al. Cerebral blood flow and fMRI BOLD auditory language activation in temporal lobe epilepsy. Epilepsia 2012;53:631-8.
  • 27 Chang LJ, Yarkoni T, Khaw MW, Sanfey AG. Decoding the role of the insula in human cognition: functional parcellation and large-scale reverse inference. Cereb Cortex 2013;23:739-49.
  • 28 Manes F, Springer J, Jorge R, Robinson RG. Verbal memory impairment after left insular cortex infarction. J Neurol Neurosurg Psychiatry 1999;67:532-4.
  • 29 Haberg A, Unsgard G. Preoperative blood oxygen level dependent functional magnetic resonance imaging in patients with primary brain tumors: Clinical application and outcome. Neurosurgery 2004;54:902-14.
  • 30 Wong SW, Jong L, Bandur D, Bihari F, Yen YF, Takahashi AM, et al. Cortical reorganization following anterior temporal lobectomy in patients with temporal lobe epilepsy. Neurology 2009;73:518-25.
  • 31 Stefan H, Lopes da Silva FH. Epileptic neuronal networks: methods of identification and clinical relevance. Front Neurol 2013;4:8.