Patterns and predictors of language representation and the influence of epilepsy surgery on language reorganization in children and young adults with focal lesional epilepsy

Autor: Annamaria Buccoliero, Matteo Lenge, Laura Grisotto, Andrea Cherubini, Flavio Giordano, Francesca Frijia, Maria Eugenia Caligiuri, Valentina Sibilia, Tiziana Pisano, Domenico Montanaro, Susanna Rizzi, Federico Melani, Gayane Aghakhanyan, Francesco Mari, Renzo Guerrini, Anna Cavalli, Carmen Barba, Simona Pellacani
Jazyk: angličtina
Rok vydání: 2020
Předmět:
Male
Drug Resistant Epilepsy
Physiology
medicine.medical_treatment
Social Sciences
Audiology
Electroencephalography
Functional Laterality
Diagnostic Radiology
Epilepsy
Cognition
0302 clinical medicine
Pediatric Surgery
Functional Magnetic Resonance Imaging
Medicine and Health Sciences
Arcuate fasciculus
Psychology
Epilepsy surgery
Prospective Studies
Child
Anterior temporal lobectomy
Language
Clinical Neurophysiology
0303 health sciences
Brain Mapping
Multidisciplinary
medicine.diagnostic_test
Cognitive Neurology
Radiology and Imaging
Magnetic Resonance Imaging
Electrophysiology
Diffusion Tensor Imaging
medicine.anatomical_structure
Bioassays and Physiological Analysis
Neurology
Brain Electrophysiology
Laterality
Medicine
Female
Comprehension
Research Article
medicine.medical_specialty
Adolescent
Imaging Techniques
Cognitive Neuroscience
Science
Neurophysiology
Neuroimaging
Surgical and Invasive Medical Procedures
Research and Analysis Methods
behavioral disciplines and activities
Lateralization of brain function
Young Adult
03 medical and health sciences
Fluency
Signs and Symptoms
Diagnostic Medicine
Neuropsychology
medicine
Humans
030304 developmental biology
Neuropsychological Testing
Language Disorders
business.industry
Functional Neuroimaging
Electrophysiological Techniques
Cognitive Psychology
Biology and Life Sciences
medicine.disease
Lesions
Cognitive Science
Epilepsies
Partial
Clinical Medicine
business
030217 neurology & neurosurgery
Neuroscience
Zdroj: PLoS ONE, Vol 15, Iss 9, p e0238389 (2020)
PLoS ONE
ISSN: 1932-6203
Popis: Mapping brain functions is crucial for neurosurgical planning in patients with drug-resistant seizures. However, presurgical language mapping using either functional or structural networks can be challenging, especially in children. In fact, most of the evidence on this topic derives from cross-sectional or retrospective studies in adults submitted to anterior temporal lobectomy. In this prospective study, we used fMRI and DTI to explore patterns of language representation, their predictors and impact on cognitive performances in 29 children and young adults (mean age at surgery: 14.6 ± 4.5 years) with focal lesional epilepsy. In 20 of them, we also assessed the influence of epilepsy surgery on language lateralization. All patients were consecutively enrolled at a single epilepsy surgery center between 2009 and 2015 and assessed with preoperative structural and functional 3T brain MRI during three language tasks: Word Generation (WG), Rhyme Generation (RG) and a comprehension task. We also acquired DTI data on arcuate fasciculus in 24 patients. We first assessed patterns of language representation (relationship of activations with the epileptogenic lesion and Laterality Index (LI)) and then hypothesized a causal model to test whether selected clinical variables would influence the patterns of language representation and the ensuing impact of the latter on cognitive performances. Twenty out of 29 patients also underwent postoperative language fMRI. We analyzed possible changes of fMRI and DTI LIs and their clinical predictors. Preoperatively, we found atypical language lateralization in four patients during WG task, in one patient during RG task and in seven patients during the comprehension task. Diffuse interictal EEG abnormalities predicted a more atypical language representation on fMRI (p = 0.012), which in turn correlated with lower attention (p = 0.036) and IQ/GDQ scores (p = 0.014). Postoperative language reorganization implied shifting towards atypical language representation. Abnormal postoperative EEG (p = 0.003) and surgical failures (p = 0.015) were associated with more atypical language lateralization, in turn correlating with worsened fluency. Neither preoperative asymmetry nor postoperative DTI LI changes in the arcuate fasciculus were observed. Focal lesional epilepsy associated with diffuse EEG abnormalities may favor atypical language lateralization and worse cognitive performances, which are potentially reversible after successful surgery.
Databáze: OpenAIRE
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