CORTICAL LOCALIZATION IN TEMPORAL LOBE EPILEPSY

颞叶癫痫的皮质定位

• 批准号: 6126279
• 负责人: MARLA J HAMBERGER
• 金额: $ 12.12万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-12-01 至 2001-11-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6126279
• 关键词: brain mapping; clinical research; cognition; hearing; human subject; language; neurosurgery; partial seizure; postoperative complications; speech; temporal lobe /cortex disorder; visual perception

DESCRIPTION (Applicant's Abstract): Successful surgical treatment of intractable epilepsy requires accurate presurgical localization of cortical seizure foci. Presurgically, cognitive assessment contributes to lateralization and localization of cortical dysfunction associated with epileptogenic tissue and assists prediction of postoperative abilities. In certain cases, cortical mapping of cognitive functions is required to prevent postoperative decline. Visual object naming is a major component in presurgical assessment of verbal skills and is widely utilized during cortical mapping to prevent postoperative language dysfunction in patients with seizures arising near language cortex. However, many temporal lobe epilepsy (TLE) patients who complain of word finding difficulties and show deficits in conversation show no deficits on object naming tasks. Furthermore, postoperative word finding deficits can arise or become more severe despite utilization of visual naming tasks during language mapping. These observations challenge the validity of using visual naming 1) to detect word finding difficulties and thereby infer localization of seizure foci and 2) to help prevent postoperative language decline. Preliminary findings suggested that auditory naming was significantly more sensitive to word retrieval deficits in left TLE (i.e., language dominant, LTLE) patients than was visual naming. This discrepancy may reflect differences in the cognitive operations underlying word retrieval during object naming and during speech. In addition, preliminary observations during cortical mapping using visual and auditory naming tasks indicated that these functions were differentially impaired by stimulation at a given cortical site, suggesting they reflect different aspects of language processing.

描述（申请人的摘要）：成功的手术治疗 顽固性癫痫需要精确的皮质前术定位 癫痫发作焦点。 预防性，认知评估有助于 与皮质功能障碍相关的皮质功能障碍的横向和定位 癫痫组织和有助于术后能力的预测。 在 某些情况下，认知功能的皮质映射需要 防止术后下降。 视觉对象命名是术前评估的主要组成部分 口头技能，在皮质图中广泛使用以防止 癫痫发作患者的术后语言功能障碍 语言皮质。 但是，许多颞叶癫痫（TLE）患者 抱怨单词发现困难并在对话中表现出赤字 对象命名任务没有缺陷。 此外，术后词发现 尽管使用了视觉 在语言映射期间命名任务。 这些观察结果挑战了 使用视觉命名的有效性1）检测单词发现困难和 从而推断出癫痫发作的本地化和2）帮助防止 术后语言下降。 初步发现表明 听觉命名对单词检索缺陷更为敏感 在左图（即语言主导，LTLE）患者中，比视觉命名。 这种差异可能反映了认知操作的差异 对象命名和语音期间的基本单词检索。 在 此外，使用视觉和视觉和 听觉命名任务表明这些功能是差异的 在给定的皮质部位受到刺激的损害，表明它们反映 语言处理的不同方面。