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Sample records for medial-temporal lobe functioning

  1. Medial temporal lobe

    International Nuclear Information System (INIS)

    Silver, A.J.; Cross, D.T.; Friedman, D.P.; Bello, J.A.; Hilal, S.K.

    1989-01-01

    To better define the MR appearance of hippocampal sclerosis, the authors have reviewed over 500 MR coronal images of the temporal lobes. Many cysts were noted that analysis showed were of choroid-fissure (arachnoid) origin. Their association with seizures was low. A few nontumorous, static, medial temporal lesions, noted on T2-weighted coronal images, were poorly visualized on T1-weighted images and did not enhance with gadolinium. The margins were irregular, involved the hippocampus, and were often associated with focal atrophy. The lesions usually were associated with seizure disorders and specific electroencephalographic changes, and the authors believe they represented hippocampal sclerosis

  2. Asymmetry of medial and lateral temporal regional glucose metabolism in temporal lobe epilepsy by F-18-FDG PET

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Yeo, Jeong Seok; Song, Ho Cheon; Lee, Sang Kun; Kim, Hyun Jip; Chung, June Key; Lee, Myung Chul

    1999-01-01

    We investigated the difference of glucose metabolism of medial and lateral temporal lobes of patients with temporal lobe epilepsy (TLE) utilizing quantitative comparison of regional metabolic activities using asymmetric index. We studied 19 pathologically proven mesial TLE and 25 lateral TLE patients. Lateral TLE patients were either normal on magnetic resonance imaging (cryptogenic: n=14) or had structural lesions (lesional: n=11). Asymmetric index (ASI) was calculated as [(ipsilateral contralateral)/(ipsilateral + contralateral )]x200. ASI of medial and lateral lobes of mesial TLE was decreased (-16.4±8.3 and -12.7± 5.5, respectively). In cryptogenic lateral TLE, ASI of lateral temporal lobe was decreased (-11.8± 4.7), whereas that of medial temporal lobe was not decreased (-4.6±6.3). ASI of medial lobe of lesional lateral TLE was -7.3±9.1, which was significantly different from that of mesial TLE (p<0.05). Patients with lesional lateral TLE had evident metabolic defects or decrease (ASI: -22±10.5) in lateral temporal lobe. While we could not find the difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by ASI quantitation. Asymmetric decrease of metabolic activity in both medial and lateral temporal lobes indicates medial temporal epilepsy. Symmetry of metabolic activity in medial temporal lobe combined with asymmetry of that in lateral temporal lobe may give hints that the epileptogenic zone is lateral

  3. Early seizure propagation from the occipital lobe to medial temporal structures and its surgical implication.

    Science.gov (United States)

    Usui, Naotaka; Mihara, Tadahiro; Baba, Koichi; Matsuda, Kazumi; Tottori, Takayasu; Umeoka, Shuichi; Nakamura, Fumihiro; Terada, Kiyohito; Usui, Keiko; Inoue, Yushi

    2008-12-01

    Intracranial EEG documentation of seizure propagation from the occipital lobe to medial temporal structures is relatively rare. We retrospectively analyzed intracranial EEG recorded with electrodes implanted in the medial temporal lobe in patients who underwent occipital lobe surgery. Four patients with occipital lesions, who underwent intracranial EEG monitoring with intracerebral electrodes implanted in the medial temporal lobe prior to occipital lobe surgery, were studied. Subdural electrodes were placed over the occipital lobe and adjacent areas. Intracerebral electrodes were implanted into bilateral hippocampi and the amygdala in three patients, and in the hippocampus and amygdala ipsilateral to the lesion in one. In light of the intracranial EEG findings, the occipital lobe was resected but the medial temporal lobe was spared in all patients. The follow-up period ranged from six to 16 years, and seizure outcome was Engel Class I in all patients. Sixty six seizures were analyzed. The majority of the seizures originated from the occipital lobe. In complex partial seizures, ictal discharges propagated to the medial temporal lobe. No seizures originating from the temporal lobe were documented. In some seizures, the ictal-onset zone could not be identified. In these seizures, very early propagation to the medial temporal lobe was observed. Interictal spikes were recorded in the medial temporal lobe in all cases. Intracranial EEG revealed very early involvement of the medial temporal lobe in some seizures. Seizure control was achieved without resection of the medial temporal structures.

  4. Radiosurgery for Medial Temporal Lobe Epilepsy Resulting from Mesial Temporal Sclerosis.

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    Gianaris, Thomas; Witt, Thomas; Barbaro, Nicholas M

    2016-01-01

    Medial temporal lobe epilepsy associated with mesial temporal sclerosis (MTS) is perhaps the most well-defined epilepsy syndrome that is responsive to structural interventions such as surgery. Several minimally invasive techniques have arisen that provide additional options for the treatment of MTS while potentially avoiding many of open surgery's associated risks. By evading these risks, they also open up treatment options to patients who otherwise are poor surgical candidates. Radiosurgery is one of the most intensively studied of these alternatives and has found a growing role in the treatment of medial temporal lobe epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  5. Working Memory, Long-Term Memory, and Medial Temporal Lobe Function

    Science.gov (United States)

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance…

  6. Visual perception and memory systems: from cortex to medial temporal lobe.

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    Khan, Zafar U; Martín-Montañez, Elisa; Baxter, Mark G

    2011-05-01

    Visual perception and memory are the most important components of vision processing in the brain. It was thought that the perceptual aspect of a visual stimulus occurs in visual cortical areas and that this serves as the substrate for the formation of visual memory in a distinct part of the brain called the medial temporal lobe. However, current evidence indicates that there is no functional separation of areas. Entire visual cortical pathways and connecting medial temporal lobe are important for both perception and visual memory. Though some aspects of this view are debated, evidence from both sides will be explored here. In this review, we will discuss the anatomical and functional architecture of the entire system and the implications of these structures in visual perception and memory.

  7. Frontal lobe function in temporal lobe epilepsy

    Science.gov (United States)

    Stretton, J.; Thompson, P.J.

    2012-01-01

    Summary Temporal lobe epilepsy (TLE) is typically associated with long-term memory dysfunction. The frontal lobes support high-level cognition comprising executive skills and working memory that is vital for daily life functioning. Deficits in these functions have been increasingly reported in TLE. Evidence from both the neuropsychological and neuroimaging literature suggests both executive function and working memory are compromised in the presence of TLE. In relation to executive impairment, particular focus has been paid to set shifting as measured by the Wisconsin Card Sorting Task. Other discrete executive functions such as decision-making and theory of mind also appear vulnerable but have received little attention. With regard to working memory, the medial temporal lobe structures appear have a more critical role, but with emerging evidence of hippocampal dependent and independent processes. The relative role of underlying pathology and seizure spread is likely to have considerable bearing upon the cognitive phenotype and trajectory in TLE. The identification of the nature of frontal lobe dysfunction in TLE thus has important clinical implications for prognosis and surgical management. Longitudinal neuropsychological and neuroimaging studies assessing frontal lobe function in TLE patients pre- and postoperatively will improve our understanding further. PMID:22100147

  8. Temporal and extra-temporal hypoperfusion in medial temporal lobe epilepsy evaluated by arterial-spin-labeling based MRI

    International Nuclear Information System (INIS)

    Shen Lianfang; Zhang Zhiqiang; Lu Guangming; Yuan Cuiping; Wang Zhengge; Wang Haoxue; Huang Wei; Wei Fangyuan; Chen Guanghui; Tan Qifu

    2012-01-01

    Objective: To evaluate the feasibility of the lateralization of unilateral medial temporal lobe epilepsy (mTLE) by using arterial-spin-labeling (ASL) based perfusion MR imaging and investigate the changes of perfusion in the regions related to mTLE network and the relationship between the perfusion and the clinical status. Methods: Twenty-five patients with left-sided and 23 with right-sided mTLE were enrolled, and 30 healthy volunteers were recruited. The cerebral blood flow (CBF) of related region was measured based on pulsed-ASL sequence on Siemens 3 T scanner. The CBF of the mTLE group were compared with that in the controls by using ANOVA analysis. The asymmetric indices of CBF in the medial temporal lobe were calculated as the lesion side compared with the normal side in matched region in mTLE group. Results: Compared with the volunteers, the patients with mTLE showed the decrease of CBF in the bilateral medial and lateral temporal, the frontal and parietal regions relating to the default-mode network and more serious in lesion side. The CBF values of the medial temporal lobe were negatively correlated with the epilepsy duration (r=-0.51, P<0.01). The asymmetric index of CBF as-0.01 has a 76.0% (19/25) sensitivity and a 78.3% (18/23) specificity to distinguish the lesion side. Conclusions: The decrease of CBF in the temporal and extra-temporal region by ASL-based MRI suggests the functional abnormalities in the network involved by mTLE. The ASL technique is a useful tool for lateralizing the unilateral mTLE. (authors)

  9. Fornix and medial temporal lobe lesions lead to comparable deficits in complex visual perception.

    Science.gov (United States)

    Lech, Robert K; Koch, Benno; Schwarz, Michael; Suchan, Boris

    2016-05-04

    Recent research dealing with the structures of the medial temporal lobe (MTL) has shifted away from exclusively investigating memory-related processes and has repeatedly incorporated the investigation of complex visual perception. Several studies have demonstrated that higher level visual tasks can recruit structures like the hippocampus and perirhinal cortex in order to successfully perform complex visual discriminations, leading to a perceptual-mnemonic or representational view of the medial temporal lobe. The current study employed a complex visual discrimination paradigm in two patients suffering from brain lesions with differing locations and origin. Both patients, one with extensive medial temporal lobe lesions (VG) and one with a small lesion of the anterior fornix (HJK), were impaired in complex discriminations while showing otherwise mostly intact cognitive functions. The current data confirmed previous results while also extending the perceptual-mnemonic theory of the MTL to the main output structure of the hippocampus, the fornix. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  10. Parametric fMRI analysis of visual encoding in the human medial temporal lobe.

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    Rombouts, S A; Scheltens, P; Machielson, W C; Barkhof, F; Hoogenraad, F G; Veltman, D J; Valk, J; Witter, M P

    1999-01-01

    A number of functional brain imaging studies indicate that the medial temporal lobe system is crucially involved in encoding new information into memory. However, most studies were based on differences in brain activity between encoding of familiar vs. novel stimuli. To further study the underlying cognitive processes, we applied a parametric design of encoding. Seven healthy subjects were instructed to encode complex color pictures into memory. Stimuli were presented in a parametric fashion at different rates, thus representing different loads of encoding. Functional magnetic resonance imaging (fMRI) was used to assess changes in brain activation. To determine the number of pictures successfully stored into memory, recognition scores were determined afterwards. During encoding, brain activation occurred in the medial temporal lobe, comparable to the results obtained by others. Increasing the encoding load resulted in an increase in the number of successfully stored items. This was reflected in a significant increase in brain activation in the left lingual gyrus, in the left and right parahippocampal gyrus, and in the right inferior frontal gyrus. This study shows that fMRI can detect changes in brain activation during variation of one aspect of higher cognitive tasks. Further, it strongly supports the notion that the human medial temporal lobe is involved in encoding novel visual information into memory.

  11. Default network connectivity in medial temporal lobe amnesia.

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    Hayes, Scott M; Salat, David H; Verfaellie, Mieke

    2012-10-17

    There is substantial overlap between the brain regions supporting episodic memory and the default network. However, in humans, the impact of bilateral medial temporal lobe (MTL) damage on a large-scale neural network such as the default mode network is unknown. To examine this issue, resting fMRI was performed with amnesic patients and control participants. Seed-based functional connectivity analyses revealed robust default network connectivity in amnesia in cortical default network regions such as medial prefrontal cortex, posterior medial cortex, and lateral parietal cortex, as well as evidence of connectivity to residual MTL tissue. Relative to control participants, decreased posterior cingulate cortex connectivity to MTL and increased connectivity to cortical default network regions including lateral parietal and medial prefrontal cortex were observed in amnesic patients. In contrast, somatomotor network connectivity was intact in amnesic patients, indicating that bilateral MTL lesions may selectively impact the default network. Changes in default network connectivity in amnesia were largely restricted to the MTL subsystem, providing preliminary support from MTL amnesic patients that the default network can be fractionated into functionally and structurally distinct components. To our knowledge, this is the first examination of the default network in amnesia.

  12. Working memory for conjunctions relies on the medial temporal lobe.

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    Olson, Ingrid R; Page, Katie; Moore, Katherine Sledge; Chatterjee, Anjan; Verfaellie, Mieke

    2006-04-26

    A prominent theory of hippocampal function proposes that the hippocampus is importantly involved in relating or binding together separate pieces of information to form an episodic representation. This hypothesis has only been applied to studies of long-term memory because the paradigmatic view of the hippocampus is that it is not critical for short-term forms of memory. However, relational processing is important in many working memory tasks, especially tasks using visual stimuli. Here, we test the hypothesis that the medial temporal lobes are important for relational memory even over short delays. The task required patients with medial temporal lobe amnesia and controls to remember three objects, locations, or object-location conjunctions over 1 or 8 s delays. The results show that working memory for objects and locations was at normal levels, but that memory for conjunctions was severely impaired at 8 s delays. Additional analyses suggest that the hippocampus per se is critical for accurate conjunction working memory. We propose that the hippocampus is critically involved in memory for conjunctions at both short and long delays.

  13. MRI parcellation of ex vivo medial temporal lobe.

    Science.gov (United States)

    Augustinack, Jean C; Magnain, Caroline; Reuter, Martin; van der Kouwe, André J W; Boas, David; Fischl, Bruce

    2014-06-01

    Recent advancements in radio frequency coils, field strength and sophisticated pulse sequences have propelled modern brain mapping and have made validation to biological standards - histology and pathology - possible. The medial temporal lobe has long been established as a pivotal brain region for connectivity, function and unique structure in the human brain, and reveals disconnection in mild Alzheimer's disease. Specific brain mapping of mesocortical areas affected with neurofibrillary tangle pathology early in disease progression provides not only an accurate description for location of these areas but also supplies spherical coordinates that allow comparison between other ex vivo cases and larger in vivo datasets. We have identified several cytoarchitectonic features in the medial temporal lobe with high resolution ex vivo MRI, including gray matter structures such as the entorhinal layer II 'islands', perirhinal layer II-III columns, presubicular 'clouds', granule cell layer of the dentate gyrus as well as lamina of the hippocampus. Localization of Brodmann areas 28 and 35 (entorhinal and perirhinal, respectively) demonstrates MRI based area boundaries validated with multiple methods and histological stains. Based on our findings, both myelin and Nissl staining relate to contrast in ex vivo MRI. Precise brain mapping serves to create modern atlases for cortical areas, allowing accurate localization with important applications to detecting early disease processes. Copyright © 2013 Elsevier Inc. All rights reserved.

  14. Medial Temporal Lobe Activity during Source Retrieval Reflects Information Type, Not Memory Strength

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    Diana, Rachel A.; Yonelinas, Andrew P.; Ranganath, Charan

    2010-01-01

    The medial temporal lobes (MTLs) are critical for episodic memory but the functions of MTL subregions are controversial. According to memory strength theory, MTL subregions collectively support declarative memory in a graded manner. In contrast, other theories assert that MTL subregions support functionally distinct processes. For instance, one…

  15. Medial temporal lobe damage impairs representation of simple stimuli

    Directory of Open Access Journals (Sweden)

    David E Warren

    2010-05-01

    Full Text Available Medial temporal lobe damage in humans is typically thought to produce a circumscribed impairment in the acquisition of new enduring memories, but recent reports have documented deficits even in short-term maintenance. We examined possible maintenance deficits in a population of medial temporal lobe amnesics, with the goal of characterizing their impairments as either representational drift or outright loss of representation over time. Patients and healthy comparisons performed a visual search task in which the similarity of various lures to a target was varied parametrically. Stimuli were simple shapes varying along one of several visual dimensions. The task was performed in two conditions, one presenting a sample target simultaneously with the search array and the other imposing a delay between sample and array. Eye-movement data collected during search revealed that the duration of fixations to items varied with lure-target similarity for all participants, i.e., fixations were longer for items more similar to the target. In the simultaneous condition, patients and comparisons exhibited an equivalent effect of similarity on fixation durations. However, imposing a delay modulated the effect differently for the two groups: in comparisons, fixation duration to similar items was exaggerated; in patients, the original effect was diminished. These findings indicate that medial temporal lobe lesions subtly impair short-term maintenance of even simple stimuli, with performance reflecting not the complete loss of the maintained representation but rather a degradation or progressive drift of the representation over time.

  16. Adaptation to Cognitive Context and Item Information in the Medial Temporal Lobes

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    Diana, Rachel A.; Yonelinas, Andrew P.; Ranganath, Charan

    2012-01-01

    The medial temporal lobes (MTL) play an essential role in episodic memory, and accumulating evidence indicates that two MTL subregions--the perirhinal (PRc) and parahippocampal (PHc) cortices--might have different functions. According to the binding of item and context theory ( [16] and [21]), PRc is involved in processing item information, the…

  17. The relationship of medial temporal lobe epilepsy with the declarative memory system

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    Halász Péter

    2016-12-01

    Full Text Available Introduction. Medial temporal lobe of epilepsy (MTLE is considered as local/regional epilepsy. However, as was discussed in Part I of this review (Halász, 2016a there is more evidence regarding the involvement of both temporal lobes so as to consider MTLE as one of the typical bilateral system epilepsies.

  18. Recollection of episodic memory within the medial temporal lobe: behavioural dissociations from other types of memory.

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    Easton, Alexander; Eacott, Madeline J

    2010-12-31

    In recent years there has been significant debate about whether there is a single medial temporal lobe memory system or dissociable systems for episodic and other types of declarative memory. In addition there has been a similar debate over the dissociability of recollection and familiarity based processes in recognition memory. Here we present evidence from recent work using episodic memory tasks in animals that allows us to explore these issues in more depth. We review studies that demonstrate triple dissociations within the medial temporal lobe, with only the hippocampal system being necessary for episodic memory. Similarly we review behavioural evidence for a dissociation in a task of episodic memory in rats where animals with lesions of the fornix are only impaired at recollection of the episodic memory, not recognition within the same trial. This work, then, supports recent models of dissociable neural systems within the medial temporal lobe but also raises questions for future investigation about the interactions of these medial temporal lobe memory systems with other structures. Copyright © 2009 Elsevier B.V. All rights reserved.

  19. Regional activation of the human medial temporal lobe during intentional encoding of objects and positions

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    Ramsøy, Thomas Z.; Liptrot, Matthew G.; Skimminge, Arnold

    2009-01-01

    The medial temporal lobe (MTL) consists of several regions thought to be involved in learning and memory. However, the degree of functional specialization among these regions remains unclear. Previous studies have demonstrated effects of both content and processing stage, but findings have been i...

  20. Diabetes mellitus, hypertension and medial temporal lobe atrophy: the LADIS study

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    Korf, E S C; van Straaten, E C W; de Leeuw, F-E

    2007-01-01

    HYPOTHESIS: Based on recent findings on the association between vascular risk factors and hippocampal atrophy, we hypothesized that hypertension and diabetes mellitus (DM) are associated with medial temporal lobe atrophy (MTA) in subjects without disability, independent of the severity of white...... matter hyperintensities. METHODS: In the Leukoaraiosis And DISability in the elderly (LADIS) study, we investigated the relationships between DM, hypertension, blood pressure and MTA in 582 subjects, stratified by white matter hyperintensity severity, using multinomial logistic regression. MTA...... was visually scored for the left and right medial temporal lobe (score 0-4), and meaned. RESULTS: Mean age was 73.5 years (sd 5.1), 54% was female. Of the subjects, 15% had DM, and 70% had a history of hypertension. The likelihood of having MTA score 3 was significantly higher in subjects with DM (OR 2.9; 95...

  1. Episodic memory and the medial temporal lobe: not all it seems. Evidence from the temporal variants of frontotemporal dementia

    NARCIS (Netherlands)

    Pleizier, C.M.; van der Vlies, A.E.; Koedam, E.L.G.E.; Koene, T.; Barkhof, F.; van der Flier, W.M.; Scheltens, P.; Pijnenburg, Y.A.L.

    2012-01-01

    Background: Disproportionate medial temporal lobe atrophy (MTA) is an early finding in Alzheimer's disease (AD). Episodic memory impairment in AD is associated with the degree of MTA. Episodic memory impairment and MTA are also found in semantic dementia (SD) and in right temporal lobe atrophy

  2. Effects of Level of Retrieval Success on Recall-Related Frontal and Medial Temporal Lobe Activations

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    Daniela Montaldi

    2002-01-01

    Full Text Available Brain dedicated single photon emission computed tomography (SPECT was used to compare the neuroactivation produced by the cued recall of response words in a set of studied word pairs with that produced by the cued retrieval of words semantically related to unstudied stimulus words. Six of the 12 subjects scanned were extensively trained so as to have good memory of the studied pairs and the remaining six were minimally trained so as to have poor memory. When comparing episodic with semantic retrieval, the well-trained subjects showed significant left medial temporal lobe activation, which was also significantly greater than that shown by the poorly trained subjects, who failed to show significant medial temporal lobe activation. In contrast, the poorly trained subjects showed significant bilateral frontal lobe activation, which was significantly greater than that shown by the well-trained subjects who failed to show significant frontal lobe activation. The frontal activations occurred mainly in the dorsolateral region, but extended into the ventrolateral and, to a lesser extent, the frontal polar regions. It is argued that whereas the medial temporal lobe activation increased as the proportion of response words successfully recalled increased, the bilateral frontal lobe activation increased in proportion to retrieval effort, which was greater when learning had been less good.

  3. Towards a functional organization of episodic memory in the medial temporal lobe.

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    Eichenbaum, Howard; Sauvage, Magdalena; Fortin, Norbert; Komorowski, Robert; Lipton, Paul

    2012-08-01

    Here we describe a model of medial temporal lobe organization in which parallel "what" and "where" processing streams converge within the hippocampus to represent events in the spatio-temporal context in which they occurred; this circuitry also mediates the retrieval of context from event cues and vice versa, which are prototypes of episodic recall. Evidence from studies in animals are reviewed in support of this model, including experiments that distinguish characteristics of episodic recollection from familiarity, neuropsychological and recording studies that have identified a key role for the hippocampus in recollection and in associating events with the context in which they occurred, and distinct roles for parahippocampal region areas in separate "what" and "where" information processing that contributes to recollective and episodic memory. Copyright © 2011 Elsevier Ltd. All rights reserved.

  4. Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy

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    Morioka, Takato; Nishio, Shunji; Kawamura, Tadao; Fukui, Kimiko; Sasaki, Masayuki; Fukui, Masashi [Kyushu Univ., Fukuoka (Japan). Graduate School of Medical Sciences

    2001-06-01

    We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL. (author)

  5. Non-invasive examinations successfully select patients with medial temporal lobe epilepsy for anterior temporal lobectomy

    International Nuclear Information System (INIS)

    Morioka, Takato; Nishio, Shunji; Kawamura, Tadao; Fukui, Kimiko; Sasaki, Masayuki; Fukui, Masashi

    2001-01-01

    We retrospectively analyzed 8 patients with intractable medial temporal lobe epilepsy (MTLE) who underwent the anterior temporal lobectomy with hippocampectomy (ATL) without invasive examinations such as chronic subdural electrode recording. Five patients had a history of febrile convulsion. While all 8 patients had oral automatism, automatism of ipsilateral limbs with dystonic posture of contralateral limbs was demonstrated in 2 patients. Bilateral temporal paroxysmal activities on interictal EEG was observed in 4 patients and all patients had clear ictal onset zone on unilateral anterior temporal region. MRI demonstrated unilateral hippocampal sclerosis in 5 cases. Interictal FDG-PET depicted hypometabolism of the unilateral temporal lobe in all cases, however, ECD-SPECT failed to reveal the hypoperfusion of the unilateral temporal lobe in a case. Postoperatively, 7 cases became seizure free, and one had rare seizure. Non-invasive examinations, especially ictal EEG and concordant FDG-PET findings, in patients with oral automatism in seizure semiology, successfully select patients with MTLE for ATL. (author)

  6. Medial temporal lobe contributions to cued retrieval of items and contexts.

    Science.gov (United States)

    Hannula, Deborah E; Libby, Laura A; Yonelinas, Andrew P; Ranganath, Charan

    2013-10-01

    Several models have proposed that different regions of the medial temporal lobes contribute to different aspects of episodic memory. For instance, according to one view, the perirhinal cortex represents specific items, parahippocampal cortex represents information regarding the context in which these items were encountered, and the hippocampus represents item-context bindings. Here, we used event-related functional magnetic resonance imaging (fMRI) to test a specific prediction of this model-namely, that successful retrieval of items from context cues will elicit perirhinal recruitment and that successful retrieval of contexts from item cues will elicit parahippocampal cortex recruitment. Retrieval of the bound representation in either case was expected to elicit hippocampal engagement. To test these predictions, we had participants study several item-context pairs (i.e., pictures of objects and scenes, respectively), and then had them attempt to recall items from associated context cues and contexts from associated item cues during a scanned retrieval session. Results based on both univariate and multivariate analyses confirmed a role for hippocampus in content-general relational memory retrieval, and a role for parahippocampal cortex in successful retrieval of contexts from item cues. However, we also found that activity differences in perirhinal cortex were correlated with successful cued recall for both items and contexts. These findings provide partial support for the above predictions and are discussed with respect to several models of medial temporal lobe function. Copyright © 2013 Elsevier Ltd. All rights reserved.

  7. Medial Temporal Lobe Contributions to Cued Retrieval of Items and Contexts

    Science.gov (United States)

    Hannula, Deborah E.; Libby, Laura A.; Yonelinas, Andrew P.; Ranganath, Charan

    2013-01-01

    Several models have proposed that different regions of the medial temporal lobes contribute to different aspects of episodic memory. For instance, according to one view, the perirhinal cortex represents specific items, parahippocampal cortex represents information regarding the context in which these items were encountered, and the hippocampus represents item-context bindings. Here, we used event-related functional magnetic resonance imaging (fMRI) to test a specific prediction of this model – namely, that successful retrieval of items from context cues will elicit perirhinal recruitment and that successful retrieval of contexts from item cues will elicit parahippocampal cortex recruitment. Retrieval of the bound representation in either case was expected to elicit hippocampal engagement. To test these predictions, we had participants study several item-context pairs (i.e., pictures of objects and scenes, respectively), and then had them attempt to recall items from associated context cues and contexts from associated item cues during a scanned retrieval session. Results based on both univariate and multivariate analyses confirmed a role for hippocampus in content-general relational memory retrieval, and a role for parahippocampal cortex in successful retrieval of contexts from item cues. However, we also found that activity differences in perirhinal cortex were correlated with successful cued recall for both items and contexts. These findings provide partial support for the above predictions and are discussed with respect to several models of medial temporal lobe function. PMID:23466350

  8. The timing of associative memory formation: frontal lobe and anterior medial temporal lobe activity at associative binding predicts memory

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    Hales, J. B.

    2011-01-01

    The process of associating items encountered over time and across variable time delays is fundamental for creating memories in daily life, such as for stories and episodes. Forming associative memory for temporally discontiguous items involves medial temporal lobe structures and additional neocortical processing regions, including prefrontal cortex, parietal lobe, and lateral occipital regions. However, most prior memory studies, using concurrently presented stimuli, have failed to examine the temporal aspect of successful associative memory formation to identify when activity in these brain regions is predictive of associative memory formation. In the current study, functional MRI data were acquired while subjects were shown pairs of sequentially presented visual images with a fixed interitem delay within pairs. This design allowed the entire time course of the trial to be analyzed, starting from onset of the first item, across the 5.5-s delay period, and through offset of the second item. Subjects then completed a postscan recognition test for the items and associations they encoded during the scan and their confidence for each. After controlling for item-memory strength, we isolated brain regions selectively involved in associative encoding. Consistent with prior findings, increased regional activity predicting subsequent associative memory success was found in anterior medial temporal lobe regions of left perirhinal and entorhinal cortices and in left prefrontal cortex and lateral occipital regions. The temporal separation within each pair, however, allowed extension of these findings by isolating the timing of regional involvement, showing that increased response in these regions occurs during binding but not during maintenance. PMID:21248058

  9. Linking DMN connectivity to episodic memory capacity: What can we learn from patients with medial temporal lobe damage?

    Directory of Open Access Journals (Sweden)

    Cornelia McCormick

    2014-01-01

    Full Text Available Computational models predict that focal damage to the Default Mode Network (DMN causes widespread decreases and increases of functional DMN connectivity. How such alterations impact functioning in a specific cognitive domain such as episodic memory remains relatively unexplored. Here, we show in patients with unilateral medial temporal lobe epilepsy (mTLE that focal structural damage leads indeed to specific patterns of DMN functional connectivity alterations, specifically decreased connectivity between both medial temporal lobes (MTLs and the posterior part of the DMN and increased intrahemispheric anterior–posterior connectivity. Importantly, these patterns were associated with better and worse episodic memory capacity, respectively. These distinct patterns, shown here for the first time, suggest that a close dialogue between both MTLs and the posterior components of the DMN is required to fully express the extensive repertoire of episodic memory abilities.

  10. A functional MRI study of language networks in left medial temporal lobe epilepsy

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    Yu Aihong, E-mail: yuaihong163@tom.com [Department of Radiology, the 4th Medical College of Peking University, Beijing Jishuitan Hospital, Beijing 100035 (China); Wang Xiaoyi; Xu Guoqing [Beijing Normal University, State Key Laboratory of Cognitive Neuroscience and Learning, Beijing 100875 (China); Li Yongjie [Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Qin Wen; Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences (China); Wang, Yuping [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

    2011-11-15

    Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

  11. A functional MRI study of language networks in left medial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Yu Aihong; Wang Xiaoyi; Xu Guoqing; Li Yongjie; Qin Wen; Li Kuncheng; Wang, Yuping

    2011-01-01

    Purpose: The purpose of this study was to investigate the abnormality of language networks in left medial temporal lobe epilepsy (MTLE) using fMRI. Materials and methods: Eight patients with left MTLE and 15 healthy subjects were evaluated. An auditory semantic judgment (AJ) paradigm was used. The fMRI data were collected on a 3T MR system and analyzed by AFNI (analysis of functional neuroimages) to generate the activation map. Results: Behavioral data showed that the reaction time of the left MTLE patients was significantly longer than that of controls on the AJ task (t = -3.396, P < 0.05). The left MTLE patients also exhibited diffusively decreased activation in the AJ task. Right hemisphere dominance of Broca's and Wernicke's areas was demonstrated in left MTLE patients. Conclusions: Long-term activation of spikes in left MTLE patients results in language impairment, which is associated with an abnormality of the brain neural network.

  12. Integrating what and when across the primate medial temporal lobe.

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    Naya, Yuji; Suzuki, Wendy A

    2011-08-05

    Episodic memory or memory for the detailed events in our lives is critically dependent on structures of the medial temporal lobe (MTL). A fundamental component of episodic memory is memory for the temporal order of items within an episode. To understand the contribution of individual MTL structures to temporal-order memory, we recorded single-unit activity and local field potential from three MTL areas (hippocampus and entorhinal and perirhinal cortex) and visual area TE as monkeys performed a temporal-order memory task. Hippocampus provided incremental timing signals from one item presentation to the next, whereas perirhinal cortex signaled the conjunction of items and their relative temporal order. Thus, perirhinal cortex appeared to integrate timing information from hippocampus with item information from visual sensory area TE.

  13. Functional neuroimaging studies of episodic memory. Functional dissociation in the medial temporal lobe structures

    International Nuclear Information System (INIS)

    Tsukiura, Takashi

    2008-01-01

    Previous functional neuroimaging studies have demonstrated the critical role of the medial temporal lobe (MTL) regions in the encoding and retrieval of episodic memory. It has also been shown that an emotional factor in human memory enhances episodic encoding and retrieval. However, there is little evidence regarding the specific contribution of each MTL region to the relational, contextual, and emotional processes of episodic memory. The goal of this review article is to identify differential activation patterns of the processes between MTL regions. Results from functional neuroimaging studies of episodic memory show that the hippocampus is involved in encoding the relation between memory items, whereas the entorhinal and perirhinal cortices (anterior parahippocampal gyrus) contribute to the encoding of a single item. Additionally, the parahippocampal cortex (posterior parahippocampal gyrus) is selectively activated during the processing of contextual information of episodic memory. A similar pattern of functional dissociation is found in episodic memory retrieval. Functional neuroimaging has also shown that emotional information of episodic memory enhances amygdala-MTL correlations and that this enhancement is observed during both the encoding and retrieval of emotional memories. These findings from pervious neuroimaging studies suggest that different MTL regions could organize memory for personally experienced episodes via the 'relation' and 'context' factors of episodic memory, and that the emotional factor of episodes could modulate the functional organization in the MTL regions. (author)

  14. Differentiation of medial or lateral temporal lobe epilepsy by F-18-fluorodeoxyglucose positron emission tomography: comparative study with magnetic resonance imaging in 113 surgically and pathologically proven patients

    International Nuclear Information System (INIS)

    Lee, Dong Soo; Lee, Sang Kun; Chang, Ki Hyun; Chung, Chun Kee; Choi, Ki Young; Chung, June Key; Lee, Myung Chul

    1999-01-01

    As mesial temporal lobe epilepsy (TLE) shows hypometabolism of medial and lateral temporal lobe, we investigated whether symmetric uptake of F-18-FDG in medial temporal lobes can differentiate mesial from lateral TLE. In 113 patients (83 mesial TLE, 30 lateral TLE) who underwent anterior temporal lobectomy and/or corticectomy with good surgical outcome, we performed F-18-FDG PET and compared F-18-FDG uptake of medial and lateral temporal lobes. All the patients with mesial TLE had hippocampal sclerosis except one congenital abnormal hippocampus. Patients with lateral TLE revealed cerebromalacia, microdysgenesis, arteriovenous malformation, old contusion, and cortical dysplasia. Sensitivity of F-18-FDG PET and MR for mesial TLE was 84% (70/83) and 73% (62/83), respectively. Sensitivity of F-18-FDG PET and MR for lateral TLE was 90% (27/30) and 66% (20/30), respectively. Twelve patients were normal on F-18-FDG PET. 101 patients had hypometabolism of lateral temporal lobe. Among 88 patients who showed hypometabolism of medial temporal lobe as well as lateral temporal lobe, 70 were mesial TLE patients and 18 were lateral TLE on pathologic examination. Positive predictive value of medial temporal hypometabolism for mesial TLE was 80%. Among 13 patients who showed hypometabolism of only lateral temporal lobe, 4 were mesial TLE and 9 were lateral TLE. Positive predictive value of hypometabolism of lateral temporal lobe for the diagnosis of lateral TLE was 69% (9/ 13). Normal MR findings stood against medial TLE, whose negative predictive value was 66%. Lateral temporal lobe epilepsy should be suspected when there is decreased F-18-FDG uptake in lateral temporal lobe with normal uptake in medial temporal lobe

  15. Network Alterations Supporting Word Retrieval in Patients with Medial Temporal Lobe Epilepsy

    Science.gov (United States)

    Protzner, Andrea B.; McAndrews, Mary Pat

    2011-01-01

    Although the hippocampus is not considered a key structure in semantic memory, patients with medial-temporal lobe epilepsy (mTLE) have deficits in semantic access on some word retrieval tasks. We hypothesized that these deficits reflect the negative impact of focal epilepsy on remote cerebral structures. Thus, we expected that the networks that…

  16. Losing sight of the future: Impaired semantic prospection following medial temporal lobe lesions

    Science.gov (United States)

    Race, Elizabeth; Keane, Margaret M.; Verfaellie, Mieke

    2012-01-01

    The ability to imagine the future (prospection) relies on many of the same brain regions that support memory for the past. To date, scientific research has primarily focused on the neural substrates of episodic forms of prospection (mental simulation of spatiotemporally specific future events) whereas little is known about the neural substrates of semantic prospection (mental simulation of future nonpersonal facts). Of particular interest is the role of the medial temporal lobes, and specifically the hippocampus. While the hippocampus has been proposed to play a key role in episodic prospection, recent evidence suggests that it may not play a similar role in semantic prospection. To examine this possibility, amnesic patients with medial temporal lobe (MTL) lesions were asked to imagine future issues occurring in the public domain. The results showed that patients could list general semantic facts about the future, but when probed to elaborate, patients produced impoverished descriptions that lacked semantic detail. This impairment occurred despite intact performance on standard neuropsychological tests of semantic processing, and did not simply reflect deficits in narrative construction. The performance of a patient with damage limited to the hippocampus was similar to that of the remaining MTL patients and amnesic patients’ impaired elaboration of the semantic future correlated with their impaired elaboration of the semantic past. Together, these results provide novel evidence from MTL amnesia that memory and prospection are linked in the semantic domain and reveal that the medial temporal lobes play a critical role in the construction of detailed, multi-element semantic simulations. PMID:23197413

  17. Human amnesia and the medial temporal lobe illuminated by neuropsychological and neurohistological findings for patient E.P.

    Science.gov (United States)

    Insausti, Ricardo; Annese, Jacopo; Amaral, David G.; Squire, Larry R.

    2013-01-01

    We present neurohistological information for a case of bilateral, symmetrical damage to the medial temporal lobe and well-documented memory impairment. E.P. developed profound memory impairment at age 70 y and then was studied for 14 y He had no capacity for learning facts and events and had retrograde amnesia covering several decades. He also had a modest impairment of semantic knowledge. Neurohistological analysis revealed bilaterally symmetrical lesions of the medial temporal lobe that eliminated the temporal pole, the amygdala, the entorhinal cortex, the hippocampus, the perirhinal cortex, and rostral parahippocampal cortex. The lesion also extended laterally to involve the fusiform gyrus substantially. Last, the superior, inferior, and middle temporal gyri were atrophic, and subjacent white matter was gliotic. Several considerations indicate that E.P.’s severe memory impairment was caused by his medial temporal lesions, whereas his impaired semantic knowledge was caused by lateral temporal damage. His lateral temporal damage also may have contributed to his extensive retrograde amnesia. The findings illuminate the anatomical relationship between memory, perception, and semantic knowledge. PMID:23620517

  18. Usefulness of StereoEEG-based tailored surgery for medial temporal lobe epilepsy. Preliminary results in 11 patients.

    Science.gov (United States)

    Kubota, Yuichi; Ochiai, Taku; Hori, Tomokatsu; Kawamata, Takakazu

    2017-07-01

    Surgical options for medial temporal lobe epilepsy (MTLE) include anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SAH). Optimal criteria for choosing the appropriate surgical approach remain uncertain. This article reports 11 consecutive cases in which electrophysiological findings of stereoelectroencephalography (SEEG) were used to determine the optimal surgical approach. Eleven consecutive patients with MTLE underwent SEEG evaluation and were placed in either the medial or the medial+lateral group based on the findings. Patients in the medial group underwent SAH using the subtemporal approach, and patients in the medial+lateral group underwent SEEG-guided anterior temporal lobectomy. SEEG findings were also compared with other examinations including flumazenil (FMZ)-positron emission tomography (PET), fluorine-18 labeled fluorodeoxyglucose (FDG)-PET, and magnetoencephalography (MEG). Results were evaluated to determine which examinations most consistently identified the epileptogenic zone. Of the 11 cases, 4 patients were placed in the medial group, and 7 patients in the medial+lateral group. Of patients, 90.9% were classified in class I of the Engel Epilepsy Surgery Outcome Scale, while 72.7% were classified in class I by the International League Against Epilepsy (ILAE) system. Analyzed by group, 100% of the medial group experienced an Engel class I outcome in the medial group, compared to 85.7% in the medial+lateral group. SEEG findings were comparable with FDG-PET results (10 of 11, 91%). Tailored surgery guided by SEEG is an electrophysiologically feasible treatment for MTLE that can result in favorable outcomes. Although seizures are thought to originate in the medial temporal lobe in MTLE, it is important for involvement of the lateral temporal cortex to be also considered in some cases. Copyright © 2017. Published by Elsevier B.V.

  19. Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

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    M. Noulhiane

    2008-01-01

    Full Text Available This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task. Results revealed that the two patient groups (left and right temporal resection gave reduced sense of reliving (R responses and more familiarity (K responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness.

  20. Autonoetic Consciousness in Autobiographical Memories after Medial Temporal Lobe Resection

    Science.gov (United States)

    Noulhiane, M.; Piolino, P.; Hasboun, D.; Clemenceau, S.; Baulac, M.; Samson, S.

    2008-01-01

    This study aims to investigate autonoetic consciousness associated with episodic autobiographical memory in patients who had undergone unilateral medial temporal lobe resection for intractable epilepsy. Autonoetic consciousness, defined as the conscious feeling of mentally travelling back in time to relive a specific event, was assessed using the Remember/Know (R/K) paradigm across different time periods as proposed in the autobiographical memory task developed by Piolino et al. (TEMPau task). Results revealed that the two patient groups (left and right temporal resection) gave reduced sense of reliving (R) responses and more familiarity (K) responses than healthy controls. This poor autonoetic consciousness was highlighted when patients were asked to justify their Remember responses by recalling sensory-perceptive, affective or spatiotemporal specific details across all life periods. These results support the bilateral MTL contribution to episodic autobiographical memory covering the entire lifespan, which is consistent with the multiple trace theory of MTL function [7,9]. This study also demonstrates the bilateral involvement of MTL structures in recalling specific details of personal events characterized by autonoetic consciousness. PMID:18413911

  1. The Role of Medial Temporal Lobe Regions in Incidental and Intentional Retrieval of Item and Relational Information in Aging.

    Science.gov (United States)

    Wang, Wei-Chun; Giovanello, Kelly S

    2016-06-01

    Considerable neuropsychological and neuroimaging work indicates that the medial temporal lobes are critical for both item and relational memory retrieval. However, there remain outstanding issues in the literature, namely the extent to which medial temporal lobe regions are differentially recruited during incidental and intentional retrieval of item and relational information, and the extent to which aging may affect these neural substrates. The current fMRI study sought to address these questions; participants incidentally encoded word pairs embedded in sentences and incidental item and relational retrieval were assessed through speeded reading of intact, rearranged, and new word-pair sentences, while intentional item and relational retrieval were assessed through old/new associative recognition of a separate set of intact, rearranged, and new word pairs. Results indicated that, in both younger and older adults, anterior hippocampus and perirhinal cortex indexed incidental and intentional item retrieval in the same manner. In contrast, posterior hippocampus supported incidental and intentional relational retrieval in both age groups and an adjacent cluster in posterior hippocampus was recruited during both forms of relational retrieval for older, but not younger, adults. Our findings suggest that while medial temporal lobe regions do not differentiate between incidental and intentional forms of retrieval, there are distinct roles for anterior and posterior medial temporal lobe regions during retrieval of item and relational information, respectively, and further indicate that posterior regions may, under certain conditions, be over-recruited in healthy aging. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  2. Whole-brain voxel-based morphometry of white matter in medial temporal lobe epilepsy

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    Yu Aihong [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China); Li Kuncheng [Department of Radiology, Xuanwu Hospital, Capital University of Medical Sciences, Beijing 100053 (China)], E-mail: Likuncheng@vip.sina.com; Li Lin; Shan Baoci [Institute of High Energy Physics, Chinese Academy of Sciences (China); Wang Yuping; Xue Sufang [Department of Neurology, Xuanwu Hospital, Capital University of Medical Sciences (China)

    2008-01-15

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods: We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion: VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE.

  3. Whole-brain voxel-based morphometry of white matter in medial temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Yu Aihong; Li Kuncheng; Li Lin; Shan Baoci; Wang Yuping; Xue Sufang

    2008-01-01

    Purpose: The purpose of this study was to analyze whole-brain white matter changes in medial temporal lobe epilepsy (MTLE). Materials and methods: We studied 23 patients with MTLE and 13 age- and sex-matched healthy control subjects using voxel-based morphometry (VBM) on T1-weighted 3D datasets. The seizure focus was right sided in 11 patients and left sided in 12. The data were collected on a 1.5 T MR system and analyzed by SPM 99 to generate white matter density maps. Results: Voxel-based morphometry revealed diffusively reduced white matter in MTLE prominently including bilateral frontal lobes, bilateral temporal lobes and corpus callosum. White matter reduction was also found in the bilateral cerebellar hemispheres in the left MTLE group. Conclusion: VBM is a simple and automated approach that is able to identify diffuse whole-brain white matter reduction in MTLE

  4. Age-related functional changes in domain-specific medial temporal lobe pathways.

    Science.gov (United States)

    Berron, David; Neumann, Katja; Maass, Anne; Schütze, Hartmut; Fliessbach, Klaus; Kiven, Verena; Jessen, Frank; Sauvage, Magdalena; Kumaran, Dharshan; Düzel, Emrah

    2018-05-01

    There is now converging evidence from studies in animals and humans that the medial temporal lobes (MTLs) harbor anatomically distinct processing pathways for object and scene information. Recent functional magnetic resonance imaging studies in humans suggest that this domain-specific organization may be associated with a functional preference of the anterior-lateral part of the entorhinal cortex (alErC) for objects and the posterior-medial entorhinal cortex (pmErC) for scenes. As MTL subregions are differentially affected by aging and neurodegenerative diseases, the question was raised whether aging may affect the 2 pathways differentially. To address this possibility, we developed a paradigm that allows the investigation of object memory and scene memory in a mnemonic discrimination task. A group of young (n = 43) and healthy older subjects (n = 44) underwent functional magnetic resonance imaging recordings during this novel task, while they were asked to discriminate exact repetitions of object and scene stimuli from novel stimuli that were similar but modified versions of the original stimuli ("lures"). We used structural magnetic resonance images to manually segment anatomical components of the MTL including alErC and pmErC and used these segmented regions to analyze domain specificity of functional activity. Across the entire sample, object processing was associated with activation of the perirhinal cortex (PrC) and alErC, whereas for scene processing, activation was more predominant in the parahippocampal cortex and pmErC. Functional activity related to mnemonic discrimination of object and scene lures from exact repetitions was found to overlap between processing pathways and suggests that while the PrC-alErC pathway was more involved in object discrimination, both pathways were involved in the discrimination of similar scenes. Older adults were behaviorally less accurate than young adults in discriminating similar lures from exact repetitions, but this

  5. SPHENOID SINUS (SS ANTERIOR MEDIAL TEMPORAL LOBE ENCEPHALOCELE (AMTLE WITH SPONTANEOUS CSF RHINORRHOEA : A CASE REPORT

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    Laveena

    2015-09-01

    Full Text Available Cranial encephaloceles are the herniation of intracranial meninges and brain tissue through a defect in the cranium or skull base. These are rare conditions with an incidence of approximately 1 in 35,000 people, and are more common in the anterior cranial fossa than those in the middle one . 1,2 Temporal lobe herniation through a mid dle fossa defect into the lateral recess of the Sphenoid Sinus is even rarer than its medial representation. Intrasphenoidal encephaloceles are extremely rare findings 3 . Spontaneous, or primary, CSF fistula is a separate entity with no underlying cause of the CSF leak. Spontaneous CSF leaks are usually associated with a co - existing encephalocele of variable size 4 . We present a case of spontaneous CSF rhinorrhoea in a sphenoid sinus Anterior Medial Temporal lobe encephalocele herniating through a clinically silent lateral Craniopharyngeal canal.

  6. Episodic reinstatement in the medial temporal lobe.

    Science.gov (United States)

    Staresina, Bernhard P; Henson, Richard N A; Kriegeskorte, Nikolaus; Alink, Arjen

    2012-12-12

    The essence of episodic memory is our ability to reexperience past events in great detail, even in the absence of external stimulus cues. Does the phenomenological reinstatement of past experiences go along with reinstating unique neural representations in the brain? And if so, how is this accomplished by the medial temporal lobe (MTL), a brain region intimately linked to episodic memory? Computational models suggest that such reinstatement (also termed "pattern completion") in cortical regions is mediated by the hippocampus, a key region of the MTL. Although recent functional magnetic resonance imaging studies demonstrated reinstatement of coarse item properties like stimulus category or task context across different brain regions, it has not yet been shown whether reinstatement can be observed at the level of individual, discrete events-arguably the defining feature of episodic memory-nor whether MTL structures like the hippocampus support this "true episodic" reinstatement. Here we show that neural activity patterns for unique word-scene combinations encountered during encoding are reinstated in human parahippocampal cortex (PhC) during retrieval. Critically, this reinstatement occurs when word-scene combinations are successfully recollected (even though the original scene is not visually presented) and does not encompass other stimulus domains (such as word-color associations). Finally, the degree of PhC reinstatement across retrieval events correlated with hippocampal activity, consistent with a role of the hippocampus in coordinating pattern completion in cortical regions.

  7. Associative learning beyond the medial temporal lobe: many actors on the memory stage

    Directory of Open Access Journals (Sweden)

    Giulio ePergola

    2013-11-01

    Full Text Available Decades of research have established a model that includes the medial temporal lobe, and particularly the hippocampus, as a critical node for episodic memory. Neuroimaging and clinical studies have shown the involvement of additional cortical and subcortical regions. Among these areas, the thalamus, the retrosplenial cortex and the prefrontal cortices have been consistently related to episodic memory performance.This article provides evidences that these areas are in different forms and degrees critical for human memory function rather than playing only an ancillary role. First we briefly summarize findings on the involvement of the hippocampus and the medial temporal lobe in recognition memory and recall. We then focus on the clinical and neuroimaging evidence available on thalamo-frontal and thalamo-retrosplenial networks. The role of these networks in episodic memory has been considered secondary, partly because disruption of these areas does not always lead to severe impairments; to account for this evidence, we discuss methodological issues related to the investigation of these regions. We propose that these networks contribute differently to recognition memory and recall, and also that the memory stage of their contribution shows specificity to encoding or retrieval in recall tasks. We note that the same mechanisms may be in force when humans perform non-episodic tasks, e.g., semantic retrieval and mental time travel. Functional disturbance of these networks is related to cognitive impairments not only in neurological disorders, but also in psychiatric medical conditions, such as schizophrenia. Finally we discuss possible mechanisms for the contribution of these areas to memory, including regulation of oscillatory rhythms and long-term potentiation. We conclude that integrity of the thalamo-frontal and the thalamo-retrosplenial networks is necessary for the manifold features of episodic memory.

  8. Resection of the medial temporal lobe disconnects the rostral superior temporal gyrus from some of its projection targets in the frontal lobe and thalamus.

    Science.gov (United States)

    Muñoz, Monica; Mishkin, Mortimer; Saunders, Richard C

    2009-09-01

    Auditory memory in the monkey does not appear to extend beyond the limits of working memory. It is therefore surprising that this ability is impaired by medial temporal lobe (MTL) resections, because such lesions spare working memory in other sensory modalities. To determine whether MTL ablations might have caused the auditory deficit through inadvertent transection of superior temporal gyrus (STG) projections to its downstream targets, and, if so, which targets might have been compromised, we injected anterograde tracer (biotinylated dextran amine) in the STG of both the normal and MTL-lesioned hemispheres of split-brain monkeys. Interhemispheric comparison of label failed to show any effect of the MTL ablation on efferents from caudal STG, which projects to the inferior prefrontal convexity. However, the ablation did consistently interrupt the normally dense projections from rostral STG to both the ventral medial prefrontal cortex and medial thalamic nuclei. The findings support the possibility that the auditory working memory deficit after MTL ablation is due to transection of downstream auditory projections, and indicate that the candidate structures for mediating auditory working memory are the ventral medial prefrontal cortical areas, the medial thalamus, or both.

  9. Deep processing activates the medial temporal lobe in young but not in old adults.

    Science.gov (United States)

    Daselaar, Sander M; Veltman, Dick J; Rombouts, Serge A R B; Raaijmakers, Jeroen G W; Jonker, Cees

    2003-11-01

    Age-related impairments in episodic memory have been related to a deficiency in semantic processing, based on the finding that elderly adults typically benefit less than young adults from deep, semantic as opposed to shallow, nonsemantic processing of study items. In the present study, we tested the hypothesis that elderly adults are not able to perform certain cognitive operations under deep processing conditions. We further hypothesised that this inability does not involve regions commonly associated with lexical/semantic retrieval processes, but rather involves a dysfunction of the medial temporal lobe (MTL) memory system. To this end, we used functional MRI on rather extensive groups of young and elderly adults to compare brain activity patterns obtained during a deep (living/nonliving) and a shallow (uppercase/lowercase) classification task. Common activity in relation to semantic classification was observed in regions that have been previously related to semantic retrieval, including mainly left-lateralised activity in the inferior prefrontal, middle temporal, and middle frontal/anterior cingulate gyrus. Although the young adults showed more activity in some of these areas, the finding of mainly overlapping activation patterns during semantic classification supports the idea that lexical/semantic retrieval processes are still intact in elderly adults. This received further support by the finding that both groups showed similar behavioural performances as well on the deep and shallow classification tasks. Importantly, though, the young revealed significantly more activity than the elderly adults in the left anterior hippocampus during deep relative to shallow classification. This finding is in line with the idea that age-related impairments in episodic encoding are, at least partly, due to an under-recruitment of the medial temporal lobe memory system.

  10. Thalamo-Cortical Disruption Contributes to Short-Term Memory Deficits in Patients with Medial Temporal Lobe Damage.

    Science.gov (United States)

    Voets, Natalie L; Menke, Ricarda A L; Jbabdi, Saad; Husain, Masud; Stacey, Richard; Carpenter, Katherine; Adcock, Jane E

    2015-11-01

    Short-term (STM) and long-term memory (LTM) have largely been considered as separate brain systems reflecting fronto-parietal and medial temporal lobe (MTL) functions, respectively. This functional dichotomy has been called into question by evidence of deficits on aspects of working memory in patients with MTL damage, suggesting a potentially direct hippocampal contribution to STM. As the hippocampus has direct anatomical connections with the thalamus, we tested the hypothesis that damage to thalamic nuclei regulating cortico-cortical interactions may contribute to STM deficits in patients with hippocampal dysfunction. We used diffusion-weighted magnetic resonance imaging-based tractography to identify anatomical subdivisions in patients with MTL epilepsy. From these, we measured resting-state functional connectivity with detailed cortical divisions of the frontal, temporal, and parietal lobes. Whereas thalamo-temporal functional connectivity reflected LTM performance, thalamo-prefrontal functional connectivity specifically predicted STM performance. Notably, patients with hippocampal volume loss showed thalamic volume loss, most prominent in the pulvinar region, not detected in patients with normal hippocampal volumes. Aberrant thalamo-cortical connectivity in the epileptic hemisphere was mirrored in a loss of behavioral association with STM performance specifically in patients with hippocampal atrophy. These findings identify thalamo-cortical disruption as a potential mechanism contributing to STM deficits in the context of MTL damage. © The Author 2015. Published by Oxford University Press.

  11. Task activation and functional connectivity show concordant memory laterality in temporal lobe epilepsy.

    Science.gov (United States)

    Sideman, Noah; Chaitanya, Ganne; He, Xiaosong; Doucet, Gaelle; Kim, Na Young; Sperling, Michael R; Sharan, Ashwini D; Tracy, Joseph I

    2018-04-01

    In epilepsy, asymmetries in the organization of mesial temporal lobe (MTL) functions help determine the cognitive risk associated with procedures such as anterior temporal lobectomy. Past studies have investigated the change/shift in a visual episodic memory laterality index (LI) in mesial temporal lobe structures through functional magnetic resonance imaging (fMRI) task activations. Here, we examine whether underlying task-related functional connectivity (FC) is concordant with such standard fMRI laterality measures. A total of 56 patients with temporal lobe epilepsy (TLE) (Left TLE [LTLE]: 31; Right TLE [RTLE]: 25) and 34 matched healthy controls (HC) underwent fMRI scanning during performance of a scene encoding task (SET). We assessed an activation-based LI of the hippocampal gyrus (HG) and parahippocampal gyrus (PHG) during the SET and its correspondence with task-related FC measures. Analyses involving the HG and PHG showed that the patients with LTLE had a consistently higher LI (right-lateralized) than that of the HC and group with RTLE, indicating functional reorganization. The patients with RTLE did not display a reliable contralateral shift away from the pathology, with the mesial structures showing quite distinct laterality patterns (HG, no laterality bias; PHG, no evidence of LI shift). The FC data for the group with LTLE provided confirmation of reorganization effects, revealing that a rightward task LI may be based on underlying connections between several left-sided regions (middle/superior occipital and left medial frontal gyri) and the right PHG. The FCs between the right HG and left anterior cingulate/medial frontal gyri were also observed in LTLE. Importantly, the data demonstrate that the areas involved in the LTLE task activation shift to the right hemisphere showed a corresponding increase in task-related FCs between the hemispheres. Altered laterality patterns based on mesial temporal lobe epilepsy (MTLE) pathology manifest as several

  12. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    International Nuclear Information System (INIS)

    Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo

    2004-01-01

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones

  13. Voxel-based morphometry (VBM) based assessment of gray matter loss in medial temporal lobe epilepsy; comparison with FDG PET

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Hye Jin; Lee, Ho Young; Lee, Jae Sung; Kang, Eun Joo; Lee, Sang Gun; Chang, Kee Hyun; Lee, Dong Soo [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-02-01

    The aims of this study were to find brain regions in which gray matter volume was reduced and to show the capability of voxel-based morphometry (VBM) analysis for lateralizing epileptogenic zones in medial temporal lobe epilepsy (mTLE). The findings were compared with fluorodeoxyglucose positron emission tomography (FDG PET). MR T1-weighted images of 12 left mTLE and 11 right mTLE patients were compared with those of 37 normal controls. Images were transformed to standard MNI space and averaged in order to create study-specific brain template. Each image was normalized to this local template and brain tissues were segmented. Modulation VBM analysis was performed in order to observe gray matter volume change. Gray matter was smoothed with a Gaussian kernel. After these preprocessing, statistical analysis was performed using statistical parametric mapping software (SPM99). FDG PET images were compared with those of 22 normal controls using SPM. Gray matter volume was significantly reduced in the left amygdala and hippocampus in left mTLE. In addition, volume of cerebellum, anterior cingulate, and fusiform gyrus in both sides and left insula was reduced. In right mTLE, volume was reduced significantly in right hippocampus. In contrast, FDG uptake was decreased in broad areas of left or right temporal lobes in left TLE and right TLE, respectively. Gray matter loss was found in the ipsilateral hippocampus by modulation VBM analysis in medial temporal lobe epilepsy. This VBM analysis might be useful in lateralizing the epileptogenic zones in medial temporal lobe epilepsy, while SPM analysis of FDG PET disclosed hypometabolic epileptogenic zones.

  14. Quantitative Evaluation of Medial Temporal Lobe Morphology in Children with Febrile Status Epilepticus: Results of the FEBSTAT Study.

    Science.gov (United States)

    McClelland, A C; Gomes, W A; Shinnar, S; Hesdorffer, D C; Bagiella, E; Lewis, D V; Bello, J A; Chan, S; MacFall, J; Chen, M; Pellock, J M; Nordli, D R; Frank, L M; Moshé, S L; Shinnar, R C; Sun, S

    2016-12-01

    The pathogenesis of febrile status epilepticus is poorly understood, but prior studies have suggested an association with temporal lobe abnormalities, including hippocampal malrotation. We used a quantitative morphometric method to assess the association between temporal lobe morphology and febrile status epilepticus. Brain MR imaging was performed in children presenting with febrile status epilepticus and control subjects as part of the Consequences of Prolonged Febrile Seizures in Childhood study. Medial temporal lobe morphologic parameters were measured manually, including the distance of the hippocampus from the midline, hippocampal height:width ratio, hippocampal angle, collateral sulcus angle, and width of the temporal horn. Temporal lobe morphologic parameters were correlated with the presence of visual hippocampal malrotation; the strongest association was with left temporal horn width (P status epilepticus, encompassing both the right and left sides. This association was statistically strongest in the right temporal lobe, whereas hippocampal malrotation was almost exclusively left-sided in this cohort. The association between temporal lobe measurements and febrile status epilepticus persisted when the analysis was restricted to cases with visually normal imaging findings without hippocampal malrotation or other visually apparent abnormalities. Several component morphologic features of hippocampal malrotation are independently associated with febrile status epilepticus, even when complete hippocampal malrotation is absent. Unexpectedly, this association predominantly involves the right temporal lobe. These findings suggest that a spectrum of bilateral temporal lobe anomalies are associated with febrile status epilepticus in children. Hippocampal malrotation may represent a visually apparent subset of this spectrum. © 2016 by American Journal of Neuroradiology.

  15. Close but no cigar: Spatial precision deficits following medial temporal lobe lesions provide novel insight into theoretical models of navigation and memory.

    Science.gov (United States)

    Kolarik, Branden S; Baer, Trevor; Shahlaie, Kiarash; Yonelinas, Andrew P; Ekstrom, Arne D

    2018-01-01

    Increasing evidence suggests that the human hippocampus contributes to a range of different behaviors, including episodic memory, language, short-term memory, and navigation. A novel theoretical framework, the Precision and Binding Model, accounts for these phenomenon by describing a role for the hippocampus in high-resolution, complex binding. Other theories like Cognitive Map Theory, in contrast, predict a specific role for the hippocampus in allocentric navigation, while Declarative Memory Theory predicts a specific role in delay-dependent conscious memory. Navigation provides a unique venue for testing these predictions, with past results from research with humans providing inconsistent findings regarding the role of the human hippocampus in spatial navigation. Here, we tested five patients with lesions primarily restricted to the hippocampus and those extending out into the surrounding medial temporal lobe cortex on a virtual water maze task. Consistent with the Precision and Binding Model, we found partially intact allocentric memory in all patients, with impairments in the spatial precision of their searches for a hidden target. We found similar impairments at both immediate and delayed testing. Our findings are consistent with the Precision and Binding Model of hippocampal function, arguing for its role across domains in high-resolution, complex binding. Remembering goal locations in one's environment is a critical skill for survival. How this information is represented in the brain is still not fully understood, but is believed to rely in some capacity on structures in the medial temporal lobe. Contradictory findings from studies of both humans and animals have been difficult to reconcile with regard to the role of the MTL, specifically the hippocampus. By assessing impairments observed during navigation to a goal in patients with medial temporal lobe damage we can better understand the role these structures play in such behavior. Utilizing virtual reality

  16. Working memory, long-term memory, and medial temporal lobe function

    Science.gov (United States)

    Jeneson, Annette; Squire, Larry R.

    2012-01-01

    Early studies of memory-impaired patients with medial temporal lobe (MTL) damage led to the view that the hippocampus and related MTL structures are involved in the formation of long-term memory and that immediate memory and working memory are independent of these structures. This traditional idea has recently been revisited. Impaired performance in patients with MTL lesions on tasks with short retention intervals, or no retention interval, and neuroimaging findings with similar tasks have been interpreted to mean that the MTL is sometimes needed for working memory and possibly even for visual perception itself. We present a reappraisal of this interpretation. Our main conclusion is that, if the material to be learned exceeds working memory capacity, if the material is difficult to rehearse, or if attention is diverted, performance depends on long-term memory even when the retention interval is brief. This fundamental notion is better captured by the terms subspan memory and supraspan memory than by the terms short-term memory and long-term memory. We propose methods for determining when performance on short-delay tasks must depend on long-term (supraspan) memory and suggest that MTL lesions impair performance only when immediate memory and working memory are insufficient to support performance. In neuroimaging studies, MTL activity during encoding is influenced by the memory load and correlates positively with long-term retention of the material that was presented. The most parsimonious and consistent interpretation of all the data is that subspan memoranda are supported by immediate memory and working memory and are independent of the MTL. PMID:22180053

  17. Effects of medial temporal lobe degeneration on brain perfusion in amnestic MCI of AD type: deafferentation and functional compensation?

    International Nuclear Information System (INIS)

    Guedj, Eric; Barbeau, Emmanuel J.; Didic, Mira; Poncet, Michel; Ceccaldi, Mathieu; Felician, Olivier; Laforte, Catherine de; Mundler, Olivier; Ranjeva, Jean-Philippe; Cozzone, Patrick J.

    2009-01-01

    Cortical atrophy is correlated with the progression of neuropathological lesions within the medial temporal lobes (MTL) in Alzheimer's disease (AD). Our aim was to determine which local and remote functional changes result from MTL volume loss at the predementia stage. We studied the relationship between entorhinal and hippocampal MR volumes and whole-brain SPECT perfusion via a voxel-based correlative analysis in 19 patients with amnestic mild cognitive impairment with a memory profile suggestive of early AD. Right MTL volumes were positively correlated with remote posterior perfusion of the posterior cingulate cortex, and negatively correlated with remote anterior perfusion of the right medial and dorsolateral prefrontal cortex. There was no local correlation between volumes and perfusion within the MTL. These findings provide further insight into functional changes that result from MTL volume loss during the predementia stage of AD. The positive correlation between MTL volumes and posterior cingulate perfusion may reflect the deafferentation of a temporocingulate network due to mediotemporal degeneration. The paradoxical negative correlation between MTL volumes and prefrontal perfusion may result from recruitment of an alternative anterior temporofrontal network. It remains to be investigated how the ''net sum'' of this perfusion modulation affects memory and other cognitive domains through a possible compensatory perspective. (orig.)

  18. Effects of medial temporal lobe degeneration on brain perfusion in amnestic MCI of AD type: deafferentation and functional compensation?

    Energy Technology Data Exchange (ETDEWEB)

    Guedj, Eric [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR CNRS 6612, Faculte de Medecine, Marseille (France); Barbeau, Emmanuel J. [CNRS - Universite Paul Sabatier Toulouse 3, Centre de Recherche Cerveau et Cognition, UMR-5549, Toulouse (France); Didic, Mira; Poncet, Michel; Ceccaldi, Mathieu [CHU Timone, Service de Neurologie et de Neuropsychologie, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Felician, Olivier [CHU Timone, Service de Neurologie et de Neuropsychologie, Marseille (France); Universite de la Mediterranee Aix-Marseille II, Laboratoire de Neurophysiologie et Neuropsychologie, Inserm U751, Faculte de Medecine, Marseille (France); Centre Saint-Charles, Laboratoire de Neurobiologie Integrative et Adaptative, UMR CNRS 6149, Marseille (France); Laforte, Catherine de; Mundler, Olivier [Centre Hospitalo-Universitaire de la Timone, Service Central de Biophysique et de Medecine Nucleaire, Marseille Cedex 5 (France); Ranjeva, Jean-Philippe; Cozzone, Patrick J. [Universite de la Mediterranee Aix-Marseille II, Centre de Resonance Magnetique Biologique et Medicale (CRMBM), UMR CNRS 6612, Faculte de Medecine, Marseille (France)

    2009-07-15

    Cortical atrophy is correlated with the progression of neuropathological lesions within the medial temporal lobes (MTL) in Alzheimer's disease (AD). Our aim was to determine which local and remote functional changes result from MTL volume loss at the predementia stage. We studied the relationship between entorhinal and hippocampal MR volumes and whole-brain SPECT perfusion via a voxel-based correlative analysis in 19 patients with amnestic mild cognitive impairment with a memory profile suggestive of early AD. Right MTL volumes were positively correlated with remote posterior perfusion of the posterior cingulate cortex, and negatively correlated with remote anterior perfusion of the right medial and dorsolateral prefrontal cortex. There was no local correlation between volumes and perfusion within the MTL. These findings provide further insight into functional changes that result from MTL volume loss during the predementia stage of AD. The positive correlation between MTL volumes and posterior cingulate perfusion may reflect the deafferentation of a temporocingulate network due to mediotemporal degeneration. The paradoxical negative correlation between MTL volumes and prefrontal perfusion may result from recruitment of an alternative anterior temporofrontal network. It remains to be investigated how the ''net sum'' of this perfusion modulation affects memory and other cognitive domains through a possible compensatory perspective. (orig.)

  19. Aberrant Wnt signaling pathway in medial temporal lobe structures of Alzheimer's disease

    DEFF Research Database (Denmark)

    Riise, Jesper; Plath, Niels; Pakkenberg, Bente

    2015-01-01

    alterations of the intracellular Wnt pathway signaling components β-catenin, Gsk3β and Tcf7l1/Tcf3 and the phosphorylation state of β-catenin and Gsk3β in the hippocampus suggestive of a link between AD and aberrant canonical activity. Alterations in Gsk3β co-appeared with hippocampal kinase...... on isolated Wnt pathway components. Here, we provide the first comprehensive pathway-focused evaluation of the Wnt pathway in the entorhinal cortex and hippocampus of AD brains. Our data demonstrate altered Wnt pathway gene expression at all levels of the pathway in both medial temporal lobe regions...

  20. Correlation between hippocampal volumes and medial temporal lobe atrophy in patients with Alzheimer's disease

    OpenAIRE

    Dhikav, Vikas; Duraiswamy, Sharmila; Anand, Kuljeet Singh

    2017-01-01

    Introduction: Hippocampus undergoes atrophy in patients with Alzheimer's disease (AD). Calculation of hippocampal volumes can be done by a variety of methods using T1-weighted images of magnetic resonance imaging (MRI) of the brain. Medial temporal lobes atrophy (MTL) can be rated visually using T1-weighted MRI brain images. The present study was done to see if any correlation existed between hippocampal volumes and visual rating scores of the MTL using Scheltens Visual Rating Method. Materia...

  1. Contributions of Medial Temporal Lobe and Striatal Memory Systems to Learning and Retrieving Overlapping Spatial Memories

    Science.gov (United States)

    Brown, Thackery I.; Stern, Chantal E.

    2014-01-01

    Many life experiences share information with other memories. In order to make decisions based on overlapping memories, we need to distinguish between experiences to determine the appropriate behavior for the current situation. Previous work suggests that the medial temporal lobe (MTL) and medial caudate interact to support the retrieval of overlapping navigational memories in different contexts. The present study used functional magnetic resonance imaging (fMRI) in humans to test the prediction that the MTL and medial caudate play complementary roles in learning novel mazes that cross paths with, and must be distinguished from, previously learned routes. During fMRI scanning, participants navigated virtual routes that were well learned from prior training while also learning new mazes. Critically, some routes learned during scanning shared hallways with those learned during pre-scan training. Overlap between mazes required participants to use contextual cues to select between alternative behaviors. Results demonstrated parahippocampal cortex activity specific for novel spatial cues that distinguish between overlapping routes. The hippocampus and medial caudate were active for learning overlapping spatial memories, and increased their activity for previously learned routes when they became context dependent. Our findings provide novel evidence that the MTL and medial caudate play complementary roles in the learning, updating, and execution of context-dependent navigational behaviors. PMID:23448868

  2. Feasibility of the Medial Temporal lobe Atrophy index (MTAi and derived methods for measuring atrophy of the medial temporal lobe

    Directory of Open Access Journals (Sweden)

    Francisco eConejo Bayón

    2014-11-01

    Full Text Available Introduction: the Medial Temporal-lobe Atrophy index (MTAi, 2D-Medial Temporal Atrophy (2D-MTA, yearly rate of MTA (yrRMTA and yearly rate of relative MTA (yrRMTA are simple protocols for measuring the relative extent of atrophy in the MTL in relation to the global brain atrophy. Albeit preliminary studies showed interest of these methods in the diagnosis of AD, FTLD and correlation with cognitive impairment in PD, formal feasibility and validity studies remained pending. As a first step, we aimed to assess the feasibility. Mainly, we aimed to assess the reproducibility of measuring the areas needed to compute these indices. We also aimed to assess the efforts needed to start using these methods correctly. Methods: a series of 290 1.5T-MRI studies from 230 subjects ranging 65-85 years old who had been studied for cognitive impairment were used in this study. Six inexperienced tracers (IT plus one experienced tracer (ET traced the three areas needed to compute the indices. Finally, tracers underwent a short survey on their experience learning to compute the MTAi and experience of usage, including items relative to training time needed to understand and apply the MTAi, time to perform a study after training and overall satisfaction. Results: learning to trace the areas needed to compute the MTAi and derived methods is quick and easy. Results indicate very good intrarater ICC for the MTAi, good intrarater ICC for the 2D-MTA, yrMTA and yrRMTA and also good interrater ICC for the MTAi, 2D-MTA, yrMTA and yrRMTA.Conclusion: our data support that MTAi and derived methods (2D-MTA, yrMTA and yrRTMA have good to very good intrarater and interrater reproducibility and may be easily implemented in clinical practice even if new users have no experience tracing the area of regions of interest.

  3. Tau and β-Amyloid Are Associated with Medial Temporal Lobe Structure, Function, and Memory Encoding in Normal Aging

    Energy Technology Data Exchange (ETDEWEB)

    Marks, Shawn M. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Lockhart, Samuel N. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Baker, Suzanne L. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Molecular Biophysics and Integrated Bioimaging; Jagust, William J. [Univ. of California, Berkeley, CA (United States). Helen Wills Neuroscience Inst.; Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Molecular Biophysics and Integrated Bioimaging

    2017-03-22

    Normal aging is associated with a decline in episodic memory and also with aggregation of the β-amyloid (Aβ) and tau proteins and atrophy of medial temporal lobe (MTL) structures crucial to memory formation. Although some evidence suggests that Aβ is associated with aberrant neural activity, the relationships among these two aggregated proteins, neural function, and brain structure are poorly understood. Using in vivo human Aβ and tau imaging, we demonstrate that increased Aβ and tau are both associated with aberrant fMRI activity in the MTL during memory encoding in cognitively normal older adults. This pathological neural activity was in turn associated with worse memory performance and atrophy within the MTL. A mediation analysis revealed that the relationship with regional atrophy was explained by MTL tau. These findings broaden the concept of cognitive aging to include evidence of Alzheimer’s disease-related protein aggregation as an underlying mechanism of age-related memory impairment.

  4. Going beyond LTM in the MTL: A Synthesis of Neuropsychological and Neuroimaging Findings on the Role of the Medial Temporal Lobe in Memory and Perception

    Science.gov (United States)

    Graham, Kim S.; Barense, Morgan D.; Lee, Andy C. H.

    2010-01-01

    Studies in rats and non-human primates suggest that medial temporal lobe (MTL) structures play a role in perceptual processing, with the hippocampus necessary for spatial discrimination, and the perirhinal cortex for object discrimination. Until recently, there was little convergent evidence for analogous functional specialisation in humans, or…

  5. A Pencil Rescues Impaired Performance on a Visual Discrimination Task in Patients with Medial Temporal Lobe Lesions

    Science.gov (United States)

    Knutson, Ashley R.; Hopkins, Ramona O.; Squire, Larry R.

    2013-01-01

    We tested proposals that medial temporal lobe (MTL) structures support not just memory but certain kinds of visual perception as well. Patients with hippocampal lesions or larger MTL lesions attempted to identify the unique object among twin pairs of objects that had a high degree of feature overlap. Patients were markedly impaired under the more…

  6. Distinct medial temporal networks encode surprise during motivation by reward versus punishment

    Science.gov (United States)

    Murty, Vishnu P.; LaBar, Kevin S.; Adcock, R. Alison

    2016-01-01

    Adaptive motivated behavior requires predictive internal representations of the environment, and surprising events are indications for encoding new representations of the environment. The medial temporal lobe memory system, including the hippocampus and surrounding cortex, encodes surprising events and is influenced by motivational state. Because behavior reflects the goals of an individual, we investigated whether motivational valence (i.e., pursuing rewards versus avoiding punishments) also impacts neural and mnemonic encoding of surprising events. During functional magnetic resonance imaging (fMRI), participants encountered perceptually unexpected events either during the pursuit of rewards or avoidance of punishments. Despite similar levels of motivation across groups, reward and punishment facilitated the processing of surprising events in different medial temporal lobe regions. Whereas during reward motivation, perceptual surprises enhanced activation in the hippocampus, during punishment motivation surprises instead enhanced activation in parahippocampal cortex. Further, we found that reward motivation facilitated hippocampal coupling with ventromedial PFC, whereas punishment motivation facilitated parahippocampal cortical coupling with orbitofrontal cortex. Behaviorally, post-scan testing revealed that reward, but not punishment, motivation resulted in greater memory selectivity for surprising events encountered during goal pursuit. Together these findings demonstrate that neuromodulatory systems engaged by anticipation of reward and punishment target separate components of the medial temporal lobe, modulating medial temporal lobe sensitivity and connectivity. Thus, reward and punishment motivation yield distinct neural contexts for learning, with distinct consequences for how surprises are incorporated into predictive mnemonic models of the environment. PMID:26854903

  7. Distinct medial temporal networks encode surprise during motivation by reward versus punishment.

    Science.gov (United States)

    Murty, Vishnu P; LaBar, Kevin S; Adcock, R Alison

    2016-10-01

    Adaptive motivated behavior requires predictive internal representations of the environment, and surprising events are indications for encoding new representations of the environment. The medial temporal lobe memory system, including the hippocampus and surrounding cortex, encodes surprising events and is influenced by motivational state. Because behavior reflects the goals of an individual, we investigated whether motivational valence (i.e., pursuing rewards versus avoiding punishments) also impacts neural and mnemonic encoding of surprising events. During functional magnetic resonance imaging (fMRI), participants encountered perceptually unexpected events either during the pursuit of rewards or avoidance of punishments. Despite similar levels of motivation across groups, reward and punishment facilitated the processing of surprising events in different medial temporal lobe regions. Whereas during reward motivation, perceptual surprises enhanced activation in the hippocampus, during punishment motivation surprises instead enhanced activation in parahippocampal cortex. Further, we found that reward motivation facilitated hippocampal coupling with ventromedial PFC, whereas punishment motivation facilitated parahippocampal cortical coupling with orbitofrontal cortex. Behaviorally, post-scan testing revealed that reward, but not punishment, motivation resulted in greater memory selectivity for surprising events encountered during goal pursuit. Together these findings demonstrate that neuromodulatory systems engaged by anticipation of reward and punishment target separate components of the medial temporal lobe, modulating medial temporal lobe sensitivity and connectivity. Thus, reward and punishment motivation yield distinct neural contexts for learning, with distinct consequences for how surprises are incorporated into predictive mnemonic models of the environment. Copyright © 2016 Elsevier Inc. All rights reserved.

  8. SPECT image analysis using statistical parametric mapping in patients with temporal lobe epilepsy associated with hippocampal sclerosis

    International Nuclear Information System (INIS)

    Shiraki, Junko

    2004-01-01

    The author examined interictal 123 I-IMP SPECT images using statistical parametric mapping (SPM) in 19 temporal lobe epilepsy patients who revealed hippocampal sclerosis with MRI. Decreased regional cerebral blood flow (rCBF) were shown for eight patients in the medial temporal lobe, six patients in the lateral temporal lobe and five patients in the both medial and lateral temporal lobe. These patients were classified into two types; medial type and lateral type, the former decreased rCBF only in medial and the latter decreased rCBF in the other temporal area. Correlation of rCBF and clinical parameters in the lateral type, age at seizure onset was significantly older (p=0.0098, t-test) than those of patients in the medial type. SPM analysis for interictal SPECT of temporal lobe epilepsy clarified location of decreased rCBF and find correlations with clinical characteristics. In addition, SPM analysis of SPECT was useful to understand pathophysiology of the epilepsy. (author)

  9. Differential roles for medial prefrontal and medial temporal cortices in schema-dependent encoding: From congruent to incongruent

    OpenAIRE

    Kesteren, M.T.R. van; Beul, S.F.; Takashima, A.; Henson, R.N.; Ruiter, D.J.

    2013-01-01

    Information that is congruent with prior knowledge is generally remembered better than incongruent information. This effect of congruency on memory has been attributed to a facilitatory influence of activated schemas on memory encoding and consolidation processes, and hypothesised to reflect a shift between processing in medial temporal lobes (MTL) towards processing in medial prefrontal cortex (mPFC). To investigate this shift, we used functional magnetic resonance imaging (fMRI) to compare ...

  10. Role of the medial temporal lobes in relational memory: Neuropsychological evidence from a cued recognition paradigm

    OpenAIRE

    Kan, Irene P.; Giovanello, Kelly S.; Schnyer, David M.; Makris, Nikos; Verfaellie, Mieke

    2007-01-01

    In this study, we examined the role of the hippocampus in relational memory by comparing item recognition performance in amnesic patients with medial temporal lobe (MTL) damage and their matched controls. Specifically, we investigated the contribution of associative memory to item recognition using a cued recognition paradigm. Control subjects studied cue-target pairs once, whereas amnesic patients studied cue-target pairs six times. Following study, subjects made recognition judgments about ...

  11. The Medial Temporal Lobe and the Left Inferior Prefrontal Cortex Jointly Support Interference Resolution in Verbal Working Memory

    Science.gov (United States)

    Oztekin, Ilke; Curtis, Clayton E.; McElree, Brian

    2009-01-01

    During working memory retrieval, proactive interference (PI) can be induced by semantic similarity and episodic familiarity. Here, we used fMRI to test hypotheses about the role of the left inferior frontal gyrus (LIFG) and the medial temporal lobe (MTL) regions in successful resolution of PI. Participants studied six-word lists and responded to a…

  12. Theta oscillations orchestrate medial temporal lobe and neocortex in remembering autobiographical memories.

    Science.gov (United States)

    Fuentemilla, L; Barnes, G R; Düzel, E; Levine, B

    2014-01-15

    Remembering autobiographical events can be associated with detailed visual imagery. The medial temporal lobe (MTL), precuneus and prefrontal cortex are held to jointly enable such vivid retrieval, but how these regions are orchestrated remains unclear. An influential prediction from animal physiology is that neural oscillations in theta frequency may be important. In this experiment, participants prospectively collected audio recordings describing personal autobiographical episodes or semantic knowledge over 2 to 7 months. These were replayed as memory retrieval cues while recording brain activity with magnetoencephalography (MEG). We identified a peak of theta power within a left MTL region of interest during both autobiographical and General Semantic retrieval. This MTL region was selectively phase-synchronized with theta oscillations in precuneus and medial prefrontal cortex, and this synchrony was higher during autobiographical as compared to General Semantic knowledge retrieval. Higher synchrony also predicted more detailed visual imagery during retrieval. Thus, theta phase-synchrony orchestrates in humans the MTL with a distributed neocortical memory network when vividly remembering autobiographical experiences. © 2013.

  13. Pathology-Based Approach to Seizure Outcome After Surgery for Pharmacoresistant Medial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Martinoni, Matteo; Berti, Pier Paolo; Marucci, Gianluca; Rubboli, Guido; Volpi, Lilia; Riguzzi, Patrizia; Marliani, Federica; Toni, Francesco; Bisulli, Francesca; Tinuper, Paolo; Michelucci, Roberto; Baruzzi, Agostino; Giulioni, Marco

    2016-06-01

    Hippocampal sclerosis (HS) is the most common cause of drug-resistant medial temporal lobe epilepsy (MTLE). Structural abnormalities such as HS, granule cell pathology (GCP), and focal cortical dysplasia (FCD) have been classified histopathologically, possibly allowing a more accurate assessment of prognostic seizure and neuropsychologic outcomes. We correlated seizure outcome with comprehensive temporal lobe pathologic findings, identified according to the most recent classification systems of HS, GCP, and FCD. All the 83 patients who underwent anterior temporal lobectomy (ATL) for drug-resistant MTLE and with a proven diagnosis of HS between April 2001 and May 2014 were collected. Patients were divided in 2 main groups: 1) isolated HS with/without GCP (HS +/- GCP); and 2) HS associated with FCD with/without GCP (HS+FCD +/- GCP). Patients were followed up at least 1 year, and seizure outcome was reported in accordance with Engel classification. Group I: HS +/- GCP: Statistical analysis confirmed a better outcome in HS + GCP patients than in HS-no GCP (P epilepsy surgery might improve the interpretation of the results, could predict which cases will enjoy a better seizure outcome, and could help to the comprehension of the causes of failures. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Medial temporal lobe roles in human path integration.

    Directory of Open Access Journals (Sweden)

    Naohide Yamamoto

    Full Text Available Path integration is a process in which observers derive their location by integrating self-motion signals along their locomotion trajectory. Although the medial temporal lobe (MTL is thought to take part in path integration, the scope of its role for path integration remains unclear. To address this issue, we administered a variety of tasks involving path integration and other related processes to a group of neurosurgical patients whose MTL was unilaterally resected as therapy for epilepsy. These patients were unimpaired relative to neurologically intact controls in many tasks that required integration of various kinds of sensory self-motion information. However, the same patients (especially those who had lesions in the right hemisphere walked farther than the controls when attempting to walk without vision to a previewed target. Importantly, this task was unique in our test battery in that it allowed participants to form a mental representation of the target location and anticipate their upcoming walking trajectory before they began moving. Thus, these results put forth a new idea that the role of MTL structures for human path integration may stem from their participation in predicting the consequences of one's locomotor actions. The strengths of this new theoretical viewpoint are discussed.

  15. Functional connectivity evidence of cortico-cortico inhibition in temporal lobe epilepsy.

    Science.gov (United States)

    Tracy, Joseph I; Osipowicz, Karol; Spechler, Philip; Sharan, Ashwini; Skidmore, Christopher; Doucet, Gaelle; Sperling, Michael R

    2014-01-01

    Epileptic seizures can initiate a neural circuit and lead to aberrant neural communication with brain areas outside the epileptogenic region. We focus on interictal activity in focal temporal lobe epilepsy and evaluate functional connectivity (FC) differences that emerge as function of bilateral versus strictly unilateral epileptiform activity. We assess the strength of FC at rest between the ictal and non-ictal temporal lobes, in addition to whole brain connectivity with the ictal temporal lobe. Results revealed strong connectivity between the temporal lobes for both patient groups, but this did not vary as a function of unilateral versus bilateral interictal status. Both the left and right unilateral temporal lobe groups showed significant anti-correlated activity in regions outside the epileptogenic temporal lobe, primarily involving the contralateral (non-ictal/non-pathologic) hemisphere, with precuneus involvement prominent. The bilateral groups did not show this contralateral anti-correlated activity. This anti-correlated connectivity may represent a form of protective and adaptive inhibition, helping to constrain epileptiform activity to the pathologic temporal lobe. The absence of this activity in the bilateral groups may be indicative of flawed inhibitory mechanisms, helping to explain their more widespread epileptiform activity. Our data suggest that the location and build up of epilepsy networks in the brain are not truly random, and are not limited to the formation of strictly epileptogenic networks. Functional networks may develop to take advantage of the regulatory function of structures such as the precuneus to instantiate an anti-correlated network, generating protective cortico-cortico inhibition for the purpose of limiting seizure spread or epileptogenesis. Copyright © 2012 Wiley Periodicals, Inc.

  16. New MRI Markers for Alzheimer's Disease: A Meta-Analysis of Diffusion Tensor Imaging and a Comparison with Medial Temporal Lobe Measurements

    NARCIS (Netherlands)

    Clerx, L.; Visser, P.J.; Verhey, F.; Aalten, P.

    2012-01-01

    The aim of the present study is to evaluate the diagnostic value of diffusion tensor imaging (DTI) for early Alzheimer's disease (AD) in comparison to widely accepted medial temporal lobe (MTL) atrophy measurements. A systematic literature research was performed into DTI and MTL atrophy in AD and

  17. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

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    Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2004-06-01

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE.

  18. Automatic interpretation of F-18-FDG brain PET using artificial neural network: discrimination of medial and lateral temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Lee, Jae Sung; Lee, Dong Soo; Kim, Seok Ki; Park, Kwang Suk; Lee, Sang Kun; Chung, June Key; Lee, Myung Chul

    2004-01-01

    We developed a computer-aided classifier using artificial neural network (ANN) to discriminate the cerebral metabolic pattern of medial and lateral temporal lobe epilepsy (TLE). We studied brain F-18-FDG PET images of 113 epilepsy patients surgically and pathologically proven as medial TLE (left 41, right 42) or lateral TLE (left 14, right 16). PET images were spatially transformed onto a standard template and normalized to the mean counts of cortical regions. Asymmetry indices for predefined 17 mirrored regions to hemispheric midline and those for medial and lateral temporal lobes were used as input features for ANN. ANN classifier was composed of 3 independent multi-layered perceptions (1 for left/right lateralization and 2 for medial/lateral discrimination) and trained to interpret metabolic patterns and produce one of 4 diagnoses (L/R medial TLE or L/R lateral TLE). Randomly selected 8 images from each group were used to train the ANN classifier and remaining 81 images were used as test sets. The accuracy of the diagnosis with ANN was estimated by averaging the agreement rates of independent 50 trials and compared to that of nuclear medicine experts. The accuracy in lateralization was 89% by the human experts and 90% by the ANN classifier. Overall accuracy in localization of epileptogenic zones by the ANN classifier was 69%, which was comparable to that by the human experts (72%). We conclude that ANN classifier performed as well as human experts and could be potentially useful supporting tool for the differential diagnosis of TLE

  19. 99mTc-HMPAO SPECT in dementia of the Alzheimer type. Hypoperfusion in the medial temporal region

    International Nuclear Information System (INIS)

    Nakamura, Yu; Kawakatsu, Shinobu; Shinohara, Masao; Nadaoka, Toshihide; Totsuka, Shiro; Komatani, Akio

    1995-01-01

    This study examined regional cerebral blood flow (rCBF) by single photon emission computed tomography (SPECT) using technetium 99m-hexamethyl-propyleneamineoxime and correlated the results with neuropsychological findings in 30 patients with dementia of the Alzheimer type (AT dementia). Ten healthy persons served as controls. The group of mild AT dementia exhibited a significant decrease in rCBF in the lower part of the right lateral frontal lobe and in the right parietal lobe. In the group of moderate AT dementia, the significant decrease in rCBF was noted in the lower part of the bilateral frontal lobes, the parietal part of the temporal lobe, the parietal lobe, and the medial temporal lobe. Factor analysis for neuropsychological test revealed three factors involved in rCBF. There was a significantly positive correlation between the factor responsible for memory and recall and rCBF in the left frontal lobe, the anterior part of the lateral temporal lobe, and the medial temporal lobe. These findings suggested that disturbance of the memory circuit may exist in the medial temporal lobe and others as pathophysiology of AT dementia. (N.K.)

  20. The Medial Temporal Lobe – Conduit of Parallel Connectivity: A model for Attention, Memory, and Perception.

    Directory of Open Access Journals (Sweden)

    Brian B. Mozaffari

    2014-11-01

    Full Text Available Based on the notion that the brain is equipped with a hierarchical organization, which embodies environmental contingencies across many time scales, this paper suggests that the medial temporal lobe (MTL – located deep in the hierarchy – serves as a bridge connecting supra to infra – MTL levels. Bridging the upper and lower regions of the hierarchy provides a parallel architecture that optimizes information flow between upper and lower regions to aid attention, encoding, and processing of quick complex visual phenomenon. Bypassing intermediate hierarchy levels, information conveyed through the MTL ‘bridge’ allows upper levels to make educated predictions about the prevailing context and accordingly select lower representations to increase the efficiency of predictive coding throughout the hierarchy. This selection or activation/deactivation is associated with endogenous attention. In the event that these ‘bridge’ predictions are inaccurate, this architecture enables the rapid encoding of novel contingencies. A review of hierarchical models in relation to memory is provided along with a new theory, Medial-temporal-lobe Conduit for Parallel Connectivity (MCPC. In this scheme, consolidation is considered as a secondary process, occurring after a MTL-bridged connection, which eventually allows upper and lower levels to access each other directly. With repeated reactivations, as contingencies become consolidated, less MTL activity is predicted. Finally, MTL bridging may aid processing transient but structured perceptual events, by allowing communication between upper and lower levels without calling on intermediate levels of representation.

  1. Scene complexity: influence on perception, memory, and development in the medial temporal lobe

    Directory of Open Access Journals (Sweden)

    Xiaoqian J Chai

    2010-03-01

    Full Text Available Regions in the medial temporal lobe (MTL and prefrontal cortex (PFC are involved in memory formation for scenes in both children and adults. The development in children and adolescents of successful memory encoding for scenes has been associated with increased activation in PFC, but not MTL, regions. However, evidence suggests that a functional subregion of the MTL that supports scene perception, located in the parahippocampal gyrus (PHG, goes through a prolonged maturation process. Here we tested the hypothesis that maturation of scene perception supports the development of memory for complex scenes. Scenes were characterized by their levels of complexity defined by the number of unique object categories depicted in the scene. Recognition memory improved with age, in participants ages 8-24, for high, but not low, complexity scenes. High-complexity compared to low-complexity scenes activated a network of regions including the posterior PHG. The difference in activations for high- versus low- complexity scenes increased with age in the right posterior PHG. Finally, activations in right posterior PHG were associated with age-related increases in successful memory formation for high-, but not low-, complexity scenes. These results suggest that functional maturation of the right posterior PHG plays a critical role in the development of enduring long-term recollection for high-complexity scenes.

  2. Differentiation of cryptogenic lateral from mesial temporal lobe epilepsy using regional asymmetric index of F-18-FDG PET

    International Nuclear Information System (INIS)

    Song, H. C.; Lee, D. S.; Lee, S. K.; Jeong, J. M.; Jeong, Z. K.; Lee, M. C.; Ko, C. S.

    1997-01-01

    We tried to find the possibility of utilization of F-18-FDG PET to differentiate lateral (neocortical) from mesial temporal lobe epilepsy(TLE) if we adopted quantitative comparison of regional metabolic activities using asymmetric index. We studied 22 pathologically proven mesial TLE(group C in Figure), and 27 lateral TLE patients. Lateral TLE patients were normal on MR(cryptogenic: 15; group A) or had structural lesions (12: group B). Asymmetric index (AI) was calculated as (ipsilateral -contralateral) / (ipsilateral + contralateral ) x 200. AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, > 0.05) and AI of medial lobe of cryptogenic lateral TLE was not decreased (-4.66.2, >0.05) and AI of lateral lobe was decreased (-13.68.9). AI of medial and lateral lobes of mesial TLE was decreased (-3.44.7 and -16.58.9, respectively). AI of medial lobe of lesional lateral TLE was -7.39.1 (p<0.05 compared with mesial TEL). It was evident that lateral lobe of lesional lateral TLE had metabolic defect or decrease (AI: -21.410.4). While we could not find difference of metabolic activity in lateral temporal lobes between cryptogenic lateral TLE and mesial TLE patients, the difference of metabolic activity was significant in medial temporal lobes which was revealed by AI quantitation. An AI value larger than -10 (cutoff: AI) predicted positively for lateral TLE(PPV:80%) and negatively for mesial TLE(NPV:77%). Asymmetry of metabolic activity in medial and not in lateral lobe of temporal lobe could give hints about whether the epileptogenic zones were mesial or lateral

  3. Medial Temporal Lobe Contributions to Episodic Future Thinking: Scene Construction or Future Projection?

    Science.gov (United States)

    Palombo, D J; Hayes, S M; Peterson, K M; Keane, M M; Verfaellie, M

    2018-02-01

    Previous research has shown that the medial temporal lobes (MTL) are more strongly engaged when individuals think about the future than about the present, leading to the suggestion that future projection drives MTL engagement. However, future thinking tasks often involve scene processing, leaving open the alternative possibility that scene-construction demands, rather than future projection, are responsible for the MTL differences observed in prior work. This study explores this alternative account. Using functional magnetic resonance imaging, we directly contrasted MTL activity in 1) high scene-construction and low scene-construction imagination conditions matched in future thinking demands and 2) future-oriented and present-oriented imagination conditions matched in scene-construction demands. Consistent with the alternative account, the MTL was more active for the high versus low scene-construction condition. By contrast, MTL differences were not observed when comparing the future versus present conditions. Moreover, the magnitude of MTL activation was associated with the extent to which participants imagined a scene but was not associated with the extent to which participants thought about the future. These findings help disambiguate which component processes of imagination specifically involve the MTL. Published by Oxford University Press 2016.

  4. Cognitive Functioning in Temporal Lobe Epilepsy: A BOLD-fMRI Study.

    Science.gov (United States)

    Guo, Lili; Bai, Genji; Zhang, Hui; Lu, Daoyan; Zheng, Jiyong; Xu, Gang

    2017-12-01

    We aimed to analyze the association between resting-state functional magnetic resonance imaging (re-fMRI) and cognitive function (including language, executive, and memory functions) in temporal lobe epilepsy (TLE) patients, which will help to explore the mechanism of brain function in patients. 15 TLE patients and 15 non-TLE patients were recruited. All subjects underwent neuropsychological testing and memory functional evaluation. Changes in verbal intelligence quotient (VIQ), performance intelligence quotient (PIQ), full intelligence quotient (FIQ), and memory quotient (MQ) were compared between two groups. Re-fMRI data were also collected from two groups to evaluate these changes. Each individual score of neuropsychological testing and memory functional evaluation were higher in control group, which was statistically different (all P temporal gyrus back, right superior temporal gyrus, left cerebellum, left angular gyrus, left wedge anterior lobe, and left central back; while the negatively activated brain regions were left prefrontal, right cerebellum, right corner back, and right anterior cingulate gyrus. During the language task, the activated brain regions of the TLE patients were right prefrontal lobe, the lateral temporal gyri, the left cerebellum, left cornu laterale gyrus, left precuneus, and the left postcentral gyrus, whereas the negatively activated brain areas were the left prefrontal cortex, the right cerebellum, right cornu laterale gyrus, and the right anterior cingulate gyrus. During the executive task, epilepsy patients showed activation difference in right prefrontal and right frontal lobe and right brain, left superior temporal gyrus, and right cerebellum anterior lobe compared with the control group; no negatively activated differences in brain areas. During the memory task, the difference lay in bilateral anterior cingulate gyrus and bilateral wedge anterior lobe while the negatively activated brain areas were the left inferior frontal

  5. Visual working memory capacity and the medial temporal lobe.

    Science.gov (United States)

    Jeneson, Annette; Wixted, John T; Hopkins, Ramona O; Squire, Larry R

    2012-03-07

    Patients with medial temporal lobe (MTL) damage are sometimes impaired at remembering visual information across delays as short as a few seconds. Such impairments could reflect either impaired visual working memory capacity or impaired long-term memory (because attention has been diverted or because working memory capacity has been exceeded). Using a standard change-detection task, we asked whether visual working memory capacity is intact or impaired after MTL damage. Five patients with hippocampal lesions and one patient with large MTL lesions saw an array of 1, 2, 3, 4, or 6 colored squares, followed after 3, 4, or 8 s by a second array where one of the colored squares was cued. The task was to decide whether the cued square had the same color as the corresponding square in the first array or a different color. At the 1 s delay typically used to assess working memory capacity, patients performed as well as controls at all array sizes. At the longer delays, patients performed as well as controls at small array sizes, thought to be within the capacity limit, and worse than controls at large array sizes, thought to exceed the capacity limit. The findings suggest that visual working memory capacity in humans is intact after damage to the MTL structures and that damage to these structures impairs performance only when visual working memory is insufficient to support performance.

  6. Medial Temporal Lobe Contributions to Future Thinking: Evidence from Neuroimaging and Amnesia

    Directory of Open Access Journals (Sweden)

    Mieke Verfaellie

    2012-09-01

    Full Text Available Following early amnesic case reports, there is now considerable evidence suggesting a link between remembering the past and envisioning the future. This link is evident in the overlap in neural substrates as well as cognitive processes involved in both kinds of tasks. While constructing a future narrative requires multiple processes, neuroimaging and lesion data converge on a critical role for the medial temporal lobes (MTL in retrieving and recombining details from memory in the service of novel simulations. Deficient detail retrieval and recombination may lead to impairments not only in episodic, but also in semantic prospection. MTL contributions to scene construction and mental time travel may further compound impairments in amnesia on tasks that pose additional demands on these processes, but are unlikely to form the core deficit underlying amnesics' cross-domain future thinking impairment. Future studies exploring the role of episodic memory in other forms of self-projection or future-oriented behaviour may elucidate further the adaptive role of memory.

  7. Determinants of Autobiographical Memory in Patients with Unilateral Temporal Lobe Epilepsy or Excisions

    Science.gov (United States)

    St-Laurent, Marie; Moscovitch, Morris; Levine, Brian; McAndrews, Mary Pat

    2009-01-01

    Patients with unilateral temporal lobe epilepsy from hippocampal origin and patients with unilateral surgical excision of an epileptic focus located in the medial temporal lobe were compared to healthy controls on a version of the Autobiographical Interview (AI) adapted to assess memory for event-specific and generic personal episodes. For both…

  8. Representing Representation: Integration between the Temporal Lobe and the Posterior Cingulate Influences the Content and Form of Spontaneous Thought.

    Directory of Open Access Journals (Sweden)

    Jonathan Smallwood

    Full Text Available When not engaged in the moment, we often spontaneously represent people, places and events that are not present in the environment. Although this capacity has been linked to the default mode network (DMN, it remains unclear how interactions between the nodes of this network give rise to particular mental experiences during spontaneous thought. One hypothesis is that the core of the DMN integrates information from medial and lateral temporal lobe memory systems, which represent different aspects of knowledge. Individual differences in the connectivity between temporal lobe regions and the default mode network core would then predict differences in the content and form of people's spontaneous thoughts. This study tested this hypothesis by examining the relationship between seed-based functional connectivity and the contents of spontaneous thought recorded in a laboratory study several days later. Variations in connectivity from both medial and lateral temporal lobe regions was associated with different patterns of spontaneous thought and these effects converged on an overlapping region in the posterior cingulate cortex. We propose that the posterior core of the DMN acts as a representational hub that integrates information represented in medial and lateral temporal lobe and this process is important in determining the content and form of spontaneous thought.

  9. A functional magnetic resonance imaging study mapping the episodic memory encoding network in temporal lobe epilepsy

    Science.gov (United States)

    Sidhu, Meneka K.; Stretton, Jason; Winston, Gavin P.; Bonelli, Silvia; Centeno, Maria; Vollmar, Christian; Symms, Mark; Thompson, Pamela J.; Koepp, Matthias J.

    2013-01-01

    Functional magnetic resonance imaging has demonstrated reorganization of memory encoding networks within the temporal lobe in temporal lobe epilepsy, but little is known of the extra-temporal networks in these patients. We investigated the temporal and extra-temporal reorganization of memory encoding networks in refractory temporal lobe epilepsy and the neural correlates of successful subsequent memory formation. We studied 44 patients with unilateral temporal lobe epilepsy and hippocampal sclerosis (24 left) and 26 healthy control subjects. All participants performed a functional magnetic resonance imaging memory encoding paradigm of faces and words with subsequent out-of-scanner recognition assessments. A blocked analysis was used to investigate activations during encoding and neural correlates of subsequent memory were investigated using an event-related analysis. Event-related activations were then correlated with out-of-scanner verbal and visual memory scores. During word encoding, control subjects activated the left prefrontal cortex and left hippocampus whereas patients with left hippocampal sclerosis showed significant additional right temporal and extra-temporal activations. Control subjects displayed subsequent verbal memory effects within left parahippocampal gyrus, left orbitofrontal cortex and fusiform gyrus whereas patients with left hippocampal sclerosis activated only right posterior hippocampus, parahippocampus and fusiform gyrus. Correlational analysis showed that patients with left hippocampal sclerosis with better verbal memory additionally activated left orbitofrontal cortex, anterior cingulate cortex and left posterior hippocampus. During face encoding, control subjects showed right lateralized prefrontal cortex and bilateral hippocampal activations. Patients with right hippocampal sclerosis showed increased temporal activations within the superior temporal gyri bilaterally and no increased extra-temporal areas of activation compared with

  10. Preservation of episodic memory in semantic dementia: The importance of regions beyond the medial temporal lobes.

    Science.gov (United States)

    Irish, Muireann; Bunk, Steffie; Tu, Sicong; Kamminga, Jody; Hodges, John R; Hornberger, Michael; Piguet, Olivier

    2016-01-29

    Episodic memory impairment represents one of the hallmark clinical features of patients with Alzheimer's disease (AD) attributable to the degeneration of medial temporal and parietal regions of the brain. In contrast, a somewhat paradoxical profile of relatively intact episodic memory, particularly for non-verbal material, is observed in semantic dementia (SD), despite marked atrophy of the hippocampus. This retrospective study investigated the neural substrates of episodic memory retrieval in 20 patients with a diagnosis of SD and 21 disease-matched cases of AD and compared their performance to that of 35 age- and education-matched healthy older Controls. Participants completed the Rey Complex Figure and the memory subscale of the Addenbrooke's Cognitive Examination-Revised as indices of visual and verbal episodic recall, respectively. Relative to Controls, AD patients showed compromised memory performance on both visual and verbal memory tasks. In contrast, memory deficits in SD were modality-specific occurring exclusively on the verbal task. Controlling for semantic processing ameliorated these deficits in SD, while memory impairments persisted in AD. Voxel-based morphometry analyses revealed significant overlap in the neural correlates of verbal episodic memory in AD and SD with predominantly anteromedial regions, including the bilateral hippocampus, strongly implicated. Controlling for semantic processing negated this effect in SD, however, a distributed network of frontal, medial temporal, and parietal regions was implicated in AD. Our study corroborates the view that episodic memory deficits in SD arise very largely as a consequence of the conceptual loading of traditional tasks. We propose that the functional integrity of frontal and parietal regions enables new learning to occur in SD in the face of significant hippocampal and anteromedial temporal lobe pathology, underscoring the inherent complexity of the episodic memory circuitry. Copyright © 2015

  11. Reactivation of medial temporal lobe and occipital lobe during the retrieval of color information: A positron emission tomography study.

    Science.gov (United States)

    Ueno, Aya; Abe, Nobuhito; Suzuki, Maki; Hirayama, Kazumi; Mori, Etsuro; Tashiro, Manabu; Itoh, Masatoshi; Fujii, Toshikatsu

    2007-02-01

    It is widely accepted that memory traces of an event include various types of information about the content of the event and about the circumstances in which the individual experienced it. However, how these various types of information are stored and later retrieved is poorly understood. One hypothesis postulates that the retrieval of specific event information reactivates regions that were active during the encoding of this information, with the aid of binding functions of the medial temporal lobe (MTL) structures. We used positron emission tomography to identify the brain regions related to the encoding and retrieval of color information. Specifically, we assessed whether overlapping activity was found in both the MTL structures and color-related cortical regions during the encoding and retrieval of color information attached with meaningless shapes. During the study, subjects were asked to encode colored (red or green) and achromatic random shapes. At subsequent testing, subjects were presented with only achromatic shapes, which had been presented with or without colors during encoding, and were engaged in retrieval tasks of shapes and colors. Overlapping activity was found in the MTL and occipital lobe (the lingual and inferior occipital gyri) in the right hemisphere during the encoding and retrieval of meaningless shapes with color information compared with those without color information. Although there are some limitations to be considered, the present findings seem to support the view that the retrieval of specific event information is associated with reactivation of both the MTL structures and the regions involved during encoding of the information.

  12. Familiarity and recollection vs representational models of medial temporal lobe structures: A single-case study.

    Science.gov (United States)

    Lacot, Emilie; Vautier, Stéphane; Kőhler, Stefan; Pariente, Jérémie; Martin, Chris B; Puel, Michèle; Lotterie, Jean-Albert; Barbeau, Emmanuel J

    2017-09-01

    Although it is known that medial temporal lobe (MTL) structures support declarative memory, the fact these structures have different architectonics and circuitry suggests they may also play different functional roles. Selective lesions of MTL structures offer an opportunity to understand these roles. We report, in this study, on JMG, a patient who presents highly unusual lesions that completely affected all MTL structures except for the right hippocampus and parts of neighbouring medial parahippocampal cortex. We first demonstrate that JMG shows preserved recall for visual material on 5 experimental tasks. This finding suggests that his right hippocampus is functional, even though it appears largely disconnected from most of its MTL afferents. In contrast, JMG performed very poorly, as compared to control subjects, on 7 tasks of visual recognition memory for single items. Although he sometimes performed above chance, neither familiarity nor recollection appeared fully preserved. These results indicate that extrahippocampal structures, damaged bilaterally in JMG, perform critical operations for item recognition; and that the hippocampus cannot take over that role, including recollection, when these structures are largely damaged. Finally, in a set of 3 recognition memory tasks with scenes as stimuli, JMG performed at the level of control participants and obtained normal indices of familiarity and recollection. Overall, our findings suggest that the right hippocampus and remnants of parahippocampal cortex can support recognition memory for scenes in the absence of preserved item-recognition memory. The patterns of dissociations, which we report in the present study, provide support for a representational account of the functional organization of MTL structures. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Visual field defects after temporal lobe resection for epilepsy

    DEFF Research Database (Denmark)

    Steensberg, Alvilda T; Olsen, Ane Sophie; Litman, Minna

    2018-01-01

    PURPOSE: To determine visual field defects (VFDs) using methods of varying complexity and compare results with subjective symptoms in a population of newly operated temporal lobe epilepsy patients. METHODS: Forty patients were included in the study. Two patients failed to perform VFD testing...... symptoms were only reported by 28% of the patients with a VFD and in two of eight (sensitivity=25%) with a severe VFD. Most patients (86%) considered VFD information mandatory. CONCLUSION: VFD continue to be a frequent adverse event after epilepsy surgery in the medial temporal lobe and may affect...

  14. The medial temporal lobes distinguish between within-item and item-context relations during autobiographical memory retrieval.

    Science.gov (United States)

    Sheldon, Signy; Levine, Brian

    2015-12-01

    During autobiographical memory retrieval, the medial temporal lobes (MTL) relate together multiple event elements, including object (within-item relations) and context (item-context relations) information, to create a cohesive memory. There is consistent support for a functional specialization within the MTL according to these relational processes, much of which comes from recognition memory experiments. In this study, we compared brain activation patterns associated with retrieving within-item relations (i.e., associating conceptual and sensory-perceptual object features) and item-context relations (i.e., spatial relations among objects) with respect to naturalistic autobiographical retrieval. We developed a novel paradigm that cued participants to retrieve information about past autobiographical events, non-episodic within-item relations, and non-episodic item-context relations with the perceptuomotor aspects of retrieval equated across these conditions. We used multivariate analysis techniques to extract common and distinct patterns of activity among these conditions within the MTL and across the whole brain, both in terms of spatial and temporal patterns of activity. The anterior MTL (perirhinal cortex and anterior hippocampus) was preferentially recruited for generating within-item relations later in retrieval whereas the posterior MTL (posterior parahippocampal cortex and posterior hippocampus) was preferentially recruited for generating item-context relations across the retrieval phase. These findings provide novel evidence for functional specialization within the MTL with respect to naturalistic memory retrieval. © 2015 Wiley Periodicals, Inc.

  15. Medial temporal lobe contributions to short-term memory for faces

    Science.gov (United States)

    Race, Elizabeth; LaRocque, Karen F.; Keane, Margaret M.; Verfaellie, Mieke

    2015-01-01

    The role of the medial temporal lobes (MTL) in short-term memory (STM) remains a matter of debate. While imaging studies commonly show hippocampal activation during short-delay memory tasks, evidence from amnesic patients with MTL lesions is mixed. It has been argued that apparent STM impairments in amnesia may reflect long-term memory (LTM) contributions to performance. We challenge this conclusion by demonstrating that MTL amnesic patients show impaired delayed matching-to-sample (DMS) for faces in a task that meets both a traditional delay-based and a recently proposed distractor-based criterion for classification as a STM task. In Experiment 1, we demonstrate that our face DMS task meets the proposed distractor-based criterion for STM classification, in that extensive processing of delay-period distractor stimuli disrupts performance of healthy individuals. In Experiment 2, MTL amnesic patients with lesions extending into anterior subhippocampal cortex, but not patients with lesions limited to the hippocampus, show impaired performance on this task without distraction at delays as short as 8s, within temporal range of delay-based STM classification, in the context of intact perceptual matching performance. Experiment 3 provides support for the hypothesis that STM for faces relies on configural processing by showing that the extent to which healthy participants’ performance is disrupted by interference depends on the configural demands of the distractor task. Together, these findings are consistent with the notion that the amnesic impairment in STM for faces reflects a deficit in configural processing associated with subhippocampal cortices and provide novel evidence that the MTL supports cognition beyond the LTM domain. PMID:23937185

  16. Medial temporal lobe contributions to short-term memory for faces.

    Science.gov (United States)

    Race, Elizabeth; LaRocque, Karen F; Keane, Margaret M; Verfaellie, Mieke

    2013-11-01

    The role of the medial temporal lobes (MTL) in short-term memory (STM) remains a matter of debate. Whereas imaging studies commonly show hippocampal activation during short-delay memory tasks, evidence from amnesic patients with MTL lesions is mixed. It has been argued that apparent STM impairments in amnesia may reflect long-term memory (LTM) contributions to performance. We challenge this conclusion by demonstrating that MTL amnesic patients show impaired delayed matching-to-sample (DMS) for faces in a task that meets both a traditional delay-based and a recently proposed distractor-based criterion for classification as an STM task. In Experiment 1, we demonstrate that our face DMS task meets the proposed distractor-based criterion for STM classification, in that extensive processing of delay-period distractor stimuli disrupts performance of healthy individuals. In Experiment 2, MTL amnesic patients with lesions extending into anterior subhippocampal cortex, but not patients with lesions limited to the hippocampus, show impaired performance on this task without distraction at delays as short as 8 s, within temporal range of delay-based STM classification, in the context of intact perceptual matching performance. Experiment 3 provides support for the hypothesis that STM for faces relies on configural processing by showing that the extent to which healthy participants' performance is disrupted by interference depends on the configural demands of the distractor task. Together, these findings are consistent with the notion that the amnesic impairment in STM for faces reflects a deficit in configural processing associated with subhippocampal cortices and provide novel evidence that the MTL supports cognition beyond the LTM domain. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  17. Quantification of beta A4 protein deposition in the medial temporal lobe: a comparison of Alzheimer's disease and senile dementia of the Lewy body type.

    Science.gov (United States)

    Gentleman, S M; Williams, B; Royston, M C; Jagoe, R; Clinton, J; Perry, R H; Ince, P G; Allsop, D; Polak, J M; Roberts, G W

    1992-08-03

    The distribution of beta-amyloid protein (beta A4) was examined in the medial temporal lobes from cases of Alzheimer's disease (AD) (n = 13), senile dementia of Lewy body type (SDLT) (n = 12) and age matched controls (n = 9). Using a previously described image analysis technique the extent of beta A4 pathology was determined in ten distinct anatomical sites within the medial temporal lobe. AD and SDLT cases contained very similar amounts of beta A4 in the areas sampled and both contained significantly more beta A4 than the age matched controls, particularly in the dentate and parahippocampal gyri. The similarity of the beta A4 load in the two conditions is in contrast to reported differences in the number of neurofibrillary tangles which can be observed. It is suggested that AD and SDLT represent a spectrum of pathology which centres around the aberrant processing of the beta A4 precursor protein.

  18. The right hemisphere's contribution to discourse processing: A study in temporal lobe epilepsy.

    Science.gov (United States)

    Lomlomdjian, Carolina; Múnera, Claudia P; Low, Daniel M; Terpiluk, Verónica; Solís, Patricia; Abusamra, Valeria; Kochen, Silvia

    2017-08-01

    Discourse skills - in which the right hemisphere has an important role - enables verbal communication by selecting contextually relevant information and integrating it coherently to infer the correct meaning. However, language research in epilepsy has focused on single word analysis related mainly to left hemisphere processing. The purpose of this study was to investigate discourse abilities in patients with right lateralized medial temporal lobe epilepsy (RTLE) by comparing their performance to that of patients with left temporal lobe epilepsy (LTLE). 74 pharmacoresistant temporal lobe epilepsy (TLE) patients were evaluated: 34 with RTLE and 40 with LTLE. Subjects underwent a battery of tests that measure comprehension and production of conversational and narrative discourse. Disease related variables and general neuropsychological data were evaluated. The RTLE group presented deficits in interictal conversational and narrative discourse, with a disintegrated speech, lack of categorization and misinterpretation of social meaning. LTLE group, on the other hand, showed a tendency to lower performance in logical-temporal sequencing. RTLE patients showed discourse deficits which have been described in right hemisphere damaged patients due to other etiologies. Medial and anterior temporal lobe structures appear to link semantic, world knowledge, and social cognition associated areas to construct a contextually related coherent meaning. Copyright © 2017 Elsevier Inc. All rights reserved.

  19. [Mirror movement due to the medial frontal lobe lesion].

    Science.gov (United States)

    Takahashi, N; Kawamura, M; Hirayama, K

    1995-01-01

    We reported a case with acquired mirror movement in upper limbs due to the lesion of right medial frontal lobe including supplementary motor area, and also discussed a possible mechanism underlying it. A 59-year-old right-handed woman developed left hemiparesis caused by cerebral hemorrhage in the right frontoparietal lobe, on April 5, 1981. She had right hemiparesis and right hemianopsia due to cerebral hemorrhage in the left parieto-occipital lobe, 13 days later. As the patient was recovering from paresis, mirror movement appeared on upper limbs. The features of the mirror movement of this case are summarized as follows: (1) it appeared when using both proximal and distal region of upper limbs; (2) it appeared on left upper limb when the patient intended to move right upper limb or on right upper limb when intended to move left upper limb, while it appeared predominantly in the former; and (3) it was more remarkably found in habitual movement using gesture and pantomimic movement for the use of objects, and it was found in lower degree when actual object was used or when the patient tried to imitate the gesture of the examiner. The lesions in MRI were found in medial region of right frontal lobe (supplementary motor area, medial region of motor area, and cingulate gyrus), right medial parietal lobe, posterior region of right occipital lobe, and medial regions of left parietal and occipital lobes. There was no apparent abnormality in corpus callosum.(ABSTRACT TRUNCATED AT 250 WORDS)

  20. Neural activity in the medial temporal lobe reveals the fidelity of mental time travel.

    Science.gov (United States)

    Kragel, James E; Morton, Neal W; Polyn, Sean M

    2015-02-18

    Neural circuitry in the medial temporal lobe (MTL) is critically involved in mental time travel, which involves the vivid retrieval of the details of past experience. Neuroscientific theories propose that the MTL supports memory of the past by retrieving previously encoded episodic information, as well as by reactivating a temporal code specifying the position of a particular event within an episode. However, the neural computations supporting these abilities are underspecified. To test hypotheses regarding the computational mechanisms supported by different MTL subregions during mental time travel, we developed a computational model that linked a blood oxygenation level-dependent signal to cognitive operations, allowing us to predict human performance in a memory search task. Activity in the posterior MTL, including parahippocampal cortex, reflected how strongly one reactivates the temporal context of a retrieved memory, allowing the model to predict whether the next memory will correspond to a nearby moment in the study episode. A signal in the anterior MTL, including perirhinal cortex, indicated the successful retrieval of list items, without providing information regarding temporal organization. A hippocampal signal reflected both processes, consistent with theories that this region binds item and context information together to form episodic memories. These findings provide evidence for modern theories that describe complementary roles of the hippocampus and surrounding parahippocampal and perirhinal cortices during the retrieval of episodic memories, shaping how humans revisit the past. Copyright © 2015 the authors 0270-6474/15/352914-13$15.00/0.

  1. Gangliogliomas: characteristic imaging findings and role in the temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Y; Yagishita, A [Tokyo Metropolitan Neurological Hospital, Department of Neuroradiology, Tokyo (Japan)

    2008-10-15

    Ganglioglioma is an uncommon neoplasm of the central nervous system, most frequently seen in the temporal lobe, and usually associated with medically refractory epilepsy in children and young adults. Few reports have considered ganglioglioma-associated epileptogenicity arising in the temporal lobe. The purpose of our study was to define the imaging features of ganglioglioma in the temporal lobe and their relation to the seizure foci revealed by electrocorticograms. We reviewed 24 patients with pathologically confirmed ganglioglioma in the temporal lobe. Computed tomography (CT) images showed gangliogliomas to be isodense (91.7%), and on T1-weighted images (T1-WI) most gangliogliomas (79.2%) were isointense to the gray matter. A cystic lesion was seen in 14 of 24 of the gangliogliomas (58.3%). Mass effects were not seen in any of the ten tumors without cystic components. One patient showed tumor recurrence. Dual pathology was seen in two cases (8.3%). In 23 cases, epileptogenicity was confirmed in the tumors by intraoperative electrocorticogram. The remaining case had no epileptogenicity. A tumor presenting isointensity to gray matter on T1-WI without mass effects in the medial temporal lobe in a young patient with temporal lobe epilepsy (TLE) might be the characteristic imaging of temporal lobe ganglioglioma. However, such tumors are not always associated with epileptogenicity, even if a ganglioglioma is found in a patient with TLE. The seizure foci may be contralateral to the ganglioglioma. Therefore, we need to investigate the hippocampus, white matter abnormalities of the ipsilateral and contralateral anterior temporal lobe, and other focal lesions closely. (orig.)

  2. Gangliogliomas: characteristic imaging findings and role in the temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Adachi, Y.; Yagishita, A.

    2008-01-01

    Ganglioglioma is an uncommon neoplasm of the central nervous system, most frequently seen in the temporal lobe, and usually associated with medically refractory epilepsy in children and young adults. Few reports have considered ganglioglioma-associated epileptogenicity arising in the temporal lobe. The purpose of our study was to define the imaging features of ganglioglioma in the temporal lobe and their relation to the seizure foci revealed by electrocorticograms. We reviewed 24 patients with pathologically confirmed ganglioglioma in the temporal lobe. Computed tomography (CT) images showed gangliogliomas to be isodense (91.7%), and on T1-weighted images (T1-WI) most gangliogliomas (79.2%) were isointense to the gray matter. A cystic lesion was seen in 14 of 24 of the gangliogliomas (58.3%). Mass effects were not seen in any of the ten tumors without cystic components. One patient showed tumor recurrence. Dual pathology was seen in two cases (8.3%). In 23 cases, epileptogenicity was confirmed in the tumors by intraoperative electrocorticogram. The remaining case had no epileptogenicity. A tumor presenting isointensity to gray matter on T1-WI without mass effects in the medial temporal lobe in a young patient with temporal lobe epilepsy (TLE) might be the characteristic imaging of temporal lobe ganglioglioma. However, such tumors are not always associated with epileptogenicity, even if a ganglioglioma is found in a patient with TLE. The seizure foci may be contralateral to the ganglioglioma. Therefore, we need to investigate the hippocampus, white matter abnormalities of the ipsilateral and contralateral anterior temporal lobe, and other focal lesions closely. (orig.)

  3. Domain-specific impairment of source memory following a right posterior medial temporal lobe lesion.

    Science.gov (United States)

    Peters, Jan; Koch, Benno; Schwarz, Michael; Daum, Irene

    2007-01-01

    This single case analysis of memory performance in a patient with an ischemic lesion affecting posterior but not anterior right medial temporal lobe (MTL) indicates that source memory can be disrupted in a domain-specific manner. The patient showed normal recognition memory for gray-scale photos of objects (visual condition) and spoken words (auditory condition). While memory for visual source (texture/color of the background against which pictures appeared) was within the normal range, auditory source memory (male/female speaker voice) was at chance level, a performance pattern significantly different from the control group. This dissociation is consistent with recent fMRI evidence of anterior/posterior MTL dissociations depending upon the nature of source information (visual texture/color vs. auditory speaker voice). The findings are in good agreement with the view of dissociable memory processing by the perirhinal cortex (anterior MTL) and parahippocampal cortex (posterior MTL), depending upon the neocortical input that these regions receive. (c) 2007 Wiley-Liss, Inc.

  4. Cognitive Function and Heat Shock Protein 70 in Children With Temporal Lobe Epilepsy.

    Science.gov (United States)

    Oraby, Azza M; Raouf, Ehab R Abdol; El-Saied, Mostafa M; Abou-Khadra, Maha K; Helal, Suzette I; Hashish, Adel F

    2017-01-01

    We conducted the present study to examine cognitive function and serum heat shock protein 70 levels among children with temporal lobe epilepsy. The Stanford-Binet Intelligence Test was carried out to examine cognitive function in 30 children with temporal lobe epilepsy and 30 controls. Serum heat shock protein 70 levels were determined with an enzyme-linked immunosorbent assay. The epilepsy group had significantly lower cognitive function testing scores and significantly higher serum heat shock protein 70 levels than the control group; there were significant negative correlations between serum heat shock protein 70 levels and short-term memory and composite scores. Children with uncontrolled seizures had significantly lower verbal reasoning scores and significantly higher serum heat shock protein 70 levels than children with controlled seizures. Children with temporal lobe epilepsy have cognitive dysfunction and elevated levels of serum heat shock protein 70, which may be considered a stress biomarker.

  5. Medial temporal lobe structure and cognition in individuals with schizophrenia and in their non-psychotic siblings.

    Science.gov (United States)

    Karnik-Henry, Meghana S; Wang, Lei; Barch, Deanna M; Harms, Michael P; Campanella, Carolina; Csernansky, John G

    2012-07-01

    Medial temporal lobe (MTL) structures play a central role in episodic memory. Prior studies suggest that individuals with schizophrenia have deficits in episodic memory as well as structural abnormalities of the medial temporal lobe (MTL). While correlations have been reported between MTL volume loss and episodic memory deficits in such individuals, it is not clear whether such correlations reflect the influence of the disease state or of underlying genetic influences that might contribute to risk. We used high resolution magnetic resonance imaging and probabilistic algorithms for image analysis to determine whether MTL structure, episodic memory performance and the relationship between the two differed among groups of 47 healthy control subjects, 50 control siblings, 39 schizophrenia subjects, and 33 siblings of schizophrenia subjects. High-dimensional large deformation brain mapping was used to obtain volume measures of the hippocampus. Cortical distance mapping was used to obtain volume and thickness measures of the parahippocampal gyrus (PHG) and its substructures: the entorhinal cortex (ERC), the perirhinal cortex (PRC), and the parahippocampal cortex (PHC). Neuropsychological data was used to establish an episodic memory domain score for each subject. Both schizophrenia subjects and their siblings displayed abnormalities in episodic memory performance. Siblings of individuals with schizophrenia, and to a lesser extent, individuals with schizophrenia themselves, displayed abnormalities in measures of MTL structure (volume loss or cortical thinning) as compared to control groups. Further, we observed correlations between structural measures and memory performance in both schizophrenia subjects and their siblings, but not in their respective control groups. These findings suggest that disease-specific genetic factors present in both patients and their relatives may be responsible for correlated abnormalities of MTL structure and memory impairment. The observed

  6. Semantic memory is impaired in patients with unilateral anterior temporal lobe resection for temporal lobe epilepsy.

    Science.gov (United States)

    Lambon Ralph, Matthew A; Ehsan, Sheeba; Baker, Gus A; Rogers, Timothy T

    2012-01-01

    Contemporary clinical and basic neuroscience studies have increasingly implicated the anterior temporal lobe regions, bilaterally, in the formation of coherent concepts. Mounting convergent evidence for the importance of the anterior temporal lobe in semantic memory is found in patients with bilateral anterior temporal lobe damage (e.g. semantic dementia), functional neuroimaging and repetitive transcranial magnetic stimulation studies. If this proposal is correct, then one might expect patients with anterior temporal lobe resection for long-standing temporal lobe epilepsy to be semantically impaired. Such patients, however, do not present clinically with striking comprehension deficits but with amnesia and variable anomia, leading some to conclude that semantic memory is intact in resection for temporal lobe epilepsy and thus casting doubt over the conclusions drawn from semantic dementia and linked basic neuroscience studies. Whilst there is a considerable neuropsychological literature on temporal lobe epilepsy, few studies have probed semantic memory directly, with mixed results, and none have undertaken the same type of systematic investigation of semantic processing that has been conducted with other patient groups. In this study, therefore, we investigated the semantic performance of 20 patients with resection for chronic temporal lobe epilepsy with a full battery of semantic assessments, including more sensitive measures of semantic processing. The results provide a bridge between the current clinical observations about resection for temporal lobe epilepsy and the expectations from semantic dementia and other neuroscience findings. Specifically, we found that on simple semantic tasks, the patients' accuracy fell in the normal range, with the exception that some patients with left resection for temporal lobe epilepsy had measurable anomia. Once the semantic assessments were made more challenging, by probing specific-level concepts, lower frequency

  7. Sulcal and gyral anatomy of the basal occipital-temporal lobe.

    Science.gov (United States)

    Chau, Anthony Minh Tien; Stewart, Fiona; Gragnaniello, Cristian

    2014-12-01

    The sulcal and gyral anatomy of the basal occipital-temporal lobe is highly variable and detailed descriptions of this region are limited and often inconsistent. The aim of this study was to describe the salient features of the sulcal and gyral anatomy of the basal occipital-temporal lobe. We studied the sulcal and gyral patterns of 30 formalin-fixed cerebral hemispheres. The major landmarks are the collateral sulcus (separated into the rhinal, proper, and caudal segments) and occipitotemporal sulcus (often interrupted), which were always present in this study. The bifurcation of the caudal collateral sulcus is a useful landmark. In relation to these sulci, we have described the surface anatomy and nominated landmarks of the medial (parahippocampal and lingual) and lateral (fusiform) occipitotemporal gyri. Understanding of the sulcal and gyral patterns of the basal occipital-temporal lobe may provide valuable information in its radiological and intraoperative interpretation.

  8. [Effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children].

    Science.gov (United States)

    Yang, Xiao-Yan; Long, Li-Li; Xiao, Bo

    2016-07-01

    To investigate the effects of temporal lobe epilepsy and idiopathic epilepsy on cognitive function and emotion in children and the risk factors for cognitive impairment. A retrospective analysis was performed for the clinical data of 38 children with temporal lobe epilepsy and 40 children with idiopathic epilepsy. The controls were 42 healthy children. All subjects received the following neuropsychological tests: Montreal Cognitive Assessment (MoCA) scale, verbal fluency test, digit span test, block design test, Social Anxiety Scale for Children (SASC), and Depression Self-rating Scale for Children (DSRSC). Compared with the control group, the temporal lobe epilepsy and idiopathic epilepsy groups showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (Pepilepsy group, the temporal lobe epilepsy group showed significantly lower scores of MoCA, verbal fluency, digit span, and block design (Ptemporal lobe epilepsy group, MoCA score was negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.571, -0.529, and -0.545 respectively; Pepilepsy group, MoCA score was also negatively correlated with SASC score, DSRSC score, and seizure frequency (r=-0.542, -0.487, and -0.555 respectively; Ptemporal lobe epilepsy and idiopathic epilepsy show impaired whole cognition, verbal fluency, memory, and executive function and have anxiety and depression, which are more significant in children with temporal lobe epilepsy. High levels of anxiety, depression, and seizure frequency are risk factors for impaired cognitive function.

  9. Microsurgical techniques in temporal lobe epilepsy.

    Science.gov (United States)

    Alonso Vanegas, Mario A; Lew, Sean M; Morino, Michiharu; Sarmento, Stenio A

    2017-04-01

    Temporal lobe resection is the most prevalent epilepsy surgery procedure. However, there is no consensus on the best surgical approach to treat temporal lobe epilepsy. Complication rates are low and efficacy is very high regarding seizures after such procedures. However, there is still ample controversy regarding the best surgical approach to warrant maximum seizure control with minimal functional deficits. We describe the most frequently used microsurgical techniques for removal of both the lateral and mesial temporal lobe structures in the treatment of medically intractable temporal lobe epilepsy (TLE) due to mesial temporal sclerosis (corticoamygdalohippocampectomy and selective amygdalohippocampectomy). The choice of surgical technique appears to remain a surgeon's preference for the near future. Meticulous surgical technique and thorough three-dimensional microsurgical knowledge are essentials for obtaining the best results. Wiley Periodicals, Inc. © 2017 International League Against Epilepsy.

  10. Medial temporal lobe reinstatement of content-specific details predicts source memory

    Science.gov (United States)

    Liang, Jackson C.; Preston, Alison R.

    2016-01-01

    Leading theories propose that when remembering past events, medial temporal lobe (MTL) structures reinstate the neural patterns that were active when those events were initially encoded. Accurate reinstatement is hypothesized to support detailed recollection of memories, including their source. While several studies have linked cortical reinstatement to successful retrieval, indexing reinstatement within the MTL network and its relationship to memory performance has proved challenging. Here, we addressed this gap in knowledge by having participants perform an incidental encoding task, during which they visualized people, places, and objects in response to adjective cues. During a surprise memory test, participants saw studied and novel adjectives and indicated the imagery task they performed for each adjective. A multivariate pattern classifier was trained to discriminate the imagery tasks based on functional magnetic resonance imaging (fMRI) responses from hippocampus and MTL cortex at encoding. The classifier was then tested on MTL patterns during the source memory task. We found that MTL encoding patterns were reinstated during successful source retrieval. Moreover, when participants made source misattributions, errors were predicted by reinstatement of incorrect source content in MTL cortex. We further observed a gradient of content-specific reinstatement along the anterior-posterior axis of hippocampus and MTL cortex. Within anterior hippocampus, we found that reinstatement of person content was related to source memory accuracy, whereas reinstatement of place information across the entire hippocampal axis predicted correct source judgments. Content-specific reinstatement was also graded across MTL cortex, with PRc patterns evincing reactivation of people and more posterior regions, including PHc, showing evidence for reinstatement of places and objects. Collectively, these findings provide key evidence that source recollection relies on reinstatement of past

  11. Temporal Lobe Seizure

    Science.gov (United States)

    ... functions, including having odd feelings — such as euphoria, deja vu or fear. Temporal lobe seizures are sometimes called ... sudden sense of unprovoked fear or joy A deja vu experience — a feeling that what's happening has happened ...

  12. Differential contributions of the anterior temporal and medial temporal lobe to the retrieval of memory for person identity information.

    Science.gov (United States)

    Tsukiura, Takashi; Suzuki, Chisato; Shigemune, Yayoi; Mochizuki-Kawai, Hiroko

    2008-12-01

    Although previous studies have suggested the importance of the bilateral anterior temporal (ATL) and medial temporal lobes (MTL) in the retrieval of person identity information, there is little evidence concerning how these regions differentially contribute to the process. Here we investigated this question using functional magnetic resonance imaging (fMRI). Before scanning, subjects learned associations among faces (F), names (N), and job titles (as a form of person-related semantics, S). During retrieval with fMRI, subjects were presented with previously learned and new S stimuli, and judged whether the stimuli were old or new. Successful retrieval (H) trials were divided into three conditions: retrieval of S and associated F and N (HSFN); retrieval of S and associated F (HSF); and retrieval of S only (HS). The left ATL was significantly activated in HSFN, compared to HSF or HS, whereas the right ATL and MTL were significantly activated in HSFN and HSF relative to HS. In addition, activity in bilateral ATL was significantly correlated with reaction time for HSFN, whereas we found no significant correlation between activity in the right MTL and reaction time in any condition. The present findings suggest that the left ATL may mediate associations between names and person-related semantic information, whereas the right ATL mediates the association between faces and person-related semantic information in memory for person identity information. In addition, activation of the right MTL region implies that this area may contribute to a more general relational processing of associative components, including memory for person identity information. Copyright 2007 Wiley-Liss, Inc.

  13. High gamma oscillations in medial temporal lobe during overt production of speech and gestures.

    Science.gov (United States)

    Marstaller, Lars; Burianová, Hana; Sowman, Paul F

    2014-01-01

    The study of the production of co-speech gestures (CSGs), i.e., meaningful hand movements that often accompany speech during everyday discourse, provides an important opportunity to investigate the integration of language, action, and memory because of the semantic overlap between gesture movements and speech content. Behavioral studies of CSGs and speech suggest that they have a common base in memory and predict that overt production of both speech and CSGs would be preceded by neural activity related to memory processes. However, to date the neural correlates and timing of CSG production are still largely unknown. In the current study, we addressed these questions with magnetoencephalography and a semantic association paradigm in which participants overtly produced speech or gesture responses that were either meaningfully related to a stimulus or not. Using spectral and beamforming analyses to investigate the neural activity preceding the responses, we found a desynchronization in the beta band (15-25 Hz), which originated 900 ms prior to the onset of speech and was localized to motor and somatosensory regions in the cortex and cerebellum, as well as right inferior frontal gyrus. Beta desynchronization is often seen as an indicator of motor processing and thus reflects motor activity related to the hand movements that gestures add to speech. Furthermore, our results show oscillations in the high gamma band (50-90 Hz), which originated 400 ms prior to speech onset and were localized to the left medial temporal lobe. High gamma oscillations have previously been found to be involved in memory processes and we thus interpret them to be related to contextual association of semantic information in memory. The results of our study show that high gamma oscillations in medial temporal cortex play an important role in the binding of information in human memory during speech and CSG production.

  14. High gamma oscillations in medial temporal lobe during overt production of speech and gestures.

    Directory of Open Access Journals (Sweden)

    Lars Marstaller

    Full Text Available The study of the production of co-speech gestures (CSGs, i.e., meaningful hand movements that often accompany speech during everyday discourse, provides an important opportunity to investigate the integration of language, action, and memory because of the semantic overlap between gesture movements and speech content. Behavioral studies of CSGs and speech suggest that they have a common base in memory and predict that overt production of both speech and CSGs would be preceded by neural activity related to memory processes. However, to date the neural correlates and timing of CSG production are still largely unknown. In the current study, we addressed these questions with magnetoencephalography and a semantic association paradigm in which participants overtly produced speech or gesture responses that were either meaningfully related to a stimulus or not. Using spectral and beamforming analyses to investigate the neural activity preceding the responses, we found a desynchronization in the beta band (15-25 Hz, which originated 900 ms prior to the onset of speech and was localized to motor and somatosensory regions in the cortex and cerebellum, as well as right inferior frontal gyrus. Beta desynchronization is often seen as an indicator of motor processing and thus reflects motor activity related to the hand movements that gestures add to speech. Furthermore, our results show oscillations in the high gamma band (50-90 Hz, which originated 400 ms prior to speech onset and were localized to the left medial temporal lobe. High gamma oscillations have previously been found to be involved in memory processes and we thus interpret them to be related to contextual association of semantic information in memory. The results of our study show that high gamma oscillations in medial temporal cortex play an important role in the binding of information in human memory during speech and CSG production.

  15. The medial temporal lobe supports sensing-based visual working memory.

    Science.gov (United States)

    Goodrich, Robin I; Yonelinas, Andrew P

    2016-08-01

    It is well established that the medial temporal lobe (MTL), including the hippocampus, is essential for long-term memory. In addition, recent studies suggest that the MTL may also support visual working memory (VWM), but the conditions under which the MTL plays a critical role are not yet clear. To address this issue, we used a color change detection paradigm to examine the effects of MTL damage on VWM by analyzing the receiver operating characteristics of patients with MTL damage and healthy age- and education-matched controls. Compared to controls, patients with MTL damage demonstrated significant reductions in VWM accuracy. Importantly, the patients were not impaired at making accurate high-confidence judgments that a change had occurred; however, they were impaired when making low-confidence responses indicating that they sensed whether or not there had been a visual change. Moreover, these impairments were observed under conditions that emphasized the retrieval of complex bindings or the retrieval of high-resolution bindings. That is, patients with MTL damage exhibited VWM impairments when they were required to remember either a larger number of low-resolution bindings (i.e., set size of 5 and obvious color changes) or a smaller number of high-resolution bindings (i.e., set size of 3 and subtle color changes). The results indicate that only some VWM processes are dependent on the MTL, and are consistent with the proposal that the MTL plays a critical role in forming complex, high-resolution bindings. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. Manual Planimetry of the Medial Temporal Lobe Versus Automated Volumetry of the Hippocampus in the Diagnosis of Alzheimer's Disease.

    Science.gov (United States)

    Menéndez González, Manuel; Suárez-Sanmartin, Esther; García, Ciara; Martínez-Camblor, Pablo; Westman, Eric; Simmons, Andy

    2016-03-26

    Though a disproportionate rate of atrophy in the medial temporal lobe (MTA) represents a reliable marker of Alzheimer's disease (AD) pathology, measurement of the MTA is not currently widely used in daily clinical practice. This is mainly because the methods available to date are sophisticated and difficult to implement in clinical practice (volumetric methods), are poorly explored (linear and planimetric methods), or lack objectivity (visual rating). Here, we aimed to compare the results of a manual planimetric measure (the yearly rate of absolute atrophy of the medial temporal lobe, 2D-yrA-MTL) with the results of an automated volumetric measure (the yearly rate of atrophy of the hippocampus, 3D-yrA-H). A series of 1.5T MRI studies on 290 subjects in the age range of 65-85 years, including patients with AD (n = 100), mild cognitive impairment (MCI) (n = 100), and matched controls (n = 90) from the AddNeuroMed study, were examined by two independent subgroups of researchers: one in charge of volumetric measures and the other in charge of planimetric measures. The means of both methods were significantly different between AD and the other two diagnostic groups. In the differential diagnosis of AD against controls, 3D-yrA-H performed significantly better than 2D-yrA-MTL while differences were not statistically significant in the differential diagnosis of AD against MCI. Automated volumetry of the hippocampus is superior to manual planimetry of the MTL in the diagnosis of AD. Nevertheless, the 2D-yrAMTL is a simpler method that could be easily implemented in clinical practice when volumetry is not available.

  17. Can FDG PET predict verbal specific memory decline after surgery for left temporal lobe epilepsy when MRI is normal?

    International Nuclear Information System (INIS)

    Sagona, J.A.; Rowe, C.C.; Thomas, D.; Dickinson-Rowe, K.L.

    2002-01-01

    Full text: Temporal lobectomy gives excellent control of seizures in over 80% of patients with temporal lobe epilepsy. The left temporal lobe, particularly the left hippocampus, is primarily responsible for verbal memory. In most patients, the hippocampus which lies in the medial temporal lobe is abnormal and can be removed without loss of memory function. However, removal of the left hippocampus when it appears normal on MRI, often causes a significant decline in verbal specific memory (VSM) function. This paper explores the significance of pre-operative FDG-PET asymmetry in temporal lobe metabolism in predicting the VSM outcome after left temporal lobectomy when MRI demonstrates a normal hippocampus. Fifteen patients between 1993 and 2000, underwent left temporal lobectomy including left hippocampal resection, Pre-operatively all patients underwent 1.5T MRI, FDG PET and neuropsychological assessment. Neuropsychological assessment was repeated post-operatively. The left hippocampus was normal on MRI in nine and demonstrated mild T2 signal change without atrophy in six. FDG PET demonstrated temporal lobe hypometabolism in 12 patients. Post-operatively, neuropsychological evaluation documented a decline in verbal specific memory function in six patients, three with normal MRI and three with mild T2 change. We found that all patients with normal FDG PET studies (n=3) demonstrated significant verbal memory deterioration post-operatively. Nine of twelve patients (75%) with left temporal lobe hypometabolism did not show new verbal memory deficits. FDG PET improves the risk stratification for verbal specific memory decline with left temporal lobectomy in patients with normal hippocampi on MRI. Copyright (2002) The Australian and New Zealand Society of Nuclear Medicine Inc

  18. Contributions of Feature Binding During Encoding and Functional Connectivity of the Medial Temporal Lobe Structures to Episodic Memory Deficits Across the Prodromal and First-Episode Phases of Schizophrenia.

    Science.gov (United States)

    Haut, Kristen M; van Erp, Theo G M; Knowlton, Barbara; Bearden, Carrie E; Subotnik, Kenneth; Ventura, Joseph; Nuechterlein, Keith H; Cannon, Tyrone D

    2015-03-01

    Patients with and at risk for psychosis may have difficulty using associative strategies to facilitate episodic memory encoding and recall. In parallel studies, patients with first-episode schizophrenia ( n = 27) and high psychosis risk ( n = 28) compared with control participants ( n = 22 and n = 20, respectively) underwent functional MRI during a remember-know memory task. Psychophysiological interaction analyses, using medial temporal lobe (MTL) structures as regions of interest, were conducted to measure functional connectivity patterns supporting successful episodic memory. During encoding, patients with first-episode schizophrenia demonstrated reduced functional coupling between MTL regions and regions involved in stimulus representations, stimulus selection, and cognitive control. Relative to control participants and patients with high psychosis risk who did not convert to psychosis, patients with high psychosis risk who later converted to psychosis also demonstrated reduced connectivity between MTL regions and auditory-verbal and visual-association regions. These results suggest that episodic memory deficits in schizophrenia are related to inefficient recruitment of cortical connections involved in associative memory formation; such deficits precede the onset of psychosis among those individuals at high clinical risk.

  19. Electrophysiological evidence during episodic prospection implicates medial prefrontal and bilateral middle temporal gyrus.

    Science.gov (United States)

    Hsu, Chia-Fen; Sonuga-Barke, Edmund J S

    2016-08-01

    fMRI studies have implicated the medial prefrontal cortex and medial temporal lobe, components of the default mode network (DMN), in episodic prospection. This study compared quantitative EEG localized to these DMN regions during prospection and during resting and while waiting for rewards. EEG was recorded in twenty-two adults while they were asked to (i) envision future monetary episodes; (ii) wait for rewards and (iii) rest. Activation sources were localized to core DMN regions. EEG power and phase coherence were compared across conditions. Prospection, compared to resting and waiting, was associated with reduced power in the medial prefrontal gyrus and increased power in the bilateral medial temporal gyrus across frequency bands as well as greater phase synchrony between these regions in the delta band. The current quantitative EEG analysis confirms prior fMRI research suggesting that medial prefrontal and medial temporal gyrus interactions are central to the capacity for episodic prospection. Copyright © 2016 Elsevier B.V. All rights reserved.

  20. Metabolic Hyperactivity of the Medial Posterior Parietal Lobes in Psychogenic Tremor

    Directory of Open Access Journals (Sweden)

    Peter Hedera

    2012-05-01

    Full Text Available Background: The pathophysiology of psychogenic movement disorders, including psychogenic tremor (PT, is only emerging. Case Report: This is a single case report of a patient who met diagnostic criteria for PT. He underwent positron emission tomography (PET of brain with 18F-deoxyglucose at resting state. His PET study showed symmetrically increased 18F-deoxyglucose uptake in both posterior medial parietal lobes. There was no corresponding abnormality on structural imaging. Discussion: Hypermetabolism of the medial aspects of posterior parietal lobes bilaterally may reflect abnormal activity of sensory integration that is important in the pathogenesis of PT. This further supports the idea that non-organic movement disorders may be associated with detectable functional brain abnormalities.

  1. Differential Medial Temporal Lobe and Parietal Cortical Contributions to Real-world Autobiographical Episodic and Autobiographical Semantic Memory.

    Science.gov (United States)

    Brown, Thackery I; Rissman, Jesse; Chow, Tiffany E; Uncapher, Melina R; Wagner, Anthony D

    2018-04-18

    Autobiographical remembering can depend on two forms of memory: episodic (event) memory and autobiographical semantic memory (remembering personally relevant semantic knowledge, independent of recalling a specific experience). There is debate about the degree to which the neural signals that support episodic recollection relate to or build upon autobiographical semantic remembering. Pooling data from two fMRI studies of memory for real-world personal events, we investigated whether medial temporal lobe (MTL) and parietal subregions contribute to autobiographical episodic and semantic remembering. During scanning, participants made memory judgments about photograph sequences depicting past events from their life or from others' lives, and indicated whether memory was based on episodic or semantic knowledge. Results revealed several distinct functional patterns: activity in most MTL subregions was selectively associated with autobiographical episodic memory; the hippocampal tail, superior parietal lobule, and intraparietal sulcus were similarly engaged when memory was based on retrieval of an autobiographical episode or autobiographical semantic knowledge; and angular gyrus demonstrated a graded pattern, with activity declining from autobiographical recollection to autobiographical semantic remembering to correct rejections of novel events. Collectively, our data offer insights into MTL and parietal cortex functional organization, and elucidate circuitry that supports different forms of real-world autobiographical memory.

  2. Memory for fearful faces across development: specialization of amygdala nuclei and medial temporal lobe structures.

    Science.gov (United States)

    Pinabiaux, Charlotte; Hertz-Pannier, Lucie; Chiron, Catherine; Rodrigo, Sébastian; Jambaqué, Isabelle; Noulhiane, Marion

    2013-01-01

    Enhanced memory for emotional faces is a significant component of adaptive social interactions, but little is known on its neural developmental correlates. We explored the role of amygdaloid complex (AC) and medial temporal lobe (MTL) in emotional memory recognition across development, by comparing fMRI activations of successful memory encoding of fearful and neutral faces in children (n = 12; 8-12 years) and adolescents (n = 12; 13-17 years). Memory for fearful faces was enhanced compared with neutral ones in adolescents, as opposed to children. In adolescents, activations associated with successful encoding of fearful faces were centered on baso-lateral AC nuclei, hippocampus, enthorhinal and parahippocampal cortices. In children, successful encoding of fearful faces relied on activations of centro-mesial AC nuclei, which was not accompanied by functional activation of MTL memory structures. Successful encoding of neutral faces depended on activations in anterior MTL region (hippocampal head and body) in adolescents, but more posterior ones (hippocampal tail and parahippocampal cortex) in children. In conclusion, two distinct functional specializations emerge from childhood to adolescence and result in the enhancement of memory for these particular stimuli: the specialization of baso-lateral AC nuclei, which is associated with the expertise in processing emotional facial expression, and which is intimately related to the specialization of MTL memory network. How the interplay between specialization of AC nuclei and of MTL memory structures is fundamental for the edification of social interactions remains to be elucidated.

  3. Memory for fearful faces across development: specialization of amygdala nuclei and medial temporal lobe structures

    Directory of Open Access Journals (Sweden)

    Charlotte ePinabiaux

    2013-12-01

    Full Text Available Enhanced memory for emotional faces is a significant component of adaptive social interactions, but little is known on its neural developmental correlates. We explored the role of amygdaloid complex (AC and medial temporal lobe (MTL in emotional memory recognition across development, by comparing fMRI activations of successful memory encoding of fearful and neutral faces in children (n=12; 8-12 years and adolescents (n=12; 13-17 years. Memory for fearful faces was enhanced compared with neutral ones in adolescents, as opposed to children. In adolescents, activations associated with successful encoding of fearful faces were centered on baso-lateral AC nuclei, hippocampus, enthorhinal and parahippocampal cortices. In children, successful encoding of fearful faces relied on activations of centro-mesial AC nuclei, which was not accompanied by functional activation of MTL memory structures. Successful encoding of neutral faces depended on activations in anterior MTL region (hippocampal head and body in adolescents, but more posterior ones (hippocampal tail and parahippocampal cortex in children. In conclusion, two distinct functional specializations emerge from childhood to adolescence and result in the enhancement of memory for these particular stimuli: the specialization of baso-lateral AC nuclei, which is associated with the expertise in processing emotional facial expression, and which is intimately related to the specialization of MTL memory network. How the interplay between specialization of AC nuclei and of MTL memory structures is fundamental for the edification of social interactions remains to be elucidated.

  4. Dynamic imaging in mild traumatic brain injury: support for the theory of medial temporal vulnerability.

    Science.gov (United States)

    Umile, Eric M; Sandel, M Elizabeth; Alavi, Abass; Terry, Charles M; Plotkin, Rosette C

    2002-11-01

    To determine whether patients with mild traumatic brain injury (TBI) and persistent postconcussive symptoms have evidence of temporal lobe injury on dynamic imaging. Case series. An academic medical center. Twenty patients with a clinical diagnosis of mild TBI and persistent postconcussive symptoms were referred for neuropsychologic evaluation and dynamic imaging. Fifteen (75%) had normal magnetic resonance imaging (MRI) and/or computed tomography (CT) scans at the time of injury. Neuropsychologic testing, positron-emission tomography (PET), and single-photon emission-computed tomography (SPECT). Temporal lobe findings on static imaging (MRI, CT) and dynamic imaging (PET, SPECT); neuropsychologic test findings on measures of verbal and visual memory. Testing documented neurobehavioral deficits in 19 patients (95%). Dynamic imaging documented abnormal findings in 18 patients (90%). Fifteen patients (75%) had temporal lobe abnormalities on PET and SPECT (primarily in medial temporal regions); abnormal findings were bilateral in 10 patients (50%) and unilateral in 5 (25%). Six patients (30%) had frontal abnormalities, and 8 (40%) had nonfrontotemporal abnormalities. Correlations between neuropsychologic testing and dynamic imaging could be established but not consistently across the whole group. Patients with mild TBI and persistent postconcussive symptoms have a high incidence of temporal lobe injury (presumably involving the hippocampus and related structures), which may explain the frequent finding of memory disorders in this population. The abnormal temporal lobe findings on PET and SPECT in humans may be analogous to the neuropathologic evidence of medial temporal injury provided by animal studies after mild TBI. Copyright 2002 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

  5. Threat of punishment motivates memory encoding via amygdala, not midbrain, interactions with the medial temporal lobe.

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    Murty, Vishnu P; Labar, Kevin S; Adcock, R Alison

    2012-06-27

    Neural circuits associated with motivated declarative encoding and active threat avoidance have both been described, but the relative contribution of these systems to punishment-motivated encoding remains unknown. The current study used functional magnetic resonance imaging in humans to examine mechanisms of declarative memory enhancement when subjects were motivated to avoid punishments that were contingent on forgetting. A motivational cue on each trial informed participants whether they would be punished or not for forgetting an upcoming scene image. Items associated with the threat of shock were better recognized 24 h later. Punishment-motivated enhancements in subsequent memory were associated with anticipatory activation of right amygdala and increases in its functional connectivity with parahippocampal and orbitofrontal cortices. On a trial-by-trial basis, right amygdala activation during the motivational cue predicted hippocampal activation during encoding of the subsequent scene; across participants, the strength of this interaction predicted memory advantages due to motivation. Of note, punishment-motivated learning was not associated with activation of dopaminergic midbrain, as would be predicted by valence-independent models of motivation to learn. These data are consistent with the view that motivation by punishment activates the amygdala, which in turn prepares the medial temporal lobe for memory formation. The findings further suggest a brain system for declarative learning motivated by punishment that is distinct from that for learning motivated by reward.

  6. Peripheral inflammation acutely impairs human spatial memory via actions on medial temporal lobe glucose metabolism.

    Science.gov (United States)

    Harrison, Neil A; Doeller, Christian F; Voon, Valerie; Burgess, Neil; Critchley, Hugo D

    2014-10-01

    Inflammation impairs cognitive performance and is implicated in the progression of neurodegenerative disorders. Rodent studies demonstrated key roles for inflammatory mediators in many processes critical to memory, including long-term potentiation, synaptic plasticity, and neurogenesis. They also demonstrated functional impairment of medial temporal lobe (MTL) structures by systemic inflammation. However, human data to support this position are limited. Sequential fluorodeoxyglucose positron emission tomography together with experimentally induced inflammation was used to investigate effects of a systemic inflammatory challenge on human MTL function. Fluorodeoxyglucose positron emission tomography scanning was performed in 20 healthy participants before and after typhoid vaccination and saline control injection. After each scanning session, participants performed a virtual reality spatial memory task analogous to the Morris water maze and a mirror-tracing procedural memory control task. Fluorodeoxyglucose positron emission tomography data demonstrated an acute reduction in human MTL glucose metabolism after inflammation. The inflammatory challenge also selectively compromised human spatial, but not procedural, memory; this effect that was independent of actions on motivation or psychomotor response. Effects of inflammation on parahippocampal and rhinal glucose metabolism directly mediated actions of inflammation on spatial memory. These data demonstrate acute sensitivity of human MTL to mild peripheral inflammation, giving rise to associated functional impairment in the form of reduced spatial memory performance. Our findings suggest a mechanism for the observed epidemiologic link between inflammation and risk of age-related cognitive decline and progression of neurodegenerative disorders including Alzheimer's disease. Copyright © 2014 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Functional imaging of semantic memory predicts postoperative episodic memory functions in chronic temporal lobe epilepsy.

    Science.gov (United States)

    Köylü, Bülent; Walser, Gerald; Ischebeck, Anja; Ortler, Martin; Benke, Thomas

    2008-08-05

    Medial temporal (MTL) structures have crucial functions in episodic (EM), but also in semantic memory (SM) processing. Preoperative functional magnetic resonance imaging (fMRI) activity within the MTL is increasingly used to predict post-surgical memory capacities. Based on the hypothesis that EM and SM memory functions are both hosted by the MTL the present study wanted to explore the relationship between SM related activations in the MTL as assessed before and the capacity of EM functions after surgery. Patients with chronic unilateral left (n=14) and right (n=12) temporal lobe epilepsy (TLE) performed a standard word list learning test pre- and postoperatively, and a fMRI procedure before the operation using a semantic decision task. SM processing caused significant bilateral MTL activations in both patient groups. While right TLE patients showed asymmetry of fMRI activation with more activation in the left MTL, left TLE patients had almost equal activation in both MTL regions. Contrasting left TLE versus right TLE patients revealed greater activity within the right MTL, whereas no significant difference was observed for the reverse contrast. Greater effect size in the MTL region ipsilateral to the seizure focus was significantly and positively correlated with preoperative EM abilities. Greater effect size in the contralateral MTL was correlated with better postoperative verbal EM, especially in left TLE patients. These results suggest that functional imaging of SM tasks may be useful to predict postoperative verbal memory in TLE. They also advocate a common neuroanatomical basis for SM and EM processes in the MTL.

  8. Temporal lobe sclerosis associated with hippocampal sclerosis in temporal lobe epilepsy: neuropathological features.

    Science.gov (United States)

    Thom, Maria; Eriksson, Sofia; Martinian, Lillian; Caboclo, Luis O; McEvoy, Andrew W; Duncan, John S; Sisodiya, Sanjay M

    2009-08-01

    Widespread changes involving neocortical and mesial temporal lobe structures can be present in patients with temporal lobe epilepsy and hippocampal sclerosis. The incidence, pathology, and clinical significance of neocortical temporal lobe sclerosis (TLS) are not well characterized. We identified TLS in 30 of 272 surgically treated cases of hippocampal sclerosis. Temporal lobe sclerosis was defined by variable reduction of neurons from cortical layers II/III and laminar gliosis; it was typically accompanied by additional architectural abnormalities of layer II, that is, abnormal neuronal orientation and aggregation. Quantitative analysis including tessellation methods for the distribution of layer II neurons supported these observations. In 40% of cases, there was a gradient of TLS with more severe involvement toward the temporal pole, possibly signifying involvement of hippocampal projection pathways. There was a history of a febrile seizure as an initial precipitating injury in 73% of patients with TLS compared with 36% without TLS; no other clinical differences between TLS and non-TLS cases were identified. Temporal lobe sclerosis was not evident preoperatively by neuroimaging. No obvious effect of TLS on seizure outcome was noted after temporal lobe resection; 73% became seizure-free at 2-year follow-up. In conclusion, approximately 11% of surgically treated hippocampal sclerosis is accompanied by TLS. Temporal lobe sclerosis is likely an acquired process with accompanying reorganizational dysplasia and an extension of mesial temporal sclerosis rather than a separate pathological entity.

  9. Memory Functions following Surgery for Temporal Lobe Epilepsy in Children

    Science.gov (United States)

    Jambaque, Isabelle; Dellatolas, Georges; Fohlen, Martine; Bulteau, Christine; Watier, Laurence; Dorfmuller, Georg; Chiron, Catherine; Delalande, Olivier

    2007-01-01

    Surgical treatment appears to improve the cognitive prognosis in children undergoing surgery for temporal lobe epilepsy (TLE). The beneficial effects of surgery on memory functions, particularly on material-specific memory, are more difficult to assess because of potentially interacting factors such as age range, intellectual level,…

  10. Short-term and long-term memory in early temporal lobe dysfunction.

    Science.gov (United States)

    Hershey, T; Craft, S; Glauser, T A; Hale, S

    1998-01-01

    Following medial temporal damage, mature humans are impaired in retaining new information over long delays but not short delays. The question of whether a similar dissociation occurs in children was addressed by testing children (ages 7-16) with unilateral temporal lobe epilepsy (TLE) and controls on short- and long-term memory tasks, including a spatial delayed response task (SDR). Early-onset TLE did not affect performance on short delays on SDR, but it did impair performance at the longest delay (60 s), similar to adults with unilateral medial temporal damage. In addition, early-onset TLE affected performance on pattern recall, spatial span, and verbal span with rehearsal interference. No differences were found on story recall or on a response inhibition task.

  11. Memory for relations in the short term and the long term after medial temporal lobe damage.

    Science.gov (United States)

    Squire, Larry R

    2017-05-01

    A central idea about the organization of declarative memory and the function of the hippocampus is that the hippocampus provides for the coding of relationships between items. A question arises whether this idea refers to the process of forming long-term memory or whether, as some studies have suggested, memory for relations might depend on the hippocampus even at short retention intervals and even when the task falls within the province of short-term (working) memory. The latter formulation appears to place the operation of relational memory into conflict with the idea that working memory is independent of medial temporal lobe (MTL) structures. In this report, the concepts of relational memory and working memory are discussed in the light of a simple demonstration experiment. Patients with MTL lesions successfully learned and recalled two word pairs when tested directly after learning but failed altogether when tested after a delay. The results do not contradict the idea that the hippocampus has a fundamental role in relational memory. However, there is a need for further elaboration and specification of the idea in order to explain why patients with MTL lesions can establish relational memory in the short term but not in long-term memory. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  12. New learning of music after bilateral medial temporal lobe damage: evidence from an amnesic patient.

    Science.gov (United States)

    Valtonen, Jussi; Gregory, Emma; Landau, Barbara; McCloskey, Michael

    2014-01-01

    Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ's rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece's musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ's complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

  13. New Learning of Music after Bilateral Medial Temporal Lobe Damage: Evidence from an Amnesic Patient

    Science.gov (United States)

    Valtonen, Jussi; Gregory, Emma; Landau, Barbara; McCloskey, Michael

    2014-01-01

    Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ’s rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed and closely matched for factors contributing to a piece’s musical complexity. LSJ practiced playing two of the pieces, one in each of the two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ’s complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance. PMID:25232312

  14. New Learning of Music after Bilateral Medial Temporal Lobe Damage: Evidence from an Amnesic Patient

    Directory of Open Access Journals (Sweden)

    Jussi eValtonen

    2014-09-01

    Full Text Available Damage to the hippocampus impairs the ability to acquire new declarative memories, but not the ability to learn simple motor tasks. An unresolved question is whether hippocampal damage affects learning for music performance, which requires motor processes, but in a cognitively complex context. We studied learning of novel musical pieces by sight-reading in a newly-identified amnesic, LSJ, who was a skilled amateur violist prior to contracting herpes simplex encephalitis. LSJ has suffered virtually complete destruction of the hippocampus bilaterally, as well as extensive damage to other medial temporal lobe structures and the left anterior temporal lobe. Because of LSJ’s rare combination of musical training and near-complete hippocampal destruction, her case provides a unique opportunity to investigate the role of the hippocampus for complex motor learning processes specifically related to music performance. Three novel pieces of viola music were composed, closely matched for factors contributing to a piece’s musical complexity. LSJ practiced playing two of the pieces, one in each of two sessions during the same day. Relative to a third unpracticed control piece, LSJ showed significant pre- to post-training improvement for the two practiced pieces. Learning effects were observed both with detailed analyses of correctly played notes, and with subjective whole-piece performance evaluations by string instrument players. The learning effects were evident immediately after practice and 14 days later. The observed learning stands in sharp contrast to LSJ’s complete lack of awareness that the same pieces were being presented repeatedly, and to the profound impairments she exhibits in other learning tasks. Although learning in simple motor tasks has been previously observed in amnesic patients, our results demonstrate that non-hippocampal structures can support complex learning of novel musical sequences for music performance.

  15. Long-term consolidation of declarative memory: insight from temporal lobe epilepsy.

    Science.gov (United States)

    Tramoni, Eve; Felician, Olivier; Barbeau, Emmanuel J; Guedj, Eric; Guye, Maxime; Bartolomei, Fabrice; Ceccaldi, Mathieu

    2011-03-01

    Several experiments carried out with a subset of patients with temporal lobe epilepsy have demonstrated normal memory performance at standard delays of recall (i.e. minutes to hours) but impaired performance over longer delays (i.e. days or weeks), suggesting altered long-term consolidation mechanisms. These mechanisms were specifically investigated in a group of five adult-onset pharmaco-sensitive patients with temporal lobe epilepsy, exhibiting severe episodic memory complaints despite normal performance at standardized memory assessment. In a first experiment, the magnitude of autobiographical memory loss was evaluated using retrograde personal memory tasks based on verbal and visual cues. In both conditions, results showed an unusual U-shaped pattern of personal memory impairment, encompassing most of the patients' life, sparing however, periods of the childhood, early adulthood and past several weeks. This profile was suggestive of a long-term consolidation impairment of personal episodes, adequately consolidated over 'short-term' delays but gradually forgotten thereafter. Therefore, in a subsequent experiment, patients were submitted to a protocol specifically devised to investigate short and long-term consolidation of contextually-bound experiences (episodic memory) and context-free information (semantic knowledge and single-items). In the short term (1 h), performance at both contextually-free and contextually-bound memory tasks was intact. After a 6-week delay, however, contextually-bound memory performance was impaired while contextually-free memory performance remained preserved. This effect was independent of task difficulty and the modality of retrieval (recall and recognition). Neuroimaging studies revealed the presence of mild metabolic changes within medial temporal lobe structures. Taken together, these results show the existence of different consolidation systems within declarative memory. They suggest that mild medial temporal lobe dysfunction

  16. Mesial temporal lobe epilepsy diminishes functional connectivity during emotion perception.

    Science.gov (United States)

    Steiger, Bettina K; Muller, Angela M; Spirig, Esther; Toller, Gianina; Jokeit, Hennric

    2017-08-01

    Unilateral mesial temporal lobe epilepsy (MTLE) has been associated with impaired recognition of emotional facial expressions. Correspondingly, imaging studies showed decreased activity of the amygdala and cortical face processing regions in response to emotional faces. However, functional connectivity among regions involved in emotion perception has not been studied so far. To address this, we examined intrinsic functional connectivity (FC) modulated by the perception of dynamic fearful faces among the amygdala and limbic, frontal, temporal and brainstem regions. Regions of interest were identified in an activation analysis by presenting a block-design with dynamic fearful faces and dynamic landscapes to 15 healthy individuals. This led to 10 predominately right-hemispheric regions. Functional connectivity between these regions during the perception of fearful faces was examined in drug-refractory patients with left- (n=16) or right-sided (n=17) MTLE, epilepsy patients with extratemporal seizure onset (n=15) and a second group of 15 healthy controls. Healthy controls showed a widespread functional network modulated by the perception of fearful faces that encompassed bilateral amygdalae, limbic, cortical, subcortical and brainstem regions. In patients with left MTLE, a downsized network of frontal and temporal regions centered on the right amygdala was present. Patients with right MTLE showed almost no significant functional connectivity. A maintained network in the epilepsy control group indicates that findings in mesial temporal lobe epilepsy could not be explained by clinical factors such as seizures and antiepileptic medication. Functional networks underlying facial emotion perception are considerably changed in left and right MTLE. Alterations are present for both hemispheres in either MTLE group, but are more pronounced in right MTLE. Disruption of the functional network architecture possibly contributes to deficits in facial emotion recognition frequently

  17. The role of medial temporal lobe in retrieving spatial and nonspatial relations from episodic and semantic memory.

    Science.gov (United States)

    Ryan, Lee; Lin, Chun-Yu; Ketcham, Katie; Nadel, Lynn

    2010-01-01

    This study examined the involvement of medial temporal lobe, especially the hippocampus, in processing spatial and nonspatial relations using episodic and semantic versions of a relational judgment task. Participants studied object arrays and were tested on different types of relations between pairs of objects. Three prevalent views of hippocampal function were considered. Cognitive map theory (O'Keefe and Nadel (1978) The Hippocampus as a Cognitive Map. USA: Oxford University Press) emphasizes hippocampal involvement in spatial relational tasks. Multiple trace theory (Nadel and Moscovitch (1997) Memory consolidation, retrograde amnesia and the hippocampal complex Curr Opin Neurobiol 7:217-227) emphasizes hippocampal involvement in episodic tasks. Eichenbaum and Cohen's ((2001) From Conditioning to Conscious Recollection: Memory Systems of the Brain. USA: Oxford University Press) relational theory predicts equivalent hippocampal involvement in all relational tasks within both semantic and episodic memory. The fMRI results provided partial support for all three theories, though none of them fit the data perfectly. We observed hippocampal activation during all relational tasks, with increased activation for spatial compared to nonspatial relations, and for episodic compared to semantic relations. The placement of activation along the anterior-posterior axis of the hippocampus also differentiated the conditions. We suggest a view of hippocampal function in memory that incorporates aspects of all three theories. Copyright 2009 Wiley-Liss, Inc.

  18. Imaging structural and functional brain networks in temporal lobe epilepsy

    Science.gov (United States)

    Bernhardt, Boris C.; Hong, SeokJun; Bernasconi, Andrea; Bernasconi, Neda

    2013-01-01

    Early imaging studies in temporal lobe epilepsy (TLE) focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing the topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy. PMID:24098281

  19. Imaging structural and functional brain networks in temporal lobe epilepsy.

    Science.gov (United States)

    Bernhardt, Boris C; Hong, Seokjun; Bernasconi, Andrea; Bernasconi, Neda

    2013-10-01

    Early imaging studies in temporal lobe epilepsy (TLE) focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing the topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy.

  20. Imaging structural and functional brain networks in temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Boris eBernhardt

    2013-10-01

    Full Text Available Early imaging studies in temporal lobe epilepsy (TLE focused on the search for mesial temporal sclerosis, as its surgical removal results in clinically meaningful improvement in about 70% of patients. Nevertheless, a considerable subgroup of patients continues to suffer from post-operative seizures. Although the reasons for surgical failure are not fully understood, electrophysiological and imaging data suggest that anomalies extending beyond the temporal lobe may have negative impact on outcome. This hypothesis has revived the concept of human epilepsy as a disorder of distributed brain networks. Recent methodological advances in non-invasive neuroimaging have led to quantify structural and functional networks in vivo. While structural networks can be inferred from diffusion MRI tractography and inter-regional covariance patterns of structural measures such as cortical thickness, functional connectivity is generally computed based on statistical dependencies of neurophysiological time-series, measured through functional MRI or electroencephalographic techniques. This review considers the application of advanced analytical methods in structural and functional connectivity analyses in TLE. We will specifically highlight findings from graph-theoretical analysis that allow assessing topological organization of brain networks. These studies have provided compelling evidence that TLE is a system disorder with profound alterations in local and distributed networks. In addition, there is emerging evidence for the utility of network properties as clinical diagnostic markers. Nowadays, a network perspective is considered to be essential to the understanding of the development, progression, and management of epilepsy.

  1. Medial temporal lobe involvement in an implicit memory task: evidence of collaborating implicit and explicit memory systems from FMRI and Alzheimer's disease.

    Science.gov (United States)

    Koenig, Phyllis; Smith, Edward E; Troiani, Vanessa; Anderson, Chivon; Moore, Peachie; Grossman, Murray

    2008-12-01

    We used a prototype extraction task to assess implicit learning of a meaningful novel visual category. Cortical activation was monitored in young adults with functional magnetic resonance imaging. We observed occipital deactivation at test consistent with perceptually based implicit learning, and lateral temporal cortex deactivation reflecting implicit acquisition of the category's semantic nature. Medial temporal lobe (MTL) activation during exposure and test suggested involvement of explicit memory as well. Behavioral performance of Alzheimer's disease (AD) patients and healthy seniors was also assessed, and AD performance was correlated with gray matter volume using voxel-based morphometry. AD patients showed learning, consistent with preserved implicit memory, and confirming that AD patients' implicit memory is not limited to abstract patterns. However, patients were somewhat impaired relative to healthy seniors. Occipital and lateral temporal cortical volume correlated with successful AD patient performance, and thus overlapped with young adults' areas of deactivation. Patients' severe MTL atrophy precluded involvement of this region. AD patients thus appear to engage a cortically based implicit memory mechanism, whereas their relative deficit on this task may reflect their MTL disease. These findings suggest that implicit and explicit memory systems collaborate in neurologically intact individuals performing an ostensibly implicit memory task.

  2. Improved Cerebral Function in Mesial Temporal Lobe Epilepsy after Subtemporal Amygdalohippocampectomy

    Science.gov (United States)

    Takaya, Shigetoshi; Mikuni, Nobuhiro; Mitsueda, Takahiro; Satow, Takeshi; Taki, Junya; Kinoshita, Masako; Miyamoto, Susumu; Hashimoto, Nobuo; Ikeda, Akio; Fukuyama, Hidenao

    2009-01-01

    The functional changes that occur throughout the human brain after the selective removal of an epileptogenic lesion remain unclear. Subtemporal selective amygdalohippocampectomy (SAH) has been advocated as a minimally invasive surgical procedure for patients with medically intractable mesial temporal lobe epilepsy (MTLE). We evaluated the effects…

  3. [Pathological neocortical findings in patients with medication-resistant medial temporal lobe epilepsy submitted to surgery].

    Science.gov (United States)

    Estupiñán-Díaz, B; Morales-Chacón, L M; Lorigados-Pedre, L; García-Maeso, I; Bender-del Busto, J E; Trápaga-Quincoses, O; Hidalgo-Portal, L; García-Navarro, M E; Sánchez-Coroneaux, A; Orozco-Suárez, S

    The dual pathology consisting of hippocampal sclerosis plus focal cortical dysplasia (FCD) is often reported in patients with medication-resistant medial temporal lobe epilepsy (MTLE). To determine the histopathological changes that take place in the neocortex of patients with medication-resistant MTLE submitted to surgery and to evaluate the relation between the histopathological changes, pathological background and the clinical course of patients who had received surgical treatment. Tissue obtained by en bloc resection from the neocortex of 18 patients with MTLE refractory to medical treatment was processed histologically and a tailored temporal lobectomy was performed with electrocorticography. Dual pathology was diagnosed in 13 patients (72.2%). Imaging studies confirmed the existence of mesial sclerosis of the temporal in 100% of cases and there was no evidence of neocortical lesions. Histologically, 46.15% and 38.46% of the patients were diagnosed as belonging to FCD type 1a and FCD type 1b, respectively. Only one patient presented FCD type 2a. A statistically significant relation was found between the presence of dual pathology and the existence of an early precipitating injury (p = 0.04). One year after surgery, 72.7% (8/11) patients with dual pathology were classified as belonging to Engel class I. In patients with MTLE there are microscopic FCD-type alterations in the neocortex. There is an association between these alterations and the existence of an initial precipitating injury. Complete resection of the epileptogenic area, which is guaranteed by the lobectomy tailored by electrocorticography, allows patients to enjoy a favourable post-surgical progression one year after surgery.

  4. Temporal Lobe Epilepsy in Children

    Science.gov (United States)

    Nickels, Katherine C.; Wong-Kisiel, Lily C.; Moseley, Brian D.; Wirrell, Elaine C.

    2012-01-01

    The temporal lobe is a common focus for epilepsy. Temporal lobe epilepsy in infants and children differs from the relatively homogeneous syndrome seen in adults in several important clinical and pathological ways. Seizure semiology varies by age, and the ictal EEG pattern may be less clear cut than what is seen in adults. Additionally, the occurrence of intractable seizures in the developing brain may impact neurocognitive function remote from the temporal area. While many children will respond favorably to medical therapy, those with focal imaging abnormalities including cortical dysplasia, hippocampal sclerosis, or low-grade tumors are likely to be intractable. Expedient workup and surgical intervention in these medically intractable cases are needed to maximize long-term developmental outcome. PMID:22957247

  5. Enhancement of Neocortical-Medial Temporal EEG Correlations during Non-REM Sleep

    Directory of Open Access Journals (Sweden)

    Nikolai Axmacher

    2008-01-01

    Full Text Available Interregional interactions of oscillatory activity are crucial for the integrated processing of multiple brain regions. However, while the EEG in virtually all brain structures passes through substantial modifications during sleep, it is still an open question whether interactions between neocortical and medial temporal EEG oscillations also depend on the state of alertness. Several previous studies in animals and humans suggest that hippocampal-neocortical interactions crucially depend on the state of alertness (i.e., waking state or sleep. Here, we analyzed scalp and intracranial EEG recordings during sleep and waking state in epilepsy patients undergoing presurgical evaluation. We found that the amplitudes of oscillations within the medial temporal lobe and the neocortex were more closely correlated during sleep, in particular during non-REM sleep, than during waking state. Possibly, the encoding of novel sensory inputs, which mainly occurs during waking state, requires that medial temporal dynamics are rather independent from neocortical dynamics, while the consolidation of memories during sleep may demand closer interactions between MTL and neocortex.

  6. Medial temporal lobe-dependent repetition suppression and enhancement due to implicit versus explicit processing of individual repeated search displays

    Directory of Open Access Journals (Sweden)

    Thomas eGeyer

    2012-10-01

    Full Text Available Using visual search, functional magnetic resonance imaging (fMRI and patient studies have demonstrated that medial temporal lobe (MTL structures differentiate repeated from novel displays – even when observers are unaware of display repetitions. This suggests a role for MTL in both explicit and, importantly, implicit learning of repeated sensory information (Greene et al., 2007. However, recent behavioral studies suggest, by examining visual search and recognition performance concurrently, that observers have explicit knowledge of at least some of the repeated displays (Geyer et al., 2010. The aim of the present fMRI study was thus to contribute new evidence regarding the contribution of MTL structures to explicit versus implicit learning in visual search. It was found that MTL activation was increased for explicit and, respectively, decreased for implicit relative to baseline displays. These activation differences were most pronounced in left anterior parahippocampal cortex, especially when observers were highly trained on the repeated displays. The data are taken to suggest that explicit and implicit memory processes are linked within MTL structures, but expressed via functionally separable mechanisms (repetition enhancement vs. -suppression. They further show that repetition effects in visual search would have to be investigated at the display level.

  7. Electroencephalography in Mesial Temporal Lobe Epilepsy: A Review

    Science.gov (United States)

    Javidan, Manouchehr

    2012-01-01

    Electroencephalography (EEG) has an important role in the diagnosis and classification of epilepsy. It can provide information for predicting the response to antiseizure drugs and to identify the surgically remediable epilepsies. In temporal lobe epilepsy (TLE) seizures could originate in the medial or lateral neocortical temporal region, and many of these patients are refractory to medical treatment. However, majority of patients have had excellent results after surgery and this often relies on the EEG and magnetic resonance imaging (MRI) data in presurgical evaluation. If the scalp EEG data is insufficient or discordant, invasive EEG recording with placement of intracranial electrodes could identify the seizure focus prior to surgery. This paper highlights the general information regarding the use of EEG in epilepsy, EEG patterns resembling epileptiform discharges, and the interictal, ictal and postictal findings in mesial temporal lobe epilepsy using scalp and intracranial recordings prior to surgery. The utility of the automated seizure detection and computerized mathematical models for increasing yield of non-invasive localization is discussed. This paper also describes the sensitivity, specificity, and predictive value of EEG for seizure recurrence after withdrawal of medications following seizure freedom with medical and surgical therapy. PMID:22957235

  8. Altered organization of face processing networks in temporal lobe epilepsy

    Science.gov (United States)

    Riley, Jeffrey D.; Fling, Brett W.; Cramer, Steven C.; Lin, Jack J.

    2015-01-01

    SUMMARY Objective Deficits in social cognition are common and significant in people with temporal lobe epilepsy (TLE), but the functional and structural underpinnings remain unclear. The present study investigated how the side of seizure focus impacts face processing networks in temporal lobe epilepsy. Methods We used functional magnetic resonance imaging (fMRI) of a face processing paradigm to identify face responsive regions in 24 individuals with unilateral temporal lobe epilepsy (Left = 15; Right = 9) and 19 healthy controls. fMRI signals of face responsive regions ispilateral and contralateral to the side of seizure onset were delineated in TLE and compared to the healthy controls with right and left side combined. Diffusion tensor images were acquired to investigate structural connectivity between face regions that differed in fMRI signals between the two groups. Results In temporal lobe epilepsy, activation of the cortical face processing networks varied according to side of seizure onset. In temporal lobe epilepsy, the laterality of amygdala activation was shifted to the side contralateral to the seizure focus while controls showed no significant asymmetry. Furthermore, compared to controls, patients with TLE showed decreased activation of the occipital face responsive region in the ipsilateral side and an increased activity of the anterior temporal lobe in the contralateral side to the seizure focus. Probabilistic tractography revealed that the occipital face area and anterior temporal lobe are connected via the inferior longitudinal fasciculus, which in individuals with temporal lobe epilepsy showed reduced integrity. Significance Taken together, these findings suggest that brain function and white matter integrity of networks subserving face processing are impaired on the side of seizure onset, accompanied by altered responses on the side contralateral to the seizure. PMID:25823855

  9. [Advances in research on cognitive function related to temporal lobe epilepsy: focus on social cognitive function].

    Science.gov (United States)

    Yamano, Mitsuhiko; Akamatsu, Naoki; Tsuji, Sadatoshi

    2012-09-01

    Research on cognitive function related to temporal lobe epilepsy has thus far focused on memory, language, and general intelligence. Recently, however, the concept of social cognitive function has been proposed in the field of neuropsychology. Social cognitive function refers collectively to the higher cognitive functions that are essential in our social lives, and its representative aspects are facial expression recognition and decision-making. Emotional processing centered around the amygdala is thought to play a key role in the neural mechanism of this function. We conducted a study on the social cognitive function (decision-making) of patients with temporal lobe epilepsy, and found that this function is reduced in these patients, and that the right amygdalo-hippocampal complexes play an important role. In order to ensure the best possible treatment for epilepsy patients, it is necessary not only to make an accurate diagnosis and provide appropriate treatment, but also to provide support for enabling a smoother social life from the perspective of social cognitive function. Future research developments in this field are expected to contribute to total management in medical care for epilepsy patients.

  10. Learning and memory and its relationship with the lateralization of epileptic focus in subjects with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Daniel Fuentes

    2014-04-01

    Full Text Available Background : In medial temporal lobe epilepsy (MTLE, previous studies addressing the hemispheric laterality of epileptogenic focus and its relationship with learning and memory processes have reported controversial findings. Objective : To compare the performance of MTLE patients according to the location of the epileptogenic focus on the left (MTLEL or right temporal lobe (MTLER on tasks of episodic learning and memory for verbal and visual content. Methods : One hundred patients with MTLEL and one hundred patients with MTLER were tested with the following tasks: the Rey Auditory Verbal Learning Test (RAVLT and the Logical Memory-WMS-R to evaluate verbal learning and memory; and the Rey Visual Design Learning Test (RVDLT and the Visual Reproduction-WMS-R to evaluate visual learning and memory. Results : The MTLEL sample showed significantly worse performance on the RAVLT (p < 0.005 and on the Logical Memory tests (p < 0.01 than MTLER subjects. However, there were no significant between-group differences in regard to the visual memory tests. Discussion : Our findings suggest that verbal learning and memory abilities are dependent on the structural and functional integrity of the left temporal lobe, while visual abilities are less dependent on the right temporal lobe.

  11. Stress as a mnemonic filter: Interactions between medial temporal lobe encoding processes and post-encoding stress.

    Science.gov (United States)

    Ritchey, Maureen; McCullough, Andrew M; Ranganath, Charan; Yonelinas, Andrew P

    2017-01-01

    Acute stress has been shown to modulate memory for recently learned information, an effect attributed to the influence of stress hormones on medial temporal lobe (MTL) consolidation processes. However, little is known about which memories will be affected when stress follows encoding. One possibility is that stress interacts with encoding processes to selectively protect memories that had elicited responses in the hippocampus and amygdala, two MTL structures important for memory formation. There is limited evidence for interactions between encoding processes and consolidation effects in humans, but recent studies of consolidation in rodents have emphasized the importance of encoding "tags" for determining the impact of consolidation manipulations on memory. Here, we used functional magnetic resonance imaging in humans to test the hypothesis that the effects of post-encoding stress depend on MTL processes observed during encoding. We found that changes in stress hormone levels were associated with an increase in the contingency of memory outcomes on hippocampal and amygdala encoding responses. That is, for participants showing high cortisol reactivity, memories became more dependent on MTL activity observed during encoding, thereby shifting the distribution of recollected events toward those that had elicited relatively high activation. Surprisingly, this effect was generally larger for neutral, compared to emotionally negative, memories. The results suggest that stress does not uniformly enhance memory, but instead selectively preserves memories tagged during encoding, effectively acting as mnemonic filter. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  12. The cognitive profile of occipital lobe epilepsy and the selective association of left temporal lobe hypometabolism with verbal memory impairment.

    Science.gov (United States)

    Knopman, Alex A; Wong, Chong H; Stevenson, Richard J; Homewood, Judi; Mohamed, Armin; Somerville, Ernest; Eberl, Stefan; Wen, Lingfeng; Fulham, Michael; Bleasel, Andrew F

    2014-08-01

    We investigated the cognitive profile of structural occipital lobe epilepsy (OLE) and whether verbal memory impairment is selectively associated with left temporal lobe hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET). Nine patients with OLE, ages 8-29 years, completed presurgical neuropsychological assessment. Composite measures were calculated for intelligence quotient (IQ), speed, attention, verbal memory, nonverbal memory, and executive functioning. In addition, the Wisconsin Card Sorting Test (WCST) was used as a specific measure of frontal lobe functioning. Presurgical FDG-PET was analyzed with statistical parametric mapping in 8 patients relative to 16 healthy volunteers. Mild impairments were evident for IQ, speed, attention, and executive functioning. Four patients demonstrated moderate or severe verbal memory impairment. Temporal lobe hypometabolism was found in seven of eight patients. Poorer verbal memory was associated with left temporal lobe hypometabolism (p = 0.002), which was stronger (p = 0.03 and p = 0.005, respectively) than the association of left temporal lobe hypometabolism with executive functioning or with performance on the WCST. OLE is associated with widespread cognitive comorbidity, suggesting cortical dysfunction beyond the occipital lobe. Verbal memory impairment is selectively associated with left temporal lobe hypometabolism in OLE, supporting a link between neuropsychological dysfunction and remote hypometabolism in focal epilepsy. Wiley Periodicals, Inc. © 2014 International League Against Epilepsy.

  13. What, if anything, is the medial temporal lobe, and how can the amygdala be part of it if there is no such thing?

    Science.gov (United States)

    Murray, Elisabeth A; Wise, Steven P

    2004-11-01

    Should the medial temporal lobe (MTL) of primates--which includes allocortical structures such as the hippocampus, neocortical structures such as the parahippocampal cortex, and nuclear structures such as the basolateral amygdala--be considered a single "thing"? According to the prevailing view, here termed the reification theory, the answer is yes. According to this theory, the MTL functions as an amalgamated entity that provides the neuronal mechanisms for declarative memory; the greater the damage to the MTL or any of its components, the greater the deleterious effects on declarative memory. A countervailing view, here called the balkanization theory, holds that the various components of the MTL process and store different kinds of information. According to this theory, damage to each part of the MTL causes a unique set of behavioral deficits-some involving memory, others involving perception, and yet others involving response selection. The empirical neuropsychological evidence favors the balkanization theory, as do some new concepts in theoretical neuroanatomy.

  14. The Structural Plasticity of White Matter Networks Following Anterior Temporal Lobe Resection

    Science.gov (United States)

    Yogarajah, Mahinda; Focke, Niels K.; Bonelli, Silvia B.; Thompson, Pamela; Vollmar, Christian; McEvoy, Andrew W.; Alexander, Daniel C.; Symms, Mark R.; Koepp, Matthias J.; Duncan, John S.

    2010-01-01

    Anterior temporal lobe resection is an effective treatment for refractory temporal lobe epilepsy. The structural consequences of such surgery in the white matter, and how these relate to language function after surgery remain unknown. We carried out a longitudinal study with diffusion tensor imaging in 26 left and 20 right temporal lobe epilepsy…

  15. Mapping thalamocortical network pathology in temporal lobe epilepsy.

    Science.gov (United States)

    Bernhardt, Boris C; Bernasconi, Neda; Kim, Hosung; Bernasconi, Andrea

    2012-01-10

    Although experimental work has provided evidence that the thalamus is a crucial relay structure in temporal lobe epilepsy (TLE), the relation of the thalamus to neocortical pathology remains unclear. To assess thalamocortical network pathology in TLE, we mapped pointwise patterns of thalamic atrophy and statistically related them to neocortical thinning. We studied cross-sectionally 36 patients with drug-resistant TLE and 19 age- and sex-matched healthy control subjects using high-resolution MRI. To localize thalamic pathology, we converted manual labels into surface meshes using the spherical harmonic description and calculated local deformations relative to a template. In addition, we measured cortical thickness by means of the constrained Laplacian anatomic segmentation using proximity algorithm. Compared with control subjects, patients with TLE showed ipsilateral thalamic atrophy that was located along the medial surface, encompassing anterior, medial, and posterior divisions. Unbiased analysis correlating the degree of medial thalamic atrophy with cortical thickness measurements mapped bilateral frontocentral, lateral temporal, and mesiotemporal cortices. These areas overlapped with those of cortical thinning found when patients were compared with control subjects. Thalamic atrophy intensified with a longer duration of epilepsy and was more severe in patients with a history of febrile convulsions. The degree and distribution of thalamic pathology relates to the topography and extent of neocortical atrophy, lending support to the concept that the thalamus is an important hub in the pathologic network of TLE.

  16. Application of own computer program for assessment of brain-fluid index in the medial temporal lobe portions in patients with drug-resistant temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Boguslawska, R.; Skrobowska, E.; Rysz, A.

    2009-01-01

    Background: Epilepsy resistant to pharmacological treatment still remains one of the main problems in contemporary epileptology. The problem most frequently concerns patients with focal epilepsy, with the seizure focus possible to localize. In case of drug-resistant epilepsy, both morphological imaging methods (MR) and manual measurements or volumetry are used. Also functional studies, such as MRS (magnetic resonance spectroscopy), fMRI (functional magnetic resonance), SPECT (single photon emission tomography) and PET (positron emission tomography) are performed. Material/Methods: The study presents application of own computer program based on the method of segmentation of the cerebrospinal fluid (CSF) and the brain tissue. The program calculates automatically the brain-fluin index in the hippocampal region. The material comprises the brain-fluin index results calculated with the presented program in comparison with the method of manual delineation in a group of 50 patients with drug-resistant temporal lobe epilepsy. The program is easy to use, it reads the MR data recorded in DICOM installed on a PC. Results: The brain-fluin index result (expressed as a decimal fraction) is calculated on the basis of 4 consecutive layers examined by MR (evaluating hippocampal structures) performed using SE sequence, and T2-weighted imaging in the frontal plane perpendicular to the long axis of the temporal lobes. The results obtained in epilepsy patients were compared with 24 control subjects. Conclusions: Detailed analysis of the obtained data allowed to conclude that precise hippocampal volume assessment can be obtained by combination of both methods, i.e. manual delineation and automatic calculation of brain-fluin index taking into consideration the total volume of cerebral structures. (authors)

  17. Declarative long-term memory and the mesial temporal lobe: Insights from a 5-year postsurgery follow-up study on refractory temporal lobe epilepsy.

    Science.gov (United States)

    Salvato, Gerardo; Scarpa, Pina; Francione, Stefano; Mai, Roberto; Tassi, Laura; Scarano, Elisa; Lo Russo, Giorgio; Bottini, Gabriella

    2016-11-01

    It is largely recognized that the mesial temporal lobe and its substructure support declarative long-term memory (LTM). So far, different theories have been suggested, and the organization of declarative verbal LTM in the brain is still a matter of debate. In the current study, we retrospectively selected 151 right-handed patients with temporal lobe epilepsy with and without hippocampal sclerosis, with a homogeneous (seizure-free) clinical outcome. We analyzed verbal memory performance within a normalized scores context, by means of prose recall and word paired-associate learning tasks. Patients were tested at presurgical baseline, 6months, 2 and 5years after anteromesial temporal lobe surgery, using parallel versions of the neuropsychological tests. Our main finding revealed a key involvement of the left temporal lobe and, in particular, of the left hippocampus in prose recall rather than word paired-associate task. We also confirmed that shorter duration of epilepsy, younger age, and withdrawal of antiepileptic drugs would predict a better memory outcome. When individual memory performance was taken into account, data showed that females affected by left temporal lobe epilepsy for longer duration were more at risk of presenting a clinically pathologic LTM at 5years after surgery. Taken together, these findings shed new light on verbal declarative memory in the mesial temporal lobe and on the behavioral signature of the functional reorganization after the surgical treatment of temporal lobe epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  18. Cortical Activation during a Cognitive Challenge in Patients with Chronic Temporal Lobe Epilepsy—A Dynamic SPECT Study

    Directory of Open Access Journals (Sweden)

    P. J. Kirkpatrick

    1993-01-01

    Full Text Available In a pilot group of six patients suffering from chronic temporal lobe epilepsy, single photon emission computerized tomography (SPECT has been used to image the changes in relative cerebral blood flow between rest (static scan and conditions of cognitive activation (activated scan. The cognitive challenge used during activation comprised a test of word memory, and the performance was expressed as a word memory score (WMS for each individual. An activation index (AI was calculated from the mean normalized density counts in specific regions of interest (ROIs, and values obtained were analysed for correlation with the WMS. The mean AI was increased significantly in the right lateral temporal cortex, the right and left inferior frontal regions, the left temporal pole, and the right medial temporal cortex. A positive correlation with the WMS was found in the medial temporal cortices, and this relationship was significant for the right medial temporal ROI.

  19. White Matter Tracts Connected to the Medial Temporal Lobe Support the Development of Mnemonic Control.

    Science.gov (United States)

    Wendelken, Carter; Lee, Joshua K; Pospisil, Jacqueline; Sastre, Marcos; Ross, Julia M; Bunge, Silvia A; Ghetti, Simona

    2015-09-01

    One of the most important factors driving the development of memory during childhood is mnemonic control, or the capacity to initiate and maintain the processes that guide encoding and retrieval operations. The ability to selectively attend to and encode relevant stimuli is a particularly useful form of mnemonic control, and is one that undergoes marked improvement over childhood. We hypothesized that structural integrity of white matter tracts, in particular those connecting medial temporal lobe memory regions to other cortical areas, and/or those connecting frontal and parietal control regions, should contribute to successful mnemonic control. To test this hypothesis, we examined the relationship between structural integrity of selected white matter tracts and an experimental measure of mnemonic control, involving enhancement of memory by attention at encoding, in 116 children aged 7-11 and 25 young adults. We observed a positive relationship between integrity of uncinate fasciculus and mnemonic enhancement across age groups. In adults, but not in children, we also observed an association between mnemonic enhancement and integrity of ventral cingulum bundle and ventral fornix/fimbria. Integrity of fronto-parietal tracts, including dorsal cingulum and superior longitudinal fasciculus, was unrelated to mnemonic enhancement. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  20. Distinct medial temporal networks encode surprise during motivation by reward versus punishment

    OpenAIRE

    Murty, Vishnu P.; LaBar, Kevin S.; Adcock, R. Alison

    2016-01-01

    Adaptive motivated behavior requires predictive internal representations of the environment, and surprising events are indications for encoding new representations of the environment. The medial temporal lobe memory system, including the hippocampus and surrounding cortex, encodes surprising events and is influenced by motivational state. Because behavior reflects the goals of an individual, we investigated whether motivational valence (i.e., pursuing rewards versus avoiding punishments) also...

  1. Preoperative automated fibre quantification predicts postoperative seizure outcome in temporal lobe epilepsy.

    Science.gov (United States)

    Keller, Simon S; Glenn, G Russell; Weber, Bernd; Kreilkamp, Barbara A K; Jensen, Jens H; Helpern, Joseph A; Wagner, Jan; Barker, Gareth J; Richardson, Mark P; Bonilha, Leonardo

    2017-01-01

    Approximately one in every two patients with pharmacoresistant temporal lobe epilepsy will not be rendered completely seizure-free after temporal lobe surgery. The reasons for this are unknown and are likely to be multifactorial. Quantitative volumetric magnetic resonance imaging techniques have provided limited insight into the causes of persistent postoperative seizures in patients with temporal lobe epilepsy. The relationship between postoperative outcome and preoperative pathology of white matter tracts, which constitute crucial components of epileptogenic networks, is unknown. We investigated regional tissue characteristics of preoperative temporal lobe white matter tracts known to be important in the generation and propagation of temporal lobe seizures in temporal lobe epilepsy, using diffusion tensor imaging and automated fibre quantification. We studied 43 patients with mesial temporal lobe epilepsy associated with hippocampal sclerosis and 44 healthy controls. Patients underwent preoperative imaging, amygdalohippocampectomy and postoperative assessment using the International League Against Epilepsy seizure outcome scale. From preoperative imaging, the fimbria-fornix, parahippocampal white matter bundle and uncinate fasciculus were reconstructed, and scalar diffusion metrics were calculated along the length of each tract. Altogether, 51.2% of patients were rendered completely seizure-free and 48.8% continued to experience postoperative seizure symptoms. Relative to controls, both patient groups exhibited strong and significant diffusion abnormalities along the length of the uncinate bilaterally, the ipsilateral parahippocampal white matter bundle, and the ipsilateral fimbria-fornix in regions located within the medial temporal lobe. However, only patients with persistent postoperative seizures showed evidence of significant pathology of tract sections located in the ipsilateral dorsal fornix and in the contralateral parahippocampal white matter bundle

  2. Abnormality of cerebral cortical glucose metabolism in temporal lobe epilepsy with cognitive function impairment

    International Nuclear Information System (INIS)

    Bang-Hung Yang; Tsung-Szu Yeh; Tung-Ping Su; Jyh-Cheng Chen; Ren-Shyan Liu

    2004-01-01

    Objective: People with epilepsy commonly report having problems with their memory. Many indicate that memory difficulties significantly hinder their functioning at work, in school, and at home. Besides, some studies have reported that memory performance as a prognostic factor is of most value in patients with risk of refractory epilepsy and when used in a multidisciplinary setting. However, the cerebral cortical areas involving memory impairment in epilepsy is still unknown. The purpose of this study was to access changes of cerebral glucose metabolism of epilepsy patients using [F-18] fluorodeoxyglucose positron emission tomography (FDG PET). Method: Nine temporal lobe epilepsy patients were studied. Each patient was confirmed with lesions in right mesial temporal lobe by MRI, PET and EEG. Serial cognition function tests were performed. Regional cerebral glucose metabolism (rCMRglc) was measured by PET at 45 minutes after injection of 370 MBq of FDG. Parametric images were generated by grand mean scaling each scan to 50. The images were then transformed into standard stereotactic space. Statistical parametric mapping (SPM2) was applied to find the correlations between verbal memory, figure memory, perception intelligent quotation (PIQ) and rCMRglc in epilepsy patients. The changes of rCMRglc were significant if corrected p value was less than 0.05. Results: There was no significant relationship between figure memory score and verbal memory score. FDG-PET scan showed changes of rCMRglc positive related with verbal memory score in precentral gyms of right frontal lobe (Brodmann area 4, corrected p < 0.001, voxel size 240) and cingulated gyms of right limbic lobe (Brodmann area 32, corrected p=0.002, voxel size 143). No negative relationship was demonstrable between verbal memory and rCMRglc in this study. Besides, significanfiy positive correlation between figure memory was shown in cuneus of right occipital lobe (Brodmann area 18, corrected p < 0.001, voxel size

  3. Astrocyte uncoupling as a cause of human temporal lobe epilepsy.

    Science.gov (United States)

    Bedner, Peter; Dupper, Alexander; Hüttmann, Kerstin; Müller, Julia; Herde, Michel K; Dublin, Pavel; Deshpande, Tushar; Schramm, Johannes; Häussler, Ute; Haas, Carola A; Henneberger, Christian; Theis, Martin; Steinhäuser, Christian

    2015-05-01

    Glial cells are now recognized as active communication partners in the central nervous system, and this new perspective has rekindled the question of their role in pathology. In the present study we analysed functional properties of astrocytes in hippocampal specimens from patients with mesial temporal lobe epilepsy without (n = 44) and with sclerosis (n = 75) combining patch clamp recording, K(+) concentration analysis, electroencephalography/video-monitoring, and fate mapping analysis. We found that the hippocampus of patients with mesial temporal lobe epilepsy with sclerosis is completely devoid of bona fide astrocytes and gap junction coupling, whereas coupled astrocytes were abundantly present in non-sclerotic specimens. To decide whether these glial changes represent cause or effect of mesial temporal lobe epilepsy with sclerosis, we developed a mouse model that reproduced key features of human mesial temporal lobe epilepsy with sclerosis. In this model, uncoupling impaired K(+) buffering and temporally preceded apoptotic neuronal death and the generation of spontaneous seizures. Uncoupling was induced through intraperitoneal injection of lipopolysaccharide, prevented in Toll-like receptor4 knockout mice and reproduced in situ through acute cytokine or lipopolysaccharide incubation. Fate mapping confirmed that in the course of mesial temporal lobe epilepsy with sclerosis, astrocytes acquire an atypical functional phenotype and lose coupling. These data suggest that astrocyte dysfunction might be a prime cause of mesial temporal lobe epilepsy with sclerosis and identify novel targets for anti-epileptogenic therapeutic intervention. © The Author (2015). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  4. Brain SPECT imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Krausz, Y.; Yaffe, S.; Atlan, H.; Cohen, D.; Konstantini, S.; Meiner, Z.

    1991-01-01

    Temporal lobe epilepsy is diagnosed by clinical symptoms and signs and by localization of an epileptogenic focus. A brain SPECT study of two patients with temporal lobe epilepsy, using 99m Tc-HMPAO, was used to demonstrate a perfusion abnormality in the temporal lobe, while brain CT and MRI were non-contributory. The electroencephalogram, though abnormal, did not localize the diseased area. The potential role of the SPECT study in diagnosis and localization of temporal lobe epilepsy is discussed. (orig.)

  5. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    International Nuclear Information System (INIS)

    Deblaere, K.; Vandemaele, P.; Achten, E.; Backes, W.H.; Hofman, P.; Wilmink, J.; Boon, P.A.; Vonck, K.; Boon, P.; Troost, J.; Vermeulen, J.; Aldenkamp, A.

    2002-01-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  6. Developing a comprehensive presurgical functional MRI protocol for patients with intractable temporal lobe epilepsy: a pilot study

    Energy Technology Data Exchange (ETDEWEB)

    Deblaere, K.; Vandemaele, P.; Achten, E. [MRI Department -1 K12, Department of Radiology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Backes, W.H.; Hofman, P.; Wilmink, J. [Department of Neuroradiology, University Hospital Maastricht, Postbus 5800, 6202 AZ Maastricht (Netherlands); Boon, P.A.; Vonck, K. [Department of Neurology, Ghent University Hospital, De Pintelaan 185, 9000 Ghent (Belgium); Boon, P. [Department of Medical Psychology, University Hospital Maastricht (Netherlands); Troost, J. [Department of Neurology, University Hospital Maastricht (Netherlands); Vermeulen, J. [S.E.I.N Heemstede, Psychological Laboratory, Achterweg 5, 2103 SW Heemstede (Netherlands); Aldenkamp, A. [Epilepsy Center ' Kempenhaeghe' , Postbus 61, 5900 AB Heeze (Netherlands)

    2002-08-01

    Our aim was to put together and test a comprehensive functional MRI (fMRI) protocol which could compete with the intracarotid amytal (IAT) or Wada test for the localisation of language and memory function in patients with intractable temporal lobe epilepsy. The protocol was designed to be performed in under 1 h on a standard 1.5 tesla imager. We used five paradigms to test nine healthy right-handed subjects: complex scene-encoding, picture-naming, reading, word-generation and semantic-decision tasks. The combination of these tasks generated two activation maps related to memory in the mesial temporal lobes, and three language-related maps of activation in a major part of the known language network. The functional maps from the encoding and naming tasks showed typical and symmetrical posterior mesial temporal lobe activation related to memory in all subjects. Only four of nine subjects also showed symmetrical anterior hippocampal activation. Language lateralisation was best with the word generation and reading paradigms and proved possible in all subjects. The reading paradigm enables localisation of language function in the left anterior temporal pole and middle temporal gyrus, areas typically resected during epilepsy surgery. The combined results of this comprehensive f MRI protocol are adequate for a comparative study with the IAT in patients with epilepsy being assessed for surgery. (orig.)

  7. The neurobiology of cognitive disorders in temporal lobe epilepsy

    Science.gov (United States)

    Bell, Brian; Lin, Jack J.; Seidenberg, Michael; Hermann, Bruce

    2013-01-01

    Cognitive impairment and especially memory disruption is a major complicating feature of the epilepsies. In this review we begin with a focus on the problem of memory impairment in temporal lobe epilepsy. We start with a brief overview of the early development of knowledge regarding the anatomic substrates of memory disorder in temporal lobe epilepsy, followed by discussion of the refinement of that knowledge over time as informed by the outcomes of epilepsy surgery (anterior temporal lobectomy) and the clinical efforts to predict those patients at greatest risk of adverse cognitive outcomes following epilepsy surgery. These efforts also yielded new theoretical insights regarding the function of the human hippocampus and a few examples of these insights are touched on briefly. Finally, the vastly changing view of temporal lobe epilepsy is examined including findings demonstrating that anatomic abnormalities extend far outside the temporal lobe, cognitive impairments extend beyond memory function, with linkage of these distributed cognitive and anatomic abnormalities pointing to a new understanding of the anatomic architecture of cognitive impairment in epilepsy. Challenges remain in understanding the origin of these cognitive and anatomic abnormalities, their progression over time, and most importantly, how to intervene to protect cognitive and brain health in epilepsy. PMID:21304484

  8. MRI findings of temporal lobe ganglioglioma

    International Nuclear Information System (INIS)

    Lee, Myung Jun; Lee, Ho Kyu; Lee, Jung Kyo; Choi, Choong Gon; Suh, Dae Chul

    1999-01-01

    Ganglioglioma is a rare primary brain tumor usually found in the temporal lobe. The purpose of this study is to describe the characteristic MR findings of temporal lobe ganglioglioma. Over a seven-year period, ten patients with cerebral ganglioglioma were evaluated at our institution. Seven cases of temporal lobe ganglioma were found ; six of these involved men, and one, a woman ; their mean age was 29.6 years. In three patients, Gd-DTPA-enhanced T1-weighted images were also obtained. We retrospectively analysed the MRI findings with respect to location, size, cortical involvement, margin, cystic change, degree of enhancement, MR signal intensity, calcification and peritumoral change. In five cases, tumors were located within the temporal lobe. In one, a tumor extended from the temporal lobe to the thalamus, and in one from the temporal lobe to the thalamus and cerebral peduncle. All temporal gangliogliomas measured 1.6-3.8cm in their greatest diameter (mean diameter, 2.7cm). In all cases, the cortices were involved with the maintenance of gyriform. The tumor margin was ill defined in five cases and well defined in two. Tumors showed multiple small cystic changes in four cases, a large cyst in two, and a solid nodule in one. In three cases in which contrast media was administered, no lesions were enhanced. On T1-weighted images, iso-signal intensities were seen in five cases and high signal intensities in two. On T2-weighted images, the corresponding figures were five and two. On MRI, tumor calcification and calvarial erosion were each detected in two cases. In patients with temporal lobe epilepsy in whom cortical solid or cystic and poorly enhanced lesions were seen on brain MRI, and in whom associated findings such as calcification and or adjacent bony erosion were noted, ganglioglioma must be considered

  9. Temporal lobe surgery in childhood and neuroanatomical predictors of long-term declarative memory outcome

    Science.gov (United States)

    Skirrow, Caroline; Cross, J. Helen; Harrison, Sue; Cormack, Francesca; Harkness, William; Coleman, Rosie; Meierotto, Ellen; Gaiottino, Johanna; Vargha-Khadem, Faraneh

    2015-01-01

    The temporal lobes play a prominent role in declarative memory function, including episodic memory (memory for events) and semantic memory (memory for facts and concepts). Surgical resection for medication-resistant and well-localized temporal lobe epilepsy has good prognosis for seizure freedom, but is linked to memory difficulties in adults, especially when the removal is on the left side. Children may benefit most from surgery, because brain plasticity may facilitate post-surgical reorganization, and seizure cessation may promote cognitive development. However, the long-term impact of this intervention in children is not known. We examined memory function in 53 children (25 males, 28 females) who were evaluated for epilepsy surgery: 42 underwent unilateral temporal lobe resections (25 left, 17 right, mean age at surgery 13.8 years), 11 were treated only pharmacologically. Average follow-up was 9 years (range 5–15). Post-surgical change in visual and verbal episodic memory, and semantic memory at follow-up were examined. Pre- and post-surgical T1-weighted MRI brain scans were analysed to extract hippocampal and resection volumes, and evaluate post-surgical temporal lobe integrity. Language lateralization indices were derived from functional magnetic resonance imaging. There were no significant pre- to postoperative decrements in memory associated with surgery. In contrast, gains in verbal episodic memory were seen after right temporal lobe surgery, and visual episodic memory improved after left temporal lobe surgery, indicating a functional release in the unoperated temporal lobe after seizure reduction or cessation. Pre- to post-surgical change in memory function was not associated with any indices of brain structure derived from MRI. However, better verbal memory at follow-up was linked to greater post-surgical residual hippocampal volumes, most robustly in left surgical participants. Better semantic memory at follow-up was associated with smaller resection

  10. Factors affecting reorganisation of memory encoding networks in temporal lobe epilepsy

    Science.gov (United States)

    Sidhu, M.K.; Stretton, J.; Winston, G.P.; Symms, M.; Thompson, P.J.; Koepp, M.J.; Duncan, J.S.

    2015-01-01

    Summary Aims In temporal lobe epilepsy (TLE) due to hippocampal sclerosis reorganisation in the memory encoding network has been consistently described. Distinct areas of reorganisation have been shown to be efficient when associated with successful subsequent memory formation or inefficient when not associated with successful subsequent memory. We investigated the effect of clinical parameters that modulate memory functions: age at onset of epilepsy, epilepsy duration and seizure frequency in a large cohort of patients. Methods We studied 53 patients with unilateral TLE and hippocampal sclerosis (29 left). All participants performed a functional magnetic resonance imaging memory encoding paradigm of faces and words. A continuous regression analysis was used to investigate the effects of age at onset of epilepsy, epilepsy duration and seizure frequency on the activation patterns in the memory encoding network. Results Earlier age at onset of epilepsy was associated with left posterior hippocampus activations that were involved in successful subsequent memory formation in left hippocampal sclerosis patients. No association of age at onset of epilepsy was seen with face encoding in right hippocampal sclerosis patients. In both left hippocampal sclerosis patients during word encoding and right hippocampal sclerosis patients during face encoding, shorter duration of epilepsy and lower seizure frequency were associated with medial temporal lobe activations that were involved in successful memory formation. Longer epilepsy duration and higher seizure frequency were associated with contralateral extra-temporal activations that were not associated with successful memory formation. Conclusion Age at onset of epilepsy influenced verbal memory encoding in patients with TLE due to hippocampal sclerosis in the speech-dominant hemisphere. Shorter duration of epilepsy and lower seizure frequency were associated with less disruption of the efficient memory encoding network whilst

  11. Auditory temporal processing in patients with temporal lobe epilepsy.

    Science.gov (United States)

    Lavasani, Azam Navaei; Mohammadkhani, Ghassem; Motamedi, Mahmoud; Karimi, Leyla Jalilvand; Jalaei, Shohreh; Shojaei, Fereshteh Sadat; Danesh, Ali; Azimi, Hadi

    2016-07-01

    Auditory temporal processing is the main feature of speech processing ability. Patients with temporal lobe epilepsy, despite their normal hearing sensitivity, may present speech recognition disorders. The present study was carried out to evaluate the auditory temporal processing in patients with unilateral TLE. The present study was carried out on 25 patients with epilepsy: 11 patients with right temporal lobe epilepsy and 14 with left temporal lobe epilepsy with a mean age of 31.1years and 18 control participants with a mean age of 29.4years. The two experimental and control groups were evaluated via gap-in-noise and duration pattern sequence tests. One-way ANOVA was run to analyze the data. The mean of the threshold of the GIN test in the control group was observed to be better than that in participants with LTLE and RTLE. Also, it was observed that the percentage of correct responses on the DPS test in the control group and in participants with RTLE was better than that in participants with LTLE. Patients with TLE have difficulties in temporal processing. Difficulties are more significant in patients with LTLE, likely because the left temporal lobe is specialized for the processing of temporal information. Copyright © 2016 Elsevier Inc. All rights reserved.

  12. Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy

    Science.gov (United States)

    Boling, Warren W.

    2018-01-01

    Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis. PMID:29461485

  13. Surgical Considerations of Intractable Mesial Temporal Lobe Epilepsy

    Directory of Open Access Journals (Sweden)

    Warren W. Boling

    2018-02-01

    Full Text Available Surgery of temporal lobe epilepsy is the best opportunity for seizure freedom in medically intractable patients. The surgical approach has evolved to recognize the paramount importance of the mesial temporal structures in the majority of patients with temporal lobe epilepsy who have a seizure origin in the mesial temporal structures. For those individuals with medically intractable mesial temporal lobe epilepsy, a selective amygdalohippocampectomy surgery can be done that provides an excellent opportunity for seizure freedom and limits the resection to temporal lobe structures primarily involved in seizure genesis.

  14. Decreased functional connectivity and structural deficit in alertness network with right-sided temporal lobe epilepsy.

    Science.gov (United States)

    Gao, Yujun; Zheng, Jinou; Li, Yaping; Guo, Danni; Wang, Mingli; Cui, Xiangxiang; Ye, Wei

    2018-04-01

    Patients with temporal lobe epilepsy (TLE) often suffer from alertness alterations. However, specific regions connected with alertness remain controversial, and whether these regions have structural impairment is also elusive. This study aimed to investigate the characteristics and neural mechanisms underlying the functions and structures of alertness network in patients with right-sided temporal lobe epilepsy (rTLE) by performing the attentional network test (ANT), resting-state functional magnetic resonance imaging (R-SfMRI), and diffusion tensor imaging (DTI).A total of 47 patients with rTLE and 34 healthy controls underwent ANT, R-SfMRI, and DTI scan. The seed-based functional connectivity (FC) method and deterministic tractography were used to analyze the data.Patients with rTLE had longer reaction times in the no-cue and double-cue conditions. However, no differences were noted in the alertness effect between the 2 groups. The patient group had lower FC compared with the control group in the right inferior parietal lobe (IPL), amygdala, and insula. Structural deficits were found in the right parahippocampal gyrus, superior temporal pole, insula, and amygdala in the patient group compared with the control group. Also significantly negative correlations were observed between abnormal fractional anisotropy (between the right insula and the superior temporal pole) and illness duration in the patients with rTLE.The findings of this study suggested abnormal intrinsic and phasic alertness, decreased FC, and structural deficits within the alerting network in the rTLE. This study provided new insights into the mechanisms of alertness alterations in rTLE.

  15. Clinical study on temporal lobe epilepsy in childhood caused by temporal lobe space occupying lesions

    International Nuclear Information System (INIS)

    Matsuura, Mariko; Oguni, Hirokazu; Funatsuka, Makoto; Osawa, Makiko; Yamane, Fumitaka; Hori, Tomokatsu; Shimizu, Hiroyuki

    2008-01-01

    We studied the clinicoelectrical and neuroimaging features of 11 patients with symptomatic temporal lobe epilepsy (TLE) caused by temporal lobe space occupying lesions (SOLs), and compared its characteristics with those of 19 mesial TLE (MTLE) patients. Brain MRI demonstrated SOLs in the mesiotemporal lobe in 9, and laterotemporal lobe in the remaining 2 patients. Ten of the 11 patients successfully underwent surgery, which revealed tumors in 7 and focal cortical dysplasia in 3 patients. Comparisons of the clinical features between those with space occupying TLE (SOTLE) and MTLE showed that both conditions shared the same clinical seizure manifestations such as gastric uprising sensation or ictal fear and a favorable response to surgery. However, the patients with SOTLE had fewer febrile convulsion, and more frequent seizure recurrences as well as TLE EEG discharges and associations of the monophasic clinical course than those with MTLE. In addition, the MRI findings were characterized by unilateral hippocampal atrophy in MTLE and expanding or SOLs in the SOTLE group. Children with complex partial seizures of suspected temporal lobe origin should undergo extensive neuroimaging evaluation. (author)

  16. Decrease of NAA with aging outside the seizure focus in mesial temporal lobe epilepsy--a proton-MRS study at 3 Tesla.

    Science.gov (United States)

    Riederer, Franz; Bittsanský, Michal; Lehner-Baumgartner, Eva; Baumgartner, Christoph; Mlynárik, Vladimír; Gruber, Stephan; Moser, Ewald; Kaya, Marihan; Serles, Wolfgang

    2007-11-07

    There is evidence that chronic pharmacoresistant temporal lobe epilepsy (TLE) is a progressive disorder accompanied by mental deterioration. We investigated effects of aging on cerebral N-acetyl-aspartate (NAA) concentrations in the temporal lobe of 12 patients with pharmacoresistant mesial TLE (mTLE) and 22 healthy controls by means of proton-magnetic resonance spectroscopy ((1)H-MRS) at 3 T. Furthermore, we calculated correlations between NAA concentrations and measures of verbal and figural memory in patients. In mTLE patients but not in healthy controls the concentration of NAA in the lateral temporal lobe was negatively correlated with age. In patients with mTLE NAA in left lateral temporal voxels correlated with verbal memory. NAA in medial temporal voxels did not correlate with age or neuropsychological measures. Significant decrease of NAA with age in the lateral temporal lobe of patients with mTLE provides evidence for progressive neuronal dysfunction with aging. NAA is a marker of neuronal integrity since it correlates with verbal memory.

  17. A multicenter reproducibility study of single-voxel 1H-MRS of the medial temporal lobe

    International Nuclear Information System (INIS)

    Traeber, Frank; Block, Wolfgang; Guer, Okan; Schild, Hans H.; Freymann, Nikolaus; Heun, Reinhard; Jessen, Frank; Kucinski, Thomas; Hammen, Thilo; Ende, Gabriele; Pilatus, Ulrich; Hampel, Harald

    2006-01-01

    Proton magnetic resonance spectroscopy ( 1 H-MRS) has provided evidence for a reduction of N-acetyl-aspartate (NAA) in the medial temporal lobe (MTL) in cerebral disorders such as Alzheimer's Disease. Within the 1 H-MRS study of the German Research Network on Dementia, we determined the multicenter reproducibility of single-voxel 1 H-MRS of the MTL. At five sites with 1.5T MR systems, single-voxel 1 H spectra from the MTL of an identical healthy subject were measured. The same subject was also examined at one of the sites five times to assess intracenter stability. The protocol included water-suppressed spectra with TE 272 ms and TE 30 ms and unsuppressed spectra for absolute quantification of metabolite concentrations. The intracenter reproducibility of absolute NAA concentration, expressed as coefficient of variation (CV), was 1.8%. CV for the concentrations of creatine (Cr), choline (Cho), and myoinositol (MI) and for the ratios NAA/Cr, NAA/Cho, and MI/NAA varied by 11-16%. Intercenter CV was 3.9% for NAA and were below 10% for all other metabolites and metabolic ratios. Our study demonstrates that quantitative assessment of NAA with single-voxel MRS can be performed with high intercenter reproducibility. This is the basis for applying 1 H-MRS in large-scale early recognition and treatment studies in MTL affecting disorders. (orig.)

  18. Altered Medial Frontal and Superior Temporal Response to Implicit Processing of Emotions in Autism.

    Science.gov (United States)

    Kana, Rajesh K; Patriquin, Michelle A; Black, Briley S; Channell, Marie M; Wicker, Bruno

    2016-01-01

    Interpreting emotional expressions appropriately poses a challenge for individuals with autism spectrum disorder (ASD). In particular, difficulties with emotional processing in ASD are more pronounced in contexts where emotional expressions are subtle, automatic, and reflexive-that is, implicit. In contrast, explicit emotional processing, which requires the cognitive evaluation of an emotional experience, appears to be relatively intact in individuals with ASD. In the present study, we examined the brain activation and functional connectivity differences underlying explicit and implicit emotional processing in age- and IQ-matched adults with (n = 17) and without (n = 15) ASD. Results indicated: (1) significantly reduced levels of brain activation in participants with ASD in medial prefrontal cortex (MPFC) and superior temporal gyrus (STG) during implicit emotion processing; (2) significantly weaker functional connectivity in the ASD group in connections of the MPFC with the amygdala, temporal lobe, parietal lobe, and fusiform gyrus; (3) No group difference in performance accuracy or reaction time; and (4) Significant positive relationship between empathizing ability and STG activity in ASD but not in typically developing participants. These findings suggest that the neural mechanisms underlying implicit, but not explicit, emotion processing may be altered at multiple levels in individuals with ASD. © 2015 International Society for Autism Research, Wiley Periodicals, Inc.

  19. Temporal plus epilepsy is a major determinant of temporal lobe surgery failures.

    Science.gov (United States)

    Barba, Carmen; Rheims, Sylvain; Minotti, Lorella; Guénot, Marc; Hoffmann, Dominique; Chabardès, Stephan; Isnard, Jean; Kahane, Philippe; Ryvlin, Philippe

    2016-02-01

    Reasons for failed temporal lobe epilepsy surgery remain unclear. Temporal plus epilepsy, characterized by a primary temporal lobe epileptogenic zone extending to neighboured regions, might account for a yet unknown proportion of these failures. In this study all patients from two epilepsy surgery programmes who fulfilled the following criteria were included: (i) operated from an anterior temporal lobectomy or disconnection between January 1990 and December 2001; (ii) magnetic resonance imaging normal or showing signs of hippocampal sclerosis; and (iii) postoperative follow-up ≥ 24 months for seizure-free patients. Patients were classified as suffering from unilateral temporal lobe epilepsy, bitemporal epilepsy or temporal plus epilepsy based on available presurgical data. Kaplan-Meier survival analysis was used to calculate the probability of seizure freedom over time. Predictors of seizure recurrence were investigated using Cox proportional hazards model. Of 168 patients included, 108 (63.7%) underwent stereoelectroencephalography, 131 (78%) had hippocampal sclerosis, 149 suffered from unilateral temporal lobe epilepsy (88.7%), one from bitemporal epilepsy (0.6%) and 18 (10.7%) from temporal plus epilepsy. The probability of Engel class I outcome at 10 years of follow-up was 67.3% (95% CI: 63.4-71.2) for the entire cohort, 74.5% (95% CI: 70.6-78.4) for unilateral temporal lobe epilepsy, and 14.8% (95% CI: 5.9-23.7) for temporal plus epilepsy. Multivariate analyses demonstrated four predictors of seizure relapse: temporal plus epilepsy (P temporal lobe surgery failure was 5.06 (95% CI: 2.36-10.382) greater in patients with temporal plus epilepsy than in those with unilateral temporal lobe epilepsy. Temporal plus epilepsy represents a hitherto unrecognized prominent cause of temporal lobe surgery failures. In patients with temporal plus epilepsy, anterior temporal lobectomy appears very unlikely to control seizures and should not be advised. Whether larger

  20. Volumetric analysis of medial temporal lobe structures in brain development from childhood to adolescence.

    Science.gov (United States)

    Hu, Shiyan; Pruessner, Jens C; Coupé, Pierrick; Collins, D Louis

    2013-07-01

    Puberty is an important stage of development as a child's sexual and physical characteristics mature because of hormonal changes. To better understand puberty-related effects on brain development, we investigated the magnetic resonance imaging (MRI) data of 306 subjects from 4 to 18 years of age. Subjects were grouped into before and during puberty groups according to their sexual maturity levels measured by the puberty scores. An appearance model-based automatic segmentation method with patch-based local refinement was employed to segment the MRI data and extract the volumes of medial temporal lobe (MTL) structures including the amygdala (AG), the hippocampus (HC), the entorhinal/perirhinal cortex (EPC), and the parahippocampal cortex (PHC). Our analysis showed age-related volumetric changes for the AG, HC, right EPC, and left PHC but only before puberty. After onset of puberty, these volumetric changes then correlate more with sexual maturity level, as measured by the puberty score. When normalized for brain volume, the volumes of the right HC decrease for boys; the volumes of the left HC increase for girls; and the volumes of the left and right PHC decrease for boys. These findings suggest that the rising levels of testosterone in boys and estrogen in girls might have opposite effects, especially for the HC and the PHC. Our findings on sex-specific and sexual maturity-related volumes may be useful in better understanding the MTL developmental differences and related learning, memory, and emotion differences between boys and girls during puberty. Copyright © 2013 Elsevier Inc. All rights reserved.

  1. Magnetic resonance imaging in temporal lobe epilepsy. Usefulness for the etiological diagnosis of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Mohamed, A.; Lueders, H.O.

    2000-01-01

    With improvement in magnetic resonance (MR) imaging techniques, the ability to identify lesions responsible for temporal lobe epilepsy has increased. MR imaging has also enabled the in vivo diagnosis of hippocampal sclerosis. Brain tumors are responsible for 2-4% of epilepsies in adult population and 10-20% of medically intractable epilepsy. The sensitivity of MR imaging in the diagnosis of tumors and other lesions of the temporal lobe (vascular malformations, etc.) is around 90%. Both hippocampal sclerosis and other temporal lobe lesions are amenable to surgical therapy with excellent postsurgical seizure outcome. In this article, we characterize and underline distinguishing features of the different pathological entities. We also suggest an approach to reviewing the MR images of an epileptic patient. (author)

  2. Tissue Expressions of Soluble Human Epoxide Hydrolase-2 Enzyme in Patients with Temporal Lobe Epilepsy.

    Science.gov (United States)

    Ahmedov, Merdin Lyutviev; Kemerdere, Rahsan; Baran, Oguz; Inal, Berrin Bercik; Gumus, Alper; Coskun, Cihan; Yeni, Seher Naz; Eren, Bulent; Uzan, Mustafa; Tanriverdi, Taner

    2017-10-01

    We sought to simply demonstrate how levels of soluble human epoxide hydrolase-2 show changes in both temporal the cortex and hippocampal complex in patients with temporal lobe epilepsy. A total of 20 patients underwent anterior temporal lobe resection due to temporal lobe epilepsy. The control group comprised 15 people who died in traffic accidents or by falling from a height, and their autopsy findings were included. Adequately sized temporal cortex and hippocampal samples were removed from each patient during surgery, and the same anatomic structures were removed from the control subjects during the autopsy procedures. Each sample was stored at -80°C as rapidly as possible until the enzyme assay. The temporal cortex in the epilepsy patients had a significantly higher enzyme level than did the temporal cortex of the control group (P = 0.03). Correlation analysis showed that as the enzyme level increases in the temporal cortex, it also increases in the hippocampal complex (r 2  = 0.06, P = 0.00001). More important, enzyme tissue levels showed positive correlations with seizure frequency in both the temporal cortex and hippocampal complex in patients (r 2  = 0.7, P = 0.00001 and r 2  = 0.4, P = 0.003, respectively). The duration of epilepsy was also positively correlated with the hippocampal enzyme level (r 2  = 0.06, P = 0.00001). Soluble human epoxy hydrolase enzyme-2 is increased in both lateral and medial temporal tissues in temporal lobe epilepsy. Further studies should be conducted as inhibition of this enzyme has resulted in a significant decrease in or stopping of seizures and attenuated neuroinflammation in experimental epilepsy models in the current literature. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. A multicenter reproducibility study of single-voxel {sup 1}H-MRS of the medial temporal lobe

    Energy Technology Data Exchange (ETDEWEB)

    Traeber, Frank; Block, Wolfgang; Guer, Okan; Schild, Hans H. [University of Bonn, Department of Radiology, Bonn (Germany); Freymann, Nikolaus; Heun, Reinhard; Jessen, Frank [University of Bonn, Department of Psychiatry, Bonn (Germany); Kucinski, Thomas [University of Hamburg, Department of Neuroradiology, Hamburg (Germany); Hammen, Thilo [University of Erlangen, Department of Psychiatry, Erlangen (Germany); Ende, Gabriele [Central Institute of Mental Health, NMR Research in Psychiatry, Mannheim (Germany); Pilatus, Ulrich [University of Frankfurt, Department of Neuroradiology, Frankfurt (Germany); Hampel, Harald [University of Munich, Department of Psychiatry, Munich (Germany)

    2006-05-15

    Proton magnetic resonance spectroscopy ({sup 1}H-MRS) has provided evidence for a reduction of N-acetyl-aspartate (NAA) in the medial temporal lobe (MTL) in cerebral disorders such as Alzheimer's Disease. Within the {sup 1}H-MRS study of the German Research Network on Dementia, we determined the multicenter reproducibility of single-voxel {sup 1}H-MRS of the MTL. At five sites with 1.5T MR systems, single-voxel {sup 1}H spectra from the MTL of an identical healthy subject were measured. The same subject was also examined at one of the sites five times to assess intracenter stability. The protocol included water-suppressed spectra with TE 272 ms and TE 30 ms and unsuppressed spectra for absolute quantification of metabolite concentrations. The intracenter reproducibility of absolute NAA concentration, expressed as coefficient of variation (CV), was 1.8%. CV for the concentrations of creatine (Cr), choline (Cho), and myoinositol (MI) and for the ratios NAA/Cr, NAA/Cho, and MI/NAA varied by 11-16%. Intercenter CV was 3.9% for NAA and were below 10% for all other metabolites and metabolic ratios. Our study demonstrates that quantitative assessment of NAA with single-voxel MRS can be performed with high intercenter reproducibility. This is the basis for applying {sup 1}H-MRS in large-scale early recognition and treatment studies in MTL affecting disorders. (orig.)

  4. Temporal order processing of syllables in the left parietal lobe.

    Science.gov (United States)

    Moser, Dana; Baker, Julie M; Sanchez, Carmen E; Rorden, Chris; Fridriksson, Julius

    2009-10-07

    Speech processing requires the temporal parsing of syllable order. Individuals suffering from posterior left hemisphere brain injury often exhibit temporal processing deficits as well as language deficits. Although the right posterior inferior parietal lobe has been implicated in temporal order judgments (TOJs) of visual information, there is limited evidence to support the role of the left inferior parietal lobe (IPL) in processing syllable order. The purpose of this study was to examine whether the left inferior parietal lobe is recruited during temporal order judgments of speech stimuli. Functional magnetic resonance imaging data were collected on 14 normal participants while they completed the following forced-choice tasks: (1) syllable order of multisyllabic pseudowords, (2) syllable identification of single syllables, and (3) gender identification of both multisyllabic and monosyllabic speech stimuli. Results revealed increased neural recruitment in the left inferior parietal lobe when participants made judgments about syllable order compared with both syllable identification and gender identification. These findings suggest that the left inferior parietal lobe plays an important role in processing syllable order and support the hypothesized role of this region as an interface between auditory speech and the articulatory code. Furthermore, a breakdown in this interface may explain some components of the speech deficits observed after posterior damage to the left hemisphere.

  5. [Two cases of mesial temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe without "dual pathology"].

    Science.gov (United States)

    Morioka, T; Nishio, S; Hisada, K; Muraishi, M; Ishibashi, H; Mamiya, K; Ohfu, M; Fukui, M

    1998-05-01

    Two cases of intractable temporal lobe epilepsy associated with old intracerebral hemorrhage in the lateral temporal lobe were reported. Although preoperative magnetic resonance imaging (MRI) failed to reveal hippocampal atrophy with T2 hyperintensity, electrocorticographic (ECoG) recording with chronic invasive subdural electrodes indicated the mesial temporal lobe to be an ictal onset zone. After anterior temporal lobectomy involving the lesion and hippocampectomy, the patients became seizure-free. Hippocampal sclerosis, namely "dual pathology", was not noted on histological examination. Careful ECoG recording with chronic subdural electrodes is mandatory even when the preoperative MRI does not demonstrate the radiological hippocampal sclerosis.

  6. Diagnosis of temporal lobe epilepsy by positron emission tomography

    International Nuclear Information System (INIS)

    Shimizu, Hiroyuki; Ishijima, Buichi; Iio, Masaaki.

    1985-01-01

    Positron emission tomography(PET) was performed in 18 temporal lobe epileptics. About 20 mCi of 11 C-glucose was perorally administered to the patients and 30 minutes later scanning was started when the transport of 11 C-glucose from blood to the brain tissue reached equilibrium. At the level of 25mm above orbitomeatal line, the slice image of the temporal lobe shows a relatively high metabolic oval ring involving the amygdala, hippocapal formation and the hippocampal gyrus medially and the T 1 , T 2 and T 3 neocortices laterally in normal subjects. The epileptic focus, when detected on PET images, was observed as a defect in this oval ring. In 15(83.3%) out of 18 cases, the location of epileptic focus was confirmed as a low metabolic defect. This diagnosis rate was higher than that of other focal epilepsy by PET study. The locations of foci were devided into three types: mesial (5 cases), lateral (4 cases) and combined (6 cases). The seizure symptoms of the patients were analyzed in terms of the correspondence to the focus types. The results showed that automatism and pseudoabsence had a close relation to the mesial and combined types and psychical, vertiginous or visual seizures correlated to the combined and lateral types. Visceral or motor seizures were induced equally by any focus types. These facts suggested that automatism and pseudoabsence were correlated with the mesial organs such as the amygdala and hippocampus and psychical, vertiginous or visual seizures had origin in lateral neocortices. Visceral or motor seizures were supposed to be the results of the spread from the temporal focus to the adjacent structures. It was concluded that PET was very useful in localization diagnosis of temporal lobe epilepsy. In surgical treatment of epilepsy, in which the knowledge of the exact extent of epileptic foci is strongly demanded, PET study will offer invaluable data to the strategy of operation and foreseeing its prognosis. (author)

  7. The frontal lobes and inhibitory function

    International Nuclear Information System (INIS)

    Konishi, Seiki

    2011-01-01

    Neuropsychological studies using traditional tasks of inhibitory functions, such as the Wisconsin card sorting test (WCST) and the Go/No-Go Task have revealed that the frontal lobe is responsible for several types of inhibitory functions. However, the detailed psychological nature of the inhibitory functions and the precise location of their critical foci within the frontal lobe remain to be investigated. Functional magnetic resonance imaging provides spatial and temporal resolution that allowed us to illuminate at least 4 frontal regions involved in inhibitory functions: the dorsolateral, ventrolateral, and rostral parts of the frontal lobe and the presupplementary motor area (preSMA). The ventrolateral part of the frontal lobe in the right hemisphere was activated during response inhibition. The preSMA in the left hemisphere was activated during inhibition of proactive interference immediately after the dimension changes of the WCST. The rostral part of the frontal lobe in the left hemisphere was activated during inhibition long after the dimension changes. The dorsolateral part of the frontal lobe in the left hemisphere was activated at the dimension changes in the first time, but not in the second time. These findings provide clues to our understanding of functional differentiation of inhibitory functions and their localization in the frontal lobe. (author)

  8. Comparison of rCBF between patients with medial temporal lobe epilepsy and normal controls using H215O PET

    International Nuclear Information System (INIS)

    Kang, Eun Joo; Lee, Jae Sung; Nam, Hyun Woo; Lee, Sang Kun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul

    2002-01-01

    The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using H 2 15 O-PET. 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was performed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Duirng the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal regions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal regions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Epilepsy induced changes were found not only in relative increase/ decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period

  9. Microsurgical anatomy of the central lobe.

    Science.gov (United States)

    Frigeri, Thomas; Paglioli, Eliseu; de Oliveira, Evandro; Rhoton, Albert L

    2015-03-01

    The central lobe consists of the pre- and postcentral gyri on the lateral surface and the paracentral lobule on the medial surface and corresponds to the sensorimotor cortex. The objective of the present study was to define the neural features, craniometric relationships, arterial supply, and venous drainage of the central lobe. Cadaveric hemispheres dissected using microsurgical techniques provided the material for this study. The coronal suture is closer to the precentral gyrus and central sulcus at its lower rather than at its upper end, but they are closest at a point near where the superior temporal line crosses the coronal suture. The arterial supply of the lower two-thirds of the lateral surface of the central lobe was from the central, precentral, and anterior parietal branches that arose predominantly from the superior trunk of the middle cerebral artery. The medial surface and the superior third of the lateral surface were supplied by the posterior interior frontal, paracentral, and superior parietal branches of the pericallosal and callosomarginal arteries. The venous drainage of the superior two-thirds of the lateral surface and the central lobe on the medial surface was predominantly through the superior sagittal sinus, and the inferior third of the lateral surface was predominantly through the superficial sylvian veins to the sphenoparietal sinus or the vein of Labbé to the transverse sinus. The pre- and postcentral gyri and paracentral lobule have a morphological and functional anatomy that differentiates them from the remainder of their respective lobes and are considered by many as a single lobe. An understanding of the anatomical relationships of the central lobe can be useful in preoperative planning and in establishing reliable intraoperative landmarks.

  10. Two-population model for medial temporal lobe neurons: The vast majority are almost silent.

    Science.gov (United States)

    Magyar, Andrew; Collins, John

    2015-07-01

    Recordings in the human medial temporal lobe have found many neurons that respond to pictures (and related stimuli) of just one particular person of those presented. It has been proposed that these are concept cells, responding to just a single concept. However, a direct experimental test of the concept cell idea appears impossible, because it would need the measurement of the response of each cell to enormous numbers of other stimuli. Here we propose a new statistical method for analysis of the data that gives a more powerful way to analyze how close data are to the concept-cell idea. Central to the model is the neuronal sparsity, defined as the total fraction of stimuli that elicit an above-threshold response in the neuron. The model exploits the large number of sampled neurons to give sensitivity to situations where the average response sparsity is much less than one response for the number of presented stimuli. We show that a conventional model where a single sparsity is postulated for all neurons gives an extremely poor fit to the data. In contrast, a model with two dramatically different populations gives an excellent fit to data from the hippocampus and entorhinal cortex. In the hippocampus, one population has 7% of the cells with a 2.6% sparsity. But a much larger fraction (93%) respond to only 0.1% of the stimuli. This can result in an extreme bias in the responsiveness of reported neurons compared with a typical neuron. Finally, we show how to allow for the fact that some identified units correspond to multiple neurons and find that our conclusions at the neural level are quantitatively changed but strengthened, with an even stronger difference between the two populations.

  11. MR volumetric measurement of medial temporal lobe in differentiating Alzheimer disease and subcortical ischemic vascular dementia

    International Nuclear Information System (INIS)

    Wang Liang; Li Kuncheng; Liu Shuliang

    2003-01-01

    Objective: To evaluate the value of measurement of medial temporal structure by MR imaging volumetry in the differential diagnosis for patients with Alzheimer's disease (AD) and subcortical ischemic vascular dementia (SIVD). Methods: Thirty-three probable patients of AD, 33 normal controls, and 17 patients suspected with SIVD had been scanned by MRI, and volumetric measurements of amygdala (AMY), hippocampal formations (HF), entorhinal cortices (EC), parahippocampal gyri (PHG), and temporal horn of lateral ventricle (TH) were done on a serial reconstructed MR images. Results: Both atrophy of HF and dilatation of TH were significant (P<0.05) in SIVD group compared with that in control group. All the measurements with the exception of TH were atrophied significantly (P<0.001) in AD group compared with that in SIVD group and could significantly discriminate the two group. Among these indexes, the left EC provided the best discrimination with the specificity of 82.4%, sensitivity of 87.9%, and accuracy of 86.0%, respectively, and the average accuracy of bilateral EC in discrimination was 85%. Conclusion: The MR imaging volumetric measurements of medial temporal structure could offer useful information in discriminating individuals with AD from that with SIVD. Meanwhile, it should be understood that the AD-type pathological changes could also be induced by cerebrovascular disease

  12. A Rare Case of Craniopharyngioma in the Temporal Lobe

    Directory of Open Access Journals (Sweden)

    Sasan Razmjoo

    2017-01-01

    Full Text Available Herein, we report on a rare case of craniopharyngioma arising in the left temporal lobe with no prior history of head trauma or surgery. There was a solid-cystic mass in the left temporal lobe on MR images. To the best of our knowledge, this is the second case of a craniopharyngioma occurring in the temporal lobe.

  13. Quantifying interictal metabolic activity in human temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Henry, T.R.; Mazziotta, J.C.; Engel, J. Jr.; Christenson, P.D.; Zhang, J.X.; Phelps, M.E.; Kuhl, D.E.

    1990-01-01

    The majority of patients with complex partial seizures of unilateral temporal lobe origin have interictal temporal hypometabolism on [18F]fluorodeoxyglucose positron emission tomography (FDG PET) studies. Often, this hypometabolism extends to ipsilateral extratemporal sites. The use of accurately quantified metabolic data has been limited by the absence of an equally reliable method of anatomical analysis of PET images. We developed a standardized method for visual placement of anatomically configured regions of interest on FDG PET studies, which is particularly adapted to the widespread, asymmetric, and often severe interictal metabolic alterations of temporal lobe epilepsy. This method was applied by a single investigator, who was blind to the identity of subjects, to 10 normal control and 25 interictal temporal lobe epilepsy studies. All subjects had normal brain anatomical volumes on structural neuroimaging studies. The results demonstrate ipsilateral thalamic and temporal lobe involvement in the interictal hypometabolism of unilateral temporal lobe epilepsy. Ipsilateral frontal, parietal, and basal ganglial metabolism is also reduced, although not as markedly as is temporal and thalamic metabolism

  14. Cognitive consequences of coexisting temporal lobe developmental malformations and hippocampal sclerosis.

    Science.gov (United States)

    Martin, R; Dowler, R; Gilliam, F; Faught, E; Morawetz, R; Kuzniecky, R

    1999-09-11

    To characterize patterns of cognitive functioning in a well-defined group of patients with MRI-identified coexisting left temporal lobe developmental malformations (TLDM) and mesial temporal sclerosis (MTS), and to examine neuropsychological outcome in this dual-pathology group following epilepsy surgery. Cognitive functioning in patients with left TLDM and MTS (n = 15) was compared with patients with isolated left MTS (n = 40). TLDM and MTS were identified by high-quality MRI protocol. Patients were administered a battery of neuropsychology tests as part of their presurgical workup for possible epilepsy surgery. Unilateral temporal lobe resection was performed on 10 of the dual-pathology patients and 34 of the isolated MTS patients. Postoperative cognitive performance was also assessed. Both groups displayed impairments in verbal and visual memory, language, and academic achievement. Performance on measures of psychometric intelligence, executive function, and attention were not impaired and were similar between groups. Presence of dual pathology was associated with a significantly less efficient verbal encoding strategy on the word list learning task. Postoperatively, declines were noted for both groups across tasks of verbal memory and language. Groups were not different significantly in terms of neuropsychological outcome after surgery. Patients with coexisting TLDM and MTS have impaired cognitive functioning similar to MTS patients-in particular, with regard to episodic memory and language deficits. Temporal lobe resection produces similar cognitive changes in both groups.

  15. Supplementary CT temporal lobe cuts confer no worthwhile benefit

    International Nuclear Information System (INIS)

    Straiton, J.A.; Macpherson, P.; Teasdale, E.M.

    1991-01-01

    The value of angled temporal lobe cuts as a supplement to conventional head computed tomography (CT) has been assessed by comparing the diagnostic yield of standard axial and specific temporal lobe images (TLCT) in 62 patients with temporal lobe epilepsy and 87 with Alzheimer-type senile dementia. Fewer than one patient in six had structural abnormality in the temporal lobe most readily demonstrated by axial CT. Five patients with epilepsy and ten with dementia had changes demonstrated only by TLCT, reported on by one or other of a pair of observers. However such changes were of dubious clinical relevance, or arose as a result of artefact. In one patient with epilepsy and underlying neoplasm, axial CT was positive and TLCT false-negative. The routine addition of temporal lobe cuts to a conventional axial examination confers no added benefit to justify the prolonged examination time and increased radiation dose to the lens of the eye. (orig.)

  16. Supplementary CT temporal lobe cuts confer no worthwhile benefit

    Energy Technology Data Exchange (ETDEWEB)

    Straiton, J A; Macpherson, P; Teasdale, E M [Institute of Neurological Sciences, Glasgow (UK). Dept. of Neuroradiology

    1991-02-01

    The value of angled temporal lobe cuts as a supplement to conventional head computed tomography (CT) has been assessed by comparing the diagnostic yield of standard axial and specific temporal lobe images (TLCT) in 62 patients with temporal lobe epilepsy and 87 with Alzheimer-type senile dementia. Fewer than one patient in six had structural abnormality in the temporal lobe most readily demonstrated by axial CT. Five patients with epilepsy and ten with dementia had changes demonstrated only by TLCT, reported on by one or other of a pair of observers. However such changes were of dubious clinical relevance, or arose as a result of artefact. In one patient with epilepsy and underlying neoplasm, axial CT was positive and TLCT false-negative. The routine addition of temporal lobe cuts to a conventional axial examination confers no added benefit to justify the prolonged examination time and increased radiation dose to the lens of the eye. (orig.).

  17. A comparative perspective on the human temporal lobe

    NARCIS (Netherlands)

    Bryant, K.L.; Preuss, T.M.; Bruner, E.; Ogihara, N.; Tanabe, H.

    2018-01-01

    The temporal lobe is a morphological specialization of primates resulting from an expansion of higher-order visual cortex that is a hallmark of the primate brain. Among primates, humans possess a temporal lobe that has significantly expanded. Several uniquely human cognitive abilities, including

  18. Cognitive dysfunctions in occipital lobe epilepsy compared to temporal lobe epilepsy.

    Science.gov (United States)

    Santangelo, Gabriella; Trojano, Luigi; Vitale, Carmine; Improta, Ilaria; Alineri, Irma; Meo, Roberta; Bilo, Leonilda

    2017-06-01

    To compare cognitive profiles of occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) and to investigate whether impairment of visuospatial functions is a specific deficit of OLE. Eighteen patients with OLE, 18 patients with TLE, and 18 controls underwent a neuropsychological battery assessing memory, visuospatial functions, and frontal/executive functions. Multivariate analysis evidenced poorer performance of patients with TLE and patients with OLE relative to controls on tasks assessing verbal and non-verbal long-term memory, frontal functions, and visuospatial functions. Patients with OLE had poorer performance than patients with TLE on visuospatial tasks, whereas patients with TLE performed worse than patients with OLE on verbal long-term memory test. Discriminant analysis identified two canonical discriminant functions: The first explained 53.3% of the variance, and the second explained 46.7% of the variance. The first function included verbal and non-verbal memory tests distinguishing controls from both OLE and TLE, whereas the second factor including a visuoconstructional test distinguished OLE from TLE and controls. The results demonstrate that visuoconstructional dysfunction is related to OLE and support the idea that alterations of occipito-parietal stream may be specific to patients with OLE. © 2015 The British Psychological Society.

  19. Differential roles for medial prefrontal and medial temporal cortices in schema-dependent encoding: from congruent to incongruent.

    Science.gov (United States)

    van Kesteren, Marlieke T R; Beul, Sarah F; Takashima, Atsuko; Henson, Richard N; Ruiter, Dirk J; Fernández, Guillén

    2013-10-01

    Information that is congruent with prior knowledge is generally remembered better than incongruent information. This effect of congruency on memory has been attributed to a facilitatory influence of activated schemas on memory encoding and consolidation processes, and hypothesised to reflect a shift between processing in medial temporal lobes (MTL) towards processing in medial prefrontal cortex (mPFC). To investigate this shift, we used functional magnetic resonance imaging (fMRI) to compare brain activity during paired-associate encoding across three levels of subjective congruency of the association with prior knowledge. Participants indicated how congruent they found an object-scene pair during scanning, and were tested on item and associative recognition memory for these associations one day later. Behaviourally, we found a monotonic increase in memory performance with increasing congruency for both item and associative memory. Moreover, as hypothesised, encoding-related activity in mPFC increased linearly with increasing congruency, whereas MTL showed the opposite pattern of increasing encoding-related activity with decreasing congruency. Additionally, mPFC showed increased functional connectivity with a region in the ventral visual stream, presumably related to the binding of visual representations. These results support predictions made by a recent neuroscientific framework concerning the effects of schema on memory. Specifically, our findings show that enhanced memory for more congruent information is mediated by the mPFC, which is hypothesised to guide integration of new information into a pre-existing schema represented in cortical areas, while memory for more incongruent information relies instead on automatic encoding of arbitrary associations by the MTL. © 2013 Elsevier Ltd. All rights reserved.

  20. Temporal Lobe Epilepsy Surgery Failures: A Review

    Science.gov (United States)

    Harroud, Adil; Bouthillier, Alain; Weil, Alexander G.; Nguyen, Dang Khoa

    2012-01-01

    Patients with temporal lobe epilepsy (TLE) are refractory to antiepileptic drugs in about 30% of cases. Surgical treatment has been shown to be beneficial for the selected patients but fails to provide a seizure-free outcome in 20–30% of TLE patients. Several reasons have been identified to explain these surgical failures. This paper will address the five most common causes of TLE surgery failure (a) insufficient resection of epileptogenic mesial temporal structures, (b) relapse on the contralateral mesial temporal lobe, (c) lateral temporal neocortical epilepsy, (d) coexistence of mesial temporal sclerosis and a neocortical lesion (dual pathology); and (e) extratemporal lobe epilepsy mimicking TLE or temporal plus epilepsy. Persistence of epileptogenic mesial structures in the posterior temporal region and failure to distinguish mesial and lateral temporal epilepsy are possible causes of seizure persistence after TLE surgery. In cases of dual pathology, failure to identify a subtle mesial temporal sclerosis or regions of cortical microdysgenesis is a likely explanation for some surgical failures. Extratemporal epilepsy syndromes masquerading as or coexistent with TLE result in incomplete resection of the epileptogenic zone and seizure relapse after surgery. In particular, the insula may be an important cause of surgical failure in patients with TLE. PMID:22934162

  1. Learning related modulation of functional retrieval networks in man.

    Science.gov (United States)

    Petersson, K M; Sandblom, J; Gisselgård, J; Ingvar, M

    2001-07-01

    The medial temporal lobe has been implicated in studies of episodic memory tasks involving spatio-temporal context and object-location conjunctions. We have previously demonstrated that an increased level of practice in a free-recall task parallels a decrease in the functional activity of several brain regions, including the medial temporal lobe, the prefrontal, the anterior cingulate, the anterior insular, and the posterior parietal cortices, that in concert demonstrate a move from elaborate controlled processing towards a higher degree of automaticity. Here we report data from two experiments that extend these initial observations. We used a similar experimental approach but probed for effects of retrieval paradigms and stimulus material. In the first experiment we investigated practice related changes during recognition of object-location conjunctions and in the second during free-recall of pseudo-words. Learning in a neural network is a dynamic consequence of information processing and network plasticity. The present and previous PET results indicate that practice can induce a learning related functional restructuring of information processing. Different adaptive processes likely subserve the functional re-organisation observed. These may in part be related to different demands for attentional and working memory processing. It appears that the role(s) of the prefrontal cortex and the medial temporal lobe in memory retrieval are complex, perhaps reflecting several different interacting processes or cognitive components. We suggest that an integrative interactive perspective on the role of the prefrontal and medial temporal lobe is necessary for an understanding of the processing significance of these regions in learning and memory. It appears necessary to develop elaborated and explicit computational models for prefrontal and medial temporal functions in order to derive detailed empirical predictions, and in combination with an efficient use and development of

  2. Developmental trajectories of the fronto-temporal lobes from infancy to early adulthood in healthy individuals.

    Science.gov (United States)

    Tanaka, Chiaki; Matsui, Mie; Uematsu, Akiko; Noguchi, Kyo; Miyawaki, Toshio

    2012-01-01

    Brain development during early life in healthy individuals is rapid and dynamic, indicating that this period plays a very important role in neural and functional development. The frontal and temporal lobes are known to play a particularly important role in cognition. The study of healthy frontal and temporal lobe development in children is therefore of considerable importance. A better understanding of how these brain regions develop could also aid in the diagnosis and treatment of neurodevelopmental disorders. Some developmental studies have used magnetic resonance imaging (MRI) to examine infant brains, but it remains the case that relatively little is known about cortical brain development in the first few years of life. In the present study we examined whole brain, temporal lobe and frontal lobe developmental trajectories from infancy to early adulthood in healthy individuals, considering gender and brain hemisphere differences. We performed a cross-sectional, longitudinal morphometric MRI study of 114 healthy individuals (54 females and 60 males) aged 1 month to 25 years old (mean age ± SD 8.8 ± 6.9). We measured whole brain, temporal and frontal lobe gray matter (GM)/white matter (WM) volumes, following previously used protocols. There were significant non-linear age-related volume changes in all regions. Peak ages of whole brain, temporal lobe and frontal lobe development occurred around pre-adolescence (9-12 years old). GM volumes for all regions increased significantly as a function of age. Peak age was nevertheless lobe specific, with a pattern of earlier peak ages for females in both temporal and frontal lobes. Growth change in whole brain GM volume was larger in males than in females. However, GM volume growth changes for the temporal and frontal lobes showed a somewhat different pattern. GM volume for both temporal and frontal lobes showed a greater increase in females until around 5-6 years old, at which point this tendency reversed (GM volume

  3. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Neurologia e Psicologia Medica]. E-mail: fgraeff@keynet.com.br; Santos, A.C. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Clinica Medica; Guimaraes, F.S. [Sao Paulo Univ., Ribeirao Preto, SP (Brazil). Dept. de Farmacologia

    2003-07-01

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t{sub 21} = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t{sub 21} = 1.99, P = 0.06), right amygdala (8%, t{sub 21} = 1.83, P = 0.08), left amygdala (5%, t{sub 21} = 1.78, P 0.09) and left hippocampus (9%, t{sub 21} = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  4. Decreased left temporal lobe volume of panic patients measured by magnetic resonance imaging

    International Nuclear Information System (INIS)

    Uchida, R.R.; Del-Ben, C.M.; Araujo, D.; Crippa, J.A.; Graeff, F.G.; Santos, A.C.; Guimaraes, F.S.

    2003-01-01

    Reported neuroimaging studies have shown functional and morphological changes of temporal lobe structures in panic patients, but only one used a volumetric method. The aim of the present study was to determine the volume of temporal lobe structures in patients with panic disorder, measured by magnetic resonance imaging. Eleven panic patients and eleven controls matched for age, sex, handedness, socioeconomic status and years of education participated in the study. The mean volume of the left temporal lobe of panic patients was 9% smaller than that of controls (t 21 = 2.37, P = 0.028). In addition, there was a trend (P values between 0.05 and 0.10) to smaller volumes of the right temporal lobe (7%, t 21 = 1.99, P = 0.06), right amygdala (8%, t 21 = 1.83, P = 0.08), left amygdala (5%, t 21 = 1.78, P 0.09) and left hippocampus (9%, t 21 = 1.93, P = 0.07) in panic patients compared to controls. There was a positive correlation between left hippocampal volume and duration of panic disorder (r = 0.67, P = 0.025), with recent cases showing more reduction than older cases. The present results show that panic patients have a decreased volume of the left temporal lobe and indicate the presence of volumetric abnormalities of temporal lobe structures. (author)

  5. Charles Bonnet Syndrome in a Patient With Right Medial Occipital Lobe Infarction: Epileptic or Deafferentation Phenomenon?

    Science.gov (United States)

    Kumral, Emre; Uluakay, Arzu; Dönmez, İlknur

    2015-07-01

    Charles Bonnet syndrome (CBS) is an uncommon disorder characterized by complex and recurrent visual hallucinations in patients with visual pathway pathologic defects. To describe a patient who experienced complex visual hallucinations following infarction in the right occipital lobe and epileptic seizure who was diagnosed as having CBS. A 65-year-old man presented acute ischemic stroke caused by artery to artery embolism involving the right occipital lobe. Following ischemic stroke, complex visual hallucinations in the left visual field not associated with loss of consciousness or delusion developed in the patient. Hallucinations persisted for >1 month and during hallucination, no electrographic seizures were recorded through 24 hours of videoelectroencephalographic monitoring. CBS may develop in a patient with occipital lobe infarction following an embolic event. CBS associated with medial occipital lobe infarction and epilepsy may coexist and reflects the abnormal functioning of an integrated neuronal network.

  6. Visual rating of medial temporal lobe metabolism in mild cognitive impairment and Alzheimer's disease using FDG-PET

    International Nuclear Information System (INIS)

    Mosconi, Lisa; Santi, Susan De; Li, Yi; Li, Juan; Zhan, Jiong; Boppana, Madhu; Tsui, Wai Hon; Leon, Mony J. de; Pupi, Alberto

    2006-01-01

    This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD) using FDG-PET scans. Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MR glc ) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings. For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values glc measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified. This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD. (orig.)

  7. The anterior temporal lobes support residual comprehension in Wernicke's aphasia.

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L; Binney, Richard J; Sage, Karen; Lambon Ralph, Matthew A

    2014-03-01

    Wernicke's aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory-verbal comprehension is significantly impaired in Wernicke's aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke's aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke's aphasia and 12 control participants performed semantic animate-inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke's aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke's aphasia group displayed an 'over-activation' in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke's aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions.

  8. MRI in patients with temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Kodama, Kazuhiro

    1992-01-01

    The present study investigated magnetic resonance imaging (MRI) features in temporal lobe epilepsy and correlated them with clinical variables, such as age, illness duration, past history, and the frequency of seizure. Cerebral MRI was performed in 45 patients with temporal lobe epilepsy of unknown etiology, using a 0.5 T and/or a 1.5 T MRI systems. The temporal lobe was seen as high signal intensity on T2-weighted images and/or proton density-weighted images in 6 patients, although it was missed on CT and T1-weighted images. The high intensity area seemed to reflect sclerosis of the temporal lobe. This finding was significantly associated with partial seizure. Of these patients, 3 had a history of febrile convulsions. Ten patients had slight dilatation of the inferior horn of the lateral ventricle. They were significantly old at the time of onset and examination, as compared with those without dilatation. Furthermore, 6 patients with unilateral dilatation were significantly younger than the other 4 with bilateral dilatation. Nine patients had small multiple high signal areas in white matter, mainly in the parietal lobe, which suggested vascular origin. These patients were significantly old at the time of onset and examination, as compared with those having no such findings. In depicting high signal intensity areas, a 1.5 T MRI system was not always superior to a 0.5 T MRI system. Proton density-weighted images were better than T2-weighted images in some patients. (N.K.)

  9. Altered medial temporal activation related to local glutamate levels in subjects with prodromal signs of psychosis.

    Science.gov (United States)

    Valli, Isabel; Stone, James; Mechelli, Andrea; Bhattacharyya, Sagnik; Raffin, Marie; Allen, Paul; Fusar-Poli, Paolo; Lythgoe, David; O'Gorman, Ruth; Seal, Marc; McGuire, Philip

    2011-01-01

    Both medial temporal cortical dysfunction and perturbed glutamatergic neurotransmission are regarded as fundamental pathophysiological features of psychosis. However, although animal models of psychosis suggest that these two abnormalities are interrelated, their relationship in humans has yet to be investigated. We used a combination of functional magnetic resonance imaging and magnetic resonance spectroscopy to investigate the relationship between medial temporal activation during an episodic memory task and local glutamate levels in 22 individuals with an at-risk mental state for psychosis and 14 healthy volunteers. We observed a significant between-group difference in the coupling of medial temporal activation with local glutamate levels. In control subjects, medial temporal activation during episodic encoding was positively associated with medial temporal glutamate. However, in the clinical population, medial temporal activation was reduced, and the relationship with glutamate was absent. In individuals at high risk of psychosis, medial temporal dysfunction seemed related to a loss of the normal relationship with local glutamate levels. This study provides the first evidence that links medial temporal dysfunction with the central glutamate system in humans and is consistent with evidence that drugs that modulate glutamatergic transmission might be useful in the treatment of psychosis. Copyright © 2011 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  10. A comparison of occipital and temporal lobe epilepsies.

    Science.gov (United States)

    Appel, S; Sharan, A D; Tracy, J I; Evans, J; Sperling, M R

    2015-10-01

    Differentiating between occipital lobe epilepsy (OLE) and temporal lobe epilepsy (TLE) is often challenging. This retrospective case-control study compares OLE to TLE and explores markers that suggest the diagnosis of OLE. We queried the Jefferson Epilepsy Center surgery database for patients who underwent a resection that involved the occipital lobe. For each patient with OLE, three sequential case-control patients with TLE were matched. Demographic characteristics, symptoms, electrophysiological findings, imaging findings, and surgical outcome were compared. Nineteen patients with OLE and 57 patients with TLE were included in the study. Visual symptoms were unique to patients with OLE (8/19) and were not reported by patients with TLE (P Occipital interictal spikes (IIS) were found only in one-third of the patients with OLE (6/19) and in no patients with TLE (P lobe were found in five of 19 patients with OLE vs one of 57 patients with TLE (P = 0.003). IIS involved more than one lobe of the brain in most patients with OLE (11/19) but only in nine of 57 the TLE group. (P = 0.0003) Multilobar resection was needed in most patients with OLE (15/19), typically including the temporal lobe, but in only one of the patients with TLE (P Occipital lobe epilepsy is difficult to identify and may masquerade as temporal lobe epilepsy. Visual symptoms and occipital findings in the EEG suggest the diagnosis of OLE, but absence of these features, does not exclude the diagnosis. When posterior temporal EEG findings or multilobar involvement occurs, the diagnosis of OLE should be considered. © 2015 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  11. Effects of prior exposure on music liking and recognition in patients with temporal lobe lesions.

    Science.gov (United States)

    Samson, Séverine; Peretz, Isabelle

    2005-12-01

    Prior exposure to music typically increases liking. This manifestation of implicit memory can be dissociated from explicit memory recognition. To examine the contribution of the medial temporal lobe to musical preference and recognition, we tested patients with either left (LTL) or right (RTL) temporal lobe lesions as well as normal control (NC) participants using the procedure of Peretz et al. The results in the affect task showed that NC and LTL participants preferred the studied over nonstudied melodies, thereby demonstrating an implicit exposure effect on liking judgments, whereas RTL patients failed to exhibit this effect. Explicit recognition was impaired in both LTL and RTL patients as compared to NC participants. On the basis of these findings, we suggest that RTL structures play a critical role in the formation of melody representations that support both priming and memory recognition, whereas LTL structures are more involved in the explicit retrieval of melodies. Furthermore, we were able to test an amnesic patient (PC) with bilateral lesions of the temporal lobe. In this case, the exposure effect on liking was also absent. However, repeated exposure to melodies was found to enhance both liking and recognition judgments. This remarkable sparing of memory observed through melody repetition suggests that extensive exposure may assist both implicit and explicit memory in the presence of global amnesia.

  12. Testing the importance of the Medial Temporal Lobes in human interoception: Does it matter if there is a memory component to the task?

    Science.gov (United States)

    Berriman, Joanne; Stevenson, Richard J; Thayer, Zoe C; Thompson, Elizabeth; Mohamed, Armin; Watson, John D G; Miller, Laurie A

    2016-10-01

    Interoception is the ability to consciously perceive internal bodily states. Neuroimaging suggests that the insula (IC) and anterior cingulate cortex (ACC) mediate interoception, while studies involving patients/animals with brain lesions suggest the medial temporal lobe (MTL) is particularly important. One reason for these contrasting conclusions may lie in the types of interoceptive task used by these different approaches. Some tasks probably require integration of current physiological state with mnemonic information (e.g., how much one last ate), and these may be especially reliant upon MTL processing. We compared one task that probably requires integration - a water load task - with one that likely does not - a heart-rate tracking task - in two individuals with selective MTL damage (and with intact IC and ACC). A group of matched healthy individuals served as controls. The main finding was that individuals with MTL damage, relative to controls, were equally and significantly impaired on both types of interoception task. This suggests that MTL structures are involved in mediating interoception even when using a task (heart rate tracking) that does not seemingly require memory and that in neuroimaging studies activates the IC and ACC. The reasons for this apparent inconsistency with neuroimaging findings and the functional role of the MTL in interoception are discussed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  13. Spatial and Temporal Episodic Memory Retrieval Recruit Dissociable Functional Networks in the Human Brain

    Science.gov (United States)

    Ekstrom, Arne D.; Bookheimer, Susan Y.

    2007-01-01

    Imaging, electrophysiological studies, and lesion work have shown that the medial temporal lobe (MTL) is important for episodic memory; however, it is unclear whether different MTL regions support the spatial, temporal, and item elements of episodic memory. In this study we used fMRI to examine retrieval performance emphasizing different aspects…

  14. Effects of neonatal inferior prefrontal and medial temporal lesions on learning the rule for delayed nonmatching-to-sample.

    Science.gov (United States)

    Málková, L; Bachevalier, J; Webster, M; Mishkin, M

    2000-01-01

    The ability of rhesus monkeys to master the rule for delayed nonmatching-to-sample (DNMS) has a protracted ontogenetic development, reaching adult levels of proficiency around 4 to 5 years of age (Bachevalier, 1990). To test the possibility that this slow development could be due, at least in part, to immaturity of the prefrontal component of a temporo-prefrontal circuit important for DNMS rule learning (Kowalska, Bachevalier, & Mishkin, 1991; Weinstein, Saunders, & Mishkin, 1988), monkeys with neonatal lesions of the inferior prefrontal convexity were compared on DNMS with both normal controls and animals given neonatal lesions of the medial temporal lobe. Consistent with our previous results (Bachevalier & Mishkin, 1994; Málková, Mishkin, & Bachevalier, 1995), the neonatal medial temporal lesions led to marked impairment in rule learning (as well as in recognition memory with long delays and list lengths) at both 3 months and 2 years of age. By contrast, the neonatal inferior convexity lesions yielded no impairment in rule-learning at 3 months and only a mild impairment at 2 years, a finding that also contrasts sharply with the marked effects of the same lesion made in adulthood. This pattern of sparing closely resembles the one found earlier after neonatal lesions to the cortical visual area TE (Bachevalier & Mishkin, 1994; Málková et al., 1995). The functional sparing at 3 months probably reflects the fact that the temporo-prefrontal circuit is nonfunctional at this early age, resulting in a total dependency on medial temporal contributions to rule learning. With further development, however, this circuit begins to provide a supplementary route for learning.

  15. MRI findings of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Nakahara, Ichiro; Yin, Dali; Fukami, Masahiro; Kondo, Seiji; Takeuchi, Juji; Kanemoto, Kousuke; Sengoku, Akira; Kawai, Itsuo

    1992-01-01

    MRI findings were analyzed retrospectively in 46 patients with temporal lobe epilepsy in which the side of epileptogenic focus had been confirmed by EEG studies. T 1 - and T 2 -weighted images were obtained by the use of a 1.0 or 1.5 T superconducting-type MRI machine with a coronal scan perpendicular to the axis of the temporal horn of the lateral ventricle. Additional axial and sagittal scans were performed in some cases. The area of the hippocampal body was measured quantitatively using a computerized image-analysis system in 26 cases in which the hippocampus had been visualized with enough contrast on T 1 -weighted coronal images. Abnormal findings were observed in 31/46 (67%) cases. Hippocampal (HC) and temporal lobe (TL) atrophy were observed in 18/46 (39%) and 23/46 (50%) cases respectively, and the side of the atrophy corresponded with the side of the epileptogenic focus, as confirmed by EEG studies, with specificities of 89% and 74% respectively. A quantitative measurement of the area of the hippocampal body showed unilateral hippocampal atrophy more than 10% in 18/25 (69%) cases (10-25%: 10 cases, 25-50%: 7 cases, 50% 2 abnormality was observed in only 4 cases. Structural lesions were observed in 4 cases including an arachnoid cyst, an astrocytoma in amygdala, the Dandy-Walker syndrome, and tuberous sclerosis, using the more efficient imaging qualities than the CT scan. From these observations, it is apparant that superconducting MRI is extremely useful in the diagnosis of the epileptogenic topography of temporal lobe epilepsy. Particularly, hippocampal atrophy was found to correspond with the side of the epileptogenic focus on EEG with a high specificity; its quantitative evaluation could be one of the most important standards in detecting the operative indications for temporal lobe epilepsy. (author)

  16. Craniopharyngioma in the temporal lobe: a case report

    International Nuclear Information System (INIS)

    Sohn, Chul-Ho; Baik, Seung-Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J.

    2004-01-01

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe

  17. Craniopharyngioma in the temporal lobe: a case report

    Energy Technology Data Exchange (ETDEWEB)

    Sohn, Chul-Ho; Baik, Seung-Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J. [University of Calgary, Calgary (Canada)

    2004-03-15

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe.

  18. Magnetic resonance tomography (MRT) for lesions of the temporal lobes

    International Nuclear Information System (INIS)

    Schoerner, W.; Felix, R.; Meencke, H.J.; Freie Univ. Berlin; Freie Univ. Berlin

    1985-01-01

    A comparative study between magnetic resonance tomography (MRT) and CT was carried out in 16 patients with temporal lobe epilepsy. The MRT studies were performed on a 0.35 T Magnetom with T.1 modes in a coronal plane. MRT proved to the superior to CT. CT demonstrated a discrete temporal lobe lesion in three patients and MRT in four patients. In addition, unilateral atrophy of the temporal lobe was demonstrated by MRT in six cases; these could not be diagnosed by CT. The lack of artifacts near the skull base, the possibility of producing coronal sections and the excellent tissue differential of MRT provide the basis for improved diagnosis of lesions in the temporal lobes. (orig.) [de

  19. Multidimensional scaling of emotional responses to music in patients with temporal lobe resection.

    Science.gov (United States)

    Dellacherie, D; Bigand, E; Molin, P; Baulac, M; Samson, S

    2011-10-01

    The present study investigated emotional responses to music by using multidimensional scaling (MDS) analysis in patients with right or left medial temporal lobe (MTL) lesions and matched normal controls (NC). Participants were required to evaluate emotional dissimilarities of nine musical excerpts that were selected to express graduated changes along the valence and arousal dimensions. For this purpose, they rated dissimilarity between pairs of stimuli on an eight-point scale and the resulting matrices were submitted to an MDS analysis. The results showed that patients did not differ from NC participants in evaluating emotional feelings induced by the musical excerpts, suggesting that all participants were able to distinguish refined emotions. We concluded that the ability to detect and use emotional valence and arousal when making dissimilarity judgments was not strongly impaired by a right or left MTL lesion. This finding has important clinical implications and is discussed in light of current neuropsychological studies on emotion. It suggests that emotional responses to music can be at least partially preserved at a non-verbal level in patients with unilateral temporal lobe damage including the amygdala. Copyright © 2011 Elsevier Srl. All rights reserved.

  20. Craniopharyngioma in the Temporal Lobe: A Case Report

    Science.gov (United States)

    Baik, Seung Kug; Kim, Sang-Pyo; Kim, Il-Man; Sevick, Robert J.

    2004-01-01

    Herein, we report on an unusual case of craniopharyngioma arising in the temporal lobe with no prior history of surgery and with no connection to the craniopharyngeal duct. MR images showed a cystic tumor with a small solid portion. To the best of our knowledge, this is the first case of a craniopharyngioma occurring in the temporal lobe. PMID:15064562

  1. A High-Resolution Study of Hippocampal and Medial Temporal Lobe Correlates of Spatial Context and Prospective Overlapping Route Memory

    Science.gov (United States)

    Brown, Thackery I.; Hasselmo, Michael E.; Stern, Chantal E.

    2015-01-01

    When navigating our world we often first plan or retrieve an ideal route to our goal, avoiding alternative paths that lead to other destinations. The medial temporal lobe (MTL) has been implicated in processing contextual information, sequence memory, and uniquely retrieving routes that overlap or “cross paths.” However, the identity of subregions of the hippocampus and neighboring cortex that support these functions in humans remains unclear. The present study used high-resolution functional magnetic resonance imaging (hr-fMRI) in humans to test whether the CA3/DG hippocampal subfield and para-hippocampal cortex are important for processing spatial context and route retrieval, and whether the CA1 subfield facilitates prospective planning of mazes that must be distinguished from alternative overlapping routes. During hr-fMRI scanning, participants navigated virtual mazes that were well-learned from prior training while also learning new mazes. Some routes learned during scanning shared hallways with those learned during pre-scan training, requiring participants to select between alternative paths. Critically, each maze began with a distinct spatial contextual Cue period. Our analysis targeted activity from the Cue period, during which participants identified the current navigational episode, facilitating retrieval of upcoming route components and distinguishing mazes that overlap. Results demonstrated that multiple MTL regions were predominantly active for the contextual Cue period of the task, with specific regions of CA3/DG, parahippocampal cortex, and perirhinal cortex being consistently recruited across trials for Cue periods of both novel and familiar mazes. During early trials of the task, both CA3/DG and CA1 were more active for overlapping than non-overlapping Cue periods. Trial-by-trial Cue period responses in CA1 tracked subsequent overlapping maze performance across runs. Together, our findings provide novel insight into the contributions of MTL

  2. Temporal and occipital lobe features in children with hypochondroplasia/FGFR3 gene mutation.

    Science.gov (United States)

    Philpott, Cristina M; Widjaja, Elysa; Raybaud, Charles; Branson, Helen M; Kannu, Peter; Blaser, Susan

    2013-09-01

    Thanatophoric dysplasia (TD) and hypochondroplasia are both caused by FGFR3 (fibroblast growth factor receptor 3) gene mutations. Temporal lobe dysplasia has been well described in thanatophoric dysplasia; however, only a couple of anecdotal cases of temporal lobe dysplasia in hypochondroplasia have been described. To define temporal lobe abnormalities in patients with hypochondroplasia, given that they share the same genetic mutation. We identified brain imaging studies of nine children with hypochondroplasia. The temporal lobes were assessed on CT and MRI for size and configuration of the temporal horn and aberrant sulcation of the inferior surface of the temporal lobe. All children had a triangular-shape temporal horn and deep transverse fissures of the inferior temporal lobe surface. Neuroimaging in our cohort revealed enlarged temporal lobes and oversulcation of the mesial temporal and occipital lobes, with abnormal inferomedial orientation of these redundant gyri. Hippocampal dysplasia was also universal. We confirmed frequent inferomesial temporal and occipital lobe abnormalities in our cohort of children with hypochondroplasia. Murine models with mutant fgfr3 display increased neuroprogenitor proliferation, cortical thickness and surface area in the temporo-occipital cortex. This is thought to result in excessive convolution and likely explains the imaging findings in this patient cohort. (Note that fgfr3 is the same genetic mutation in mice as FGFR3 is in humans.).

  3. Usefulness of PET in non-lesional temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Bertuluchi, M.; Arganaraz, R.; Buznick, J.; Pomata, H.

    2011-01-01

    Objective. To evaluate the usefulness of PET in patients with refractory non-lesional temporal lobe epilepsy. Material and methods. We present three patients with features of temporal lobe epilepsy refractory to medication, where high definition MRI was normal. Results. These patients had PET hypometabolism in the temporal areas related to clinical and neurophysiological findings. Two of these patients were implanted with subdural grids to confirm the diagnosis and the third was operated directly based on the findings of PET. Encourage the presentation of the importance in recent years is acquiring the PET. Conclusion. In those patients in clinical neurophysiology and epilepsy with suspected temporal lobe, but in the MRI images show no structural lesions, PET can play an important role defining the diagnosis. (authors)

  4. The Opioid System in Temporal Lobe Epilepsy: Functional Role and Therapeutic Potential

    Directory of Open Access Journals (Sweden)

    Johannes Burtscher

    2017-08-01

    Full Text Available Temporal lobe epilepsy is considered to be one of the most common and severe forms of focal epilepsies. Patients often develop cognitive deficits and emotional blunting along the progression of the disease. The high incidence of resistance to antiepileptic drugs and a frequent lack of admissibility to surgery poses an unmet medical challenge. In the urgent quest of novel treatment strategies, neuropeptides are interesting candidates, however, their therapeutic potential has not yet been exploited. This review focuses on the functional role of the endogenous opioid system with respect to temporal lobe epilepsy, specifically in the hippocampus. The role of dynorphins and kappa opioid receptors (KOPr as modulators of neuronal excitability is well understood: both the reduced release of glutamate as well of postsynaptic hyperpolarization were shown in glutamatergic neurons. In line with this, low levels of dynorphin in humans and mice increase the risk of epilepsy development. The role of enkephalins is not understood so well. On one hand, some agonists of the delta opioid receptors (DOPr display pro-convulsant properties probably through inhibition of GABAergic interneurons. On the other hand, enkephalins play a neuro-protective role under hypoxic or anoxic conditions, most probably through positive effects on mitochondrial function. Despite the supposed absence of endorphins in the hippocampus, exogenous activation of the mu opioid receptors (MOPr induces pro-convulsant effects. Recently-expanded knowledge of the complex ways opioid receptors ligands elicit their effects (including biased agonism, mixed binding, and opioid receptor heteromers, opens up exciting new therapeutic potentials with regards to seizures and epilepsy. Potential adverse side effects of KOPr agonists may be minimized through functional selectivity. Preclinical data suggest a high potential of such compounds to control seizures, with a strong predictive validity toward human

  5. Study on memories of temporal lobes and the principles of lateralization using near infrared spectroscopy

    Science.gov (United States)

    Kamakura, Katsutoshi

    2007-01-01

    In this study we measured the variation of brain blood quantity (Oxy-Hb, Deoxy-Hb and Total-Hb) in the temporal lobes using near infrared spectroscopy (NIRS) when the tasks of the memories were presented to the subjects. The memories are classified into the short-term memory (STM) and the long-term memory (LTM) including the episodic and semantic memories. The subjects joined in this study are 11 persons who are university students including graduate students. We used the language task of letter-number sequencing, also reverse sequencing to measure STM and the task of the episodic memory to measure LTM. As a result of analysis, concerning the episodic memory, the variation of Oxy-Hb in the left temporal lobe was larger than that of Oxy-Hb in the right temporal lobe. The result might suggest that the episodic memory has a relationship with cerebral dominance concerning language area in the left temporal lobe. It seems that the episodic memory meditated with the function of language used in this study is much stored in the left temporal lobe than in the right temporal lobe. This result coincides with the principles of lateralization. The variation of Oxy-Hb in the language task of letter-number sequencing was smaller than that of Oxy-Hb in the language task of the episodic memory.

  6. More consistently altered connectivity patterns for cerebellum and medial temporal lobes than for amygdala and striatum in schizophrenia

    Directory of Open Access Journals (Sweden)

    Henning ePeters

    2016-02-01

    Full Text Available Background: Brain architecture can be divided into a cortico-thalamic system and modulatory ‘subcortical-cerebellar’ systems containing key structures such as striatum, medial temporal lobes (MTLs, amygdala, and cerebellum. Subcortical-cerebellar systems are known to be altered in schizophrenia. In particular, intrinsic functional brain connectivity (iFC between these systems has been consistently demonstrated in patients. While altered connectivity is known for each subcortical-cerebellar system separately, it is unknown whether subcortical-cerebellar systems’ connectivity patterns with the cortico-thalamic system are comparably altered across systems, i.e., if separate subcortical-cerebellar systems’ connectivity patterns are consistent across patients. Methods: To investigate this question, 18 patients with schizophrenia (3 unmedicated, 15 medicated with atypical antipsychotics and 18 healthy controls were assessed by resting-state functional magnetic resonance imaging (fMRI. Independent component analysis of fMRI data revealed cortical intrinsic brain networks (NWs with time courses representing proxies for cortico-thalamic system activity. Subcortical-cerebellar systems’ activity was represented by fMRI-based time courses of selected regions-of-interest (ROIs (i.e., striatum, MTL, amygdala, cerebellum. Correlation analysis among ROI- and NWs-time courses yielded individual connectivity matrices (i.e. connectivity between NW and ROIs (allROIs-NW, separateROI-NW, only NWs (NWs-NWs, and only ROIs (allROIs-allROIs as main outcome measures, which were classified by support-vector-machine-based leave-one-out cross-validation. Differences in classification accuracy were statistically evaluated for consistency across subjects and systems. Results: Correlation matrices based on allROIs-NWs yielded 91% classification accuracy, which was significantly superior to allROIs-allROIs and NWs-NWs (56% and 74%, respectively. Considering separate

  7. Excitatory amino acid transporters EAAT-1 and EAAT-2 in temporal lobe and hippocampus in intractable temporal lobe epilepsy

    DEFF Research Database (Denmark)

    Sarac, Sinan; Afzal, Shoaib; Broholm, Helle

    2009-01-01

    Intractable temporal lobe epilepsy (TLE) is an invalidating disease and many patients are resistant to medical treatment. Increased glutamate concentration has been found in epileptogenic foci and may induce local over-excitation and cytotoxicity; one of the proposed mechanisms involves reduced...... extra-cellular clearance of glutamate by excitatory amino acid transporters (EAAT-1 to EAAT-5). EAAT-1 and EAAT-2 are mainly expressed on astroglial cells for the reuptake of glutamate from the extra-cellular space. We have studied the expression of EAAT-1 and EAAT-2 in the hippocampus and temporal lobe...

  8. Comparison of rCBF between patients with medial temporal lobe epilepsy and normal controls using H{sub 2}{sup 15}O PET

    Energy Technology Data Exchange (ETDEWEB)

    Kang, Eun Joo; Lee, Jae Sung; Nam, Hyun Woo; Lee, Sang Kun; Lee, Dong Soo; Chung, June Key; Lee, Myung Chul [College of Medicine, Seoul National Univ., Seoul (Korea, Republic of)

    2002-06-01

    The aim of this study was to identify the brain areas whose regional cerebral blood flow (rCBF) was changed in medial temporal lobe epilepsy (mTLE) using H{sub 2}{sup 15}O-PET. 12 patients with mTLE (6 left, 6 right mTLE) and 6 normal controls were scanned during a fixation baseline period and a sensory-motor condition where subjects pressed a button to an upward arrow. A voxel-based analysis using SPM99 software was performed to compare the patient groups with the normal controls for the rCBF during fixation baseline period and for relative changes of rCBF during the sensory-motor task relative to fixation. Duirng the fixation baseline, a significant reduction of rCBF was found posterior insula bilaterally and right frontopolar regions in right mTLE patients compared to the normal controls. In left mTLE patients, the reduction was found in left frontopolar and temporal regions. During the sensory-motor task, rCBF increase over the fixation period, was reduced in left frontal and superior temporal regions in the right mTLE patients whereas in various areas of right hemisphere in left mTLE patients, relative to normal controls. However, the increased rCBF was also found in the left inferior parietal and anterior thalamic/fornix regions in both right and left mTLE patients compared to normal controls. Epilepsy induced changes were found not only in relative increase/ decrease of rCBF during a simple sensory-motor control condition relative to a fixation rest condition but also in the relative rCBF distribution during the rest period.

  9. Alteration of Interictal Brain Activity in Patients with Temporal Lobe Epilepsy in the Left Dominant Hemisphere: A Resting-State MEG Study

    Directory of Open Access Journals (Sweden)

    Haitao Zhu

    2014-01-01

    Full Text Available Resting MEG activities were compared between patients with left temporal lobe epilepsy (LTLE and normal controls. Using SAMg2, the activities of MEG data were reconstructed and normalized. Significantly elevated SAMg2 signals were found in LTLE patients in the left temporal lobe and medial structures. Marked decreases of SAMg2 signals were found in the wide extratemporal lobe regions, such as the bilateral visual cortex. The study also demonstrated a positive correlation between the seizure frequency and brain activities of the abnormal regions after the multiple linear regression analysis. These results suggested that the aberrant brain activities not only were related to the epileptogenic zones, but also existed in other extratemporal regions in patients with LTLE. The activities of the aberrant regions could be further damaged with the increase of the seizure frequency. Our findings indicated that LTLE could be a multifocal disease, including complex epileptic networks and brain dysfunction networks.

  10. The anterior temporal lobes support residual comprehension in Wernicke’s aphasia

    Science.gov (United States)

    Robson, Holly; Zahn, Roland; Keidel, James L.; Binney, Richard J.; Sage, Karen; Lambon Ralph, Matthew A.

    2014-01-01

    Wernicke’s aphasia occurs after a stroke to classical language comprehension regions in the left temporoparietal cortex. Consequently, auditory–verbal comprehension is significantly impaired in Wernicke’s aphasia but the capacity to comprehend visually presented materials (written words and pictures) is partially spared. This study used functional magnetic resonance imaging to investigate the neural basis of written word and picture semantic processing in Wernicke’s aphasia, with the wider aim of examining how the semantic system is altered after damage to the classical comprehension regions. Twelve participants with chronic Wernicke’s aphasia and 12 control participants performed semantic animate–inanimate judgements and a visual height judgement baseline task. Whole brain and region of interest analysis in Wernicke’s aphasia and control participants found that semantic judgements were underpinned by activation in the ventral and anterior temporal lobes bilaterally. The Wernicke’s aphasia group displayed an ‘over-activation’ in comparison with control participants, indicating that anterior temporal lobe regions become increasingly influential following reduction in posterior semantic resources. Semantic processing of written words in Wernicke’s aphasia was additionally supported by recruitment of the right anterior superior temporal lobe, a region previously associated with recovery from auditory-verbal comprehension impairments. Overall, the results provide support for models in which the anterior temporal lobes are crucial for multimodal semantic processing and that these regions may be accessed without support from classic posterior comprehension regions. PMID:24519979

  11. Dynamic perfusion patterns in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Dupont, Patrick; Paesschen, Wim van; Zaknun, John J.; Maes, Alex; Tepmongkol, Supatporn; Locharernkul, Chaichon; Vasquez, Silvia; Carpintiero, Silvina; Bal, C.S.; Dondi, Maurizio

    2009-01-01

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  12. Dynamic perfusion patterns in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Dupont, Patrick; Paesschen, Wim van [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); Zaknun, John J. [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); University Hospital of Innsbruck, Department of Nuclear Medicine, Innsbruck (Austria); Maes, Alex [KU Leuven/UZ Gasthuisberg, Nuclear Medicine, Medical Imaging Center and Neurology, Leuven (Belgium); AZ Groeninge, Nuclear Medicine, Kortrijk (Belgium); Tepmongkol, Supatporn; Locharernkul, Chaichon [Chulalongkorn University, Nuclear Medicine and Neurology, Bangkok (Thailand); Vasquez, Silvia; Carpintiero, Silvina [Fleni Instituto de Investigaciones Neurologicas, Nuclear Medicine, Buenos Aires (Argentina); Bal, C.S. [All India Institute of Medical Sciences, Nuclear Medicine, New Delhi (India); Dondi, Maurizio [International Atomic Energy Agency (IAEA), Nuclear Medicine Section, Division of Human Health, Wagramer Strasse 5, PO BOX 200, Vienna (Austria); Ospedale Maggiore, Nuclear Medicine, Bologna (Italy)

    2009-05-15

    To investigate dynamic ictal perfusion changes during temporal lobe epilepsy (TLE). We investigated 37 patients with TLE by ictal and interictal SPECT. All ictal injections were performed within 60 s of seizure onset. Statistical parametric mapping was used to analyse brain perfusion changes and temporal relationships with injection time and seizure duration as covariates. The analysis revealed significant ictal hyperperfusion in the ipsilateral temporal lobe extending to subcortical regions. Hypoperfusion was observed in large extratemporal areas. There were also significant dynamic changes in several extratemporal regions: ipsilateral orbitofrontal and bilateral superior frontal gyri and the contralateral cerebellum and ipsilateral striatum. The study demonstrated early dynamic perfusion changes in extratemporal regions probably involved in both propagation of epileptic activity and initiation of inhibitory mechanisms. (orig.)

  13. Working memory retrieval differences between medial temporal lobe epilepsy patients and controls: a three memory layer approach.

    Science.gov (United States)

    López-Frutos, José María; Poch, Claudia; García-Morales, Irene; Ruiz-Vargas, José María; Campo, Pablo

    2014-02-01

    Multi-store models of working memory (WM) have given way to more dynamic approaches that conceive WM as an activated subset of long-term memory (LTM). The resulting framework considers that memory representations are governed by a hierarchy of accessibility. The activated part of LTM holds representations in a heightened state of activation, some of which can reach a state of immediate accessibility according to task demands. Recent neuroimaging studies have studied the neural basis of retrieval information with different states of accessibility. It was found that the medial temporal lobe (MTL) was involved in retrieving information within immediate access store and outside this privileged zone. In the current study we further explored the contribution of MTL to WM retrieval by analyzing the consequences of MTL damage to this process considering the state of accessibility of memory representations. The performance of a group of epilepsy patients with left hippocampal sclerosis in a 12-item recognition task was compared with that of a healthy control group. We adopted an embedded model of WM that distinguishes three components: the activated LTM, the region of direct access, and a single-item focus of attention. Groups did not differ when retrieving information from single-item focus, but patients were less accurate retrieving information outside focal attention, either items from LTM or items expected to be in the WM range. Analyses focused on items held in the direct access buffer showed that consequences of MTL damage were modulated by the level of accessibility of memory representations, producing a reduced capacity. Copyright © 2013 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Ventral medial prefrontal functional connectivity and emotion regulation in chronic schizophrenia: A pilot study

    Institute of Scientific and Technical Information of China (English)

    Feng-Mei Fan; Shu-Ping Tan; Fu-De Yang; Yun-Long Tan; Yan-Li Zhao; Nan Chen; Bin-Bin Li

    2013-01-01

    People with schizophrenia exhibit impaired social cognitive functions,particularly emotion regulation.Abnormal activations of the ventral medial prefrontal cortex (vMPFC) during emotional tasks have been demonstrated in schizophrenia,suggesting its important role in emotion processing in patients.We used the resting-state functional connectivity approach,setting a functionally relevant region,the vMPFC,as a seed region to examine the intrinsic functional interactions and communication between the vMPFC and other brain regions in schizophrenic patients.We found hypo-connectivity between the vMPFC and the medial frontal cortex,right middle temporal lobe (MTL),right hippocampus,parahippocampal cortex (PHC) and amygdala.Further,there was a decreased strength of the negative connectivity (or anticorrelation) between the vMPFC and the bilateral dorsal lateral prefrontal cortex (DLPFC) and pre-supplementary motor areas.Among these connectivity alterations,reduced vMPFCDLPFC connectivity was positively correlated with positive symptoms on the Positive and Negative Syndrome Scale,while vMPFC-right MTL/PHC/amygdala functional connectivity was positively correlated with the performance of emotional regulation in patients.These findings imply that communication and coordination throughout the brain networks are disrupted in schizophrenia.The emotional correlates of vMPFC connectivity suggest a role of the hypo-connectivity between these regions in the neuropathology of abnormal social cognition in chronic schizophrenia.

  15. A protocol for manual segmentation of medial temporal lobe subregions in 7 Tesla MRI

    Directory of Open Access Journals (Sweden)

    D. Berron

    2017-01-01

    Full Text Available Recent advances in MRI and increasing knowledge on the characterization and anatomical variability of medial temporal lobe (MTL anatomy have paved the way for more specific subdivisions of the MTL in humans. In addition, recent studies suggest that early changes in many neurodegenerative and neuropsychiatric diseases are better detected in smaller subregions of the MTL rather than with whole structure analyses. Here, we developed a new protocol using 7 Tesla (T MRI incorporating novel anatomical findings for the manual segmentation of entorhinal cortex (ErC, perirhinal cortex (PrC; divided into area 35 and 36, parahippocampal cortex (PhC, and hippocampus; which includes the subfields subiculum (Sub, CA1, CA2, as well as CA3 and dentate gyrus (DG which are separated by the endfolial pathway covering most of the long axis of the hippocampus. We provide detailed instructions alongside slice-by-slice segmentations to ease learning for the untrained but also more experienced raters. Twenty-two subjects were scanned (19–32 yrs, mean age = 26 years, 12 females with a turbo spin echo (TSE T2-weighted MRI sequence with high-resolution oblique coronal slices oriented orthogonal to the long axis of the hippocampus (in-plane resolution 0.44×0.44 mm2 and 1.0 mm slice thickness. The scans were manually delineated by two experienced raters, to assess intra- and inter-rater reliability. The Dice Similarity Index (DSI was above 0.78 for all regions and the Intraclass Correlation Coefficients (ICC were between 0.76 to 0.99 both for intra- and inter-rater reliability. In conclusion, this study presents a fine-grained and comprehensive segmentation protocol for MTL structures at 7 T MRI that closely follows recent knowledge from anatomical studies. More specific subdivisions (e.g. area 35 and 36 in PrC, and the separation of DG and CA3 may pave the way for more precise delineations thereby enabling the detection of early volumetric changes in dementia and

  16. Seizure semiology identifies patients with bilateral temporal lobe epilepsy.

    Science.gov (United States)

    Loesch, Anna Mira; Feddersen, Berend; Tezer, F Irsel; Hartl, Elisabeth; Rémi, Jan; Vollmar, Christian; Noachtar, Soheyl

    2015-01-01

    Laterality in temporal lobe epilepsy is usually defined by EEG and imaging results. We investigated whether the analysis of seizure semiology including lateralizing seizure phenomena identifies bilateral independent temporal lobe seizure onset. We investigated the seizure semiology in 17 patients in whom invasive EEG-video-monitoring documented bilateral temporal seizure onset. The results were compared to 20 left and 20 right consecutive temporal lobe epilepsy (TLE) patients who were seizure free after anterior temporal lobe resection. The seizure semiology was analyzed using the semiological seizure classification with particular emphasis on the sequence of seizure phenomena over time and lateralizing seizure phenomena. Statistical analysis included chi-square test or Fisher's exact test. Bitemporal lobe epilepsy patients had more frequently different seizure semiology (100% vs. 40%; p<0.001) and significantly more often lateralizing seizure phenomena pointing to bilateral seizure onset compared to patients with unilateral TLE (67% vs. 11%; p<0.001). The sensitivity of identical vs. different seizure semiology for the identification of bilateral TLE was high (100%) with a specificity of 60%. Lateralizing seizure phenomena had a low sensitivity (59%) but a high specificity (89%). The combination of lateralizing seizure phenomena and different seizure semiology showed a high specificity (94%) but a low sensitivity (59%). The analysis of seizure semiology including lateralizing seizure phenomena adds important clinical information to identify patients with bilateral TLE. Copyright © 2014 Elsevier B.V. All rights reserved.

  17. MR imaging of temporal lobe meningoencephalocele

    International Nuclear Information System (INIS)

    Tampieri, D.; Leblanc, R.; Melangon, D.; del-Carpio-O'Donovan, R.; Ethier, R.

    1991-01-01

    Basal meningoencephaloceles represent a rare entity, and they may be associated with a variety of midline cerebral abnormalities. The classification of basal meningoencephaloceles is related to their anatomic location. This paper reports experience in 3 patients, 2 who have temporal lobe epilepsy and a bone defect in the region of the foramen rotondum. In these 2 patients the encephalocele and its covering were protruding into the pterygopalatine fossa without any orbital involvement. The third patient presented with cerebrospinal fluid rhinorrhea caused by a transsphenoidal meningoencephalocele. MR imaging is the examination of choice for detecting these lesions since it allows for the visualization of the encephalocele and its meningeal covering as well as the bone defect and associated lesions in the temporal lobes

  18. Microencephaloceles: another dual pathology of intractable temporal lobe epilepsy in childhood.

    Science.gov (United States)

    Aquilina, Kristian; Clarke, Dave F; Wheless, James W; Boop, Frederick A

    2010-04-01

    Temporal lobe encephaloceles can be associated with temporal lobe epilepsy. The authors report on the case of an adolescent with multiple microencephaloceles, in the anterolateral middle fossa floor, identified at surgery (temporal lobectomy) for intractable partial-onset seizures of temporal origin. Magnetic resonance imaging revealed only hippocampal atrophy. Subdural electrodes demonstrated ictal activity arising primarily from the anterior and lateral temporal lobe, close to the microencephaloceles, spreading to the anterior and posterior mesial structures. Pathological examination revealed diffuse temporal gliosis involving the hippocampus, together with microdysgenesis of the amygdala. The literature on epilepsy secondary to encephaloceles is reviewed and the contribution of the microencephaloceles to the seizure disorder in this patient is discussed.

  19. PET imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Semah, F.

    2006-01-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  20. PET imaging in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Semah, F. [Service Hospitalier Frederic Joliot, DSV-CEA, 91 Orsay (France)

    2006-07-01

    The research projects on epilepsy addressed two main issues: the pathophysiology of the inter-ictal hypo-metabolism in temporal lobe epilepsy and the role of the basal ganglia in the control of seizure. Our research projects focused primarily on temporal lobe epilepsy: The pathophysiology of inter-ictal hypo-metabolism and its correlation with the epileptogenic network was investigated in patients with mesial temporal lobe epilepsy. Inter-ictal hypo-metabolism is commonly found in mesio-temporal lobe epilepsy (MTLE) but its pathophysiology remains incompletely understood. We hypothesized that metabolic changes reflect the preferential networks involved in ictal discharges. We analyzed the topography of inter-ictal hypo-metabolism according to electro-clinical patterns in 50 patients with unilateral hippocampal sclerosis (HS) and consistent features of MTLE. Based on electro-clinical correlations we identified 4 groups:1) mesial group characterized by mesial seizure onset without evidence of early spread beyond the temporal lobe; 2) anterior mesio-lateral group (AML) with early anterior spread, involving the anterior lateral temporal cortex and insulo-fronto-opercular areas; 3) widespread mesio-lateral group (WML) with widespread spread, involving both anterior and posterior lateral temporal and peri-sylvian areas; 4) bi-temporal group (BT) with early contralateral temporal spread. Results of FDG-PET imaging in each group were compared to control subjects using statistical parametric mapping software (SPM99). MRI data and surgical outcome in each group were compared to metabolic findings. Hypo-metabolism was limited to the hippocampal gyrus, the temporal pole and the insula in the mesial group. Gradual involvement of the lateral temporal cortex, the insula and the peri-sylvian areas was observed in the AML and WML groups. The BT group differed from the others by mild bi-temporal involvement, bilateral insular hypo-metabolism and longer epilepsy duration. MRI

  1. Middle Temporal Gyrus Versus Inferior Temporal Gyrus Transcortical Approaches to High-Grade Astrocytomas in the Mediobasal Temporal Lobe: A Comparison of Outcomes, Functional Restoration, and Surgical Considerations.

    Science.gov (United States)

    Quinones-Hinojosa, Alfredo; Raza, Shaan M; Ahmed, Ishrat; Rincon-Torroella, Jordina; Chaichana, Kaisorn; Olivi, Alessandro

    2017-01-01

    High-grade astrocytomas of the mesial temporal lobe may pose surgical challenges. Several approaches (trans-sylvian, subtemporal, and transcortical) have been designed to circumnavigate the critical neurovascular structures and white fiber tracts that surround this area. Considering the paucity of literature on the transcortical approach for these lesions, we describe our institutional experience with transcortical approaches to Grade III/IV astrocytomas in the mesial temporal lobe. Between 1999 and 2009, 23 patients underwent surgery at the Johns Hopkins Medical Institutions for Grade III/IV astrocytomas involving the mesial temporal lobe (without involvement of the temporal neocortex). Clinical notes, operative records, and imaging were reviewed. Thirteen patients had tumors in the dominant hemisphere. All patients underwent surgery via a transcortical approach (14 via the inferior temporal gyrus and 9 via the middle temporal gyrus). Gross total resection was obtained in 92 % of the cohort. Neurological outcomes were: clinically significant stroke (2 patients), new visual deficits (2 patients), new speech deficit (1 patient); seizure control (53 %). In comparison to reported results in the literature for the transylvian and subtemporal approaches, the transcortical approach may provide the access necessary for a gross total resection with minimal neurological consequences. In our series of patients, there was no statistically significant difference in outcomes between the middle temporal gyrus versus the inferior temporal gyrus trajectories.

  2. Composing lexical versus functional adjectives: Evidence for uniformity in the left temporal lobe.

    Science.gov (United States)

    Zhang, Linmin; Pylkkänen, Liina

    2018-04-24

    Featural information (e.g., color or shape) allows interlocutors to focus their attention on the specific items under discussion from the vast set of possibilities in the environment. Intriguingly, when they are used to modify and restrict nouns, adjectives can either carry featural information themselves (e.g., green car) or retrieve featural information from the context (e.g., somebody points at a car and claims that she has the same car or a different car). Do the processing of same/different car and green car share neural correlates? For the composition of nouns with feature-carrying adjectives, prior work revealed early compositional effects (roughly 200 ms after noun onset) in the left anterior temporal lobe. However, although we know that such effects do not extend to cases of numeral quantification, which add no conceptual features to the noun (e.g., two boats), we do not know whether they extend to functional adjectives that themselves introduce no features, but instead reference features in the context. To address this question, we measured magnetoencephalography (MEG) during the processing of five types of noun phrases (NPs): same NPs (e.g., same star), different NPs (e.g., different star), color NPs (e.g., green star), comparative NPs (e.g., larger star), and another NPs (e.g., another star). Our main finding was that between 185 to 240 ms after noun onset, same and different NPs patterned with the color NPs in their elicited left temporal lobe activity, and same NPs even trended toward higher amplitudes than the color NPs. This shows that the mechanism driving combinatory effects in the left temporal cortex does not require the input words to directly name conceptual features, as long as the words reference featural information in the context, and that overlapping neural correlates underlie the composition of featural information from both linguistic and nonlinguistic sources.

  3. Epilepsy in multiple sclerosis: The role of temporal lobe damage.

    Science.gov (United States)

    Calabrese, M; Castellaro, M; Bertoldo, A; De Luca, A; Pizzini, F B; Ricciardi, G K; Pitteri, M; Zimatore, S; Magliozzi, R; Benedetti, M D; Manganotti, P; Montemezzi, S; Reynolds, R; Gajofatto, A; Monaco, S

    2017-03-01

    Although temporal lobe pathology may explain some of the symptoms of multiple sclerosis (MS), its role in the pathogenesis of seizures has not been clarified yet. To investigate the role of temporal lobe damage in MS patients suffering from epilepsy, by the application of advanced multimodal 3T magnetic resonance imaging (MRI) analysis. A total of 23 relapsing remitting MS patients who had epileptic seizures (RRMS/E) and 23 disease duration matched RRMS patients without any history of seizures were enrolled. Each patient underwent advanced 3T MRI protocol specifically conceived to evaluate grey matter (GM) damage. This includes grey matter lesions (GMLs) identification, evaluation of regional cortical thickness and indices derived from the Neurite Orientation Dispersion and Density Imaging model. Regional analysis revealed that in RRMS/E, the regions most affected by GMLs were the hippocampus (14.2%), the lateral temporal lobe (13.5%), the cingulate (10.0%) and the insula (8.4%). Cortical thinning and alteration of diffusion metrics were observed in several regions of temporal lobe, in insular cortex and in cingulate gyrus of RRMS/E compared to RRMS ( ptemporal lobe, which exceeds what would be expected on the basis of the global GM damage observed.

  4. Altered cortical anatomical networks in temporal lobe epilepsy

    Science.gov (United States)

    Lv, Bin; He, Huiguang; Lu, Jingjing; Li, Wenjing; Dai, Dai; Li, Meng; Jin, Zhengyu

    2011-03-01

    Temporal lobe epilepsy (TLE) is one of the most common epilepsy syndromes with focal seizures generated in the left or right temporal lobes. With the magnetic resonance imaging (MRI), many evidences have demonstrated that the abnormalities in hippocampal volume and the distributed atrophies in cortical cortex. However, few studies have investigated if TLE patients have the alternation in the structural networks. In the present study, we used the cortical thickness to establish the morphological connectivity networks, and investigated the network properties using the graph theoretical methods. We found that all the morphological networks exhibited the small-world efficiency in left TLE, right TLE and normal groups. And the betweenness centrality analysis revealed that there were statistical inter-group differences in the right uncus region. Since the right uncus located at the right temporal lobe, these preliminary evidences may suggest that there are topological alternations of the cortical anatomical networks in TLE, especially for the right TLE.

  5. A study using computerized tomography in the clinical practice of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Yamamoto, Kunimitsu

    1982-01-01

    The author has studied about analysis of clinical data and CT findings examined conventional method for 50 cases of temporal lobe epilepsy and how to assess the foci of temporal lobe by CT. According to the examination of conventional neuroradiologic technique and routine work of CT for temporal lobe epilepsy, an extreme space occuping lesions were detected and marked cerebral atrophy, low density area in temporal lobe were found out, but, most of them were not able to detect foci of the temporal lobe and yet, the study of CT number based on the print out data did not give any precise informations about epileptogenic lesions of temporal lobe epilepsy. The method of reversed axial section CT was designed to photograph inferior horn of lateral ventricles with the purpose to delineate the hippocampus and amygdata, and precise pictures from autopsy brain and clinical cases were obtained by that method about scanning angle of reversed axial section CT, various angles are made an experiment on scanning, such as reversed 15 0 , 20 0 , 25 0 , 30 0 , 35 0 . Among them, it is proved that the reversed angle of almost 25 0 is most suitable to delineate mesial temporal structure, so as to say, foci of the temporal lobe. (J.P.N.)

  6. Pathways of seizure propagation from the temporal to the occipital lobe.

    Science.gov (United States)

    Jacobs, Julia; Dubeau, François; Olivier, André; Andermann, Frederick

    2008-12-01

    Propagation of ictal epileptic discharges influences the clinical appearance of seizures. Fast propagation from the occipital to temporal lobe has been well described, but until now the reverse direction of spread has not been emphasized. We describe two patients who experienced ictal propagation from temporal to occipital regions. One case presented with amaurosis during a seizure with temporal onset and temporal-occipital spread. In the second, temporal-occipital spread was documented during a seizure, which continued in the occipital lobe for six minutes. Depth electrode studies suggested the temporal ictal onset of seizures in both patients. Propagation from temporal to occipital lobe structures must be considered in the assessment of patients who have seizures with both temporal and occipital features. The propagation may have predictive value for their surgical outcome. The underlying anatomical structure might be the inferior longitudinal fasciculus.

  7. Alteration of functional connectivity within visuospatial working memory-related brain network in patients with right temporal lobe epilepsy: a resting-state fMRI study.

    Science.gov (United States)

    Lv, Zong-xia; Huang, Dong-Hong; Ye, Wei; Chen, Zi-rong; Huang, Wen-li; Zheng, Jin-ou

    2014-06-01

    This study aimed to investigate the resting-state brain network related to visuospatial working memory (VSWM) in patients with right temporal lobe epilepsy (rTLE). The functional mechanism underlying the cognitive impairment in VSWM was also determined. Fifteen patients with rTLE and 16 healthy controls matched for age, gender, and handedness underwent a 6-min resting-state functional MRI session and a neuropsychological test using VSWM_Nback. The VSWM-related brain network at rest was extracted using multiple independent component analysis; the spatial distribution and the functional connectivity (FC) parameters of the cerebral network were compared between groups. Behavioral data were subsequently correlated with the mean Z-value in voxels showing significant FC difference during intergroup comparison. The distribution of the VSWM-related resting-state network (RSN) in the group with rTLE was virtually consistent with that in the healthy controls. The distribution involved the dorsolateral prefrontal lobe and parietal lobe in the right hemisphere and the partial inferior parietal lobe and posterior lobe of the cerebellum in the left hemisphere (pright superior frontal lobe (BA8), right middle frontal lobe, and right ventromedial prefrontal lobe compared with the controls (pright superior frontal lobe (BA11), right superior parietal lobe, and left posterior lobe of the cerebellum (prights reserved.

  8. Ictal spitting in left temporal lobe epilepsy: report of three cases.

    Science.gov (United States)

    Caboclo, Luís Otávio Sales Ferreira; Miyashira, Flavia Saori; Hamad, Ana Paula Andrade; Lin, Katia; Carrete, Henrique; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2006-09-01

    Ictal spitting is rarely reported in patients with epilepsy. More often it is observed in patients with temporal lobe epilepsy (TLE) and is presumed to be a lateralizing sign to language nondominant hemisphere. We report three patients with left TLE who had ictal spitting registered during prolonged video-EEG monitoring. Medical charts of all patients with medically refractory partial epilepsy submitted to prolonged video-EEG monitoring in the Epilepsy Unit at UNIFESP during a 3-year period were reviewed, in search of reports of ictal spitting. The clinical, neurophysiological and neuroimaging data of the identified patients were reviewed. Among 136 patients evaluated with prolonged video-EEG monitoring, three (2.2%) presented spitting automatisms during complex partial seizures. All of them were right-handed, and had clear signs of left hippocampal sclerosis on MRI. In two patients, in all seizures in which ictal spitting was observed, EEG seizure onset was seen in the left temporal lobe. In the third patient, ictal onset with scalp electrodes was observed in the right temporal lobe, but semi-invasive monitoring with foramen ovale electrodes revealed ictal onset in the left temporal lobe, confirming false lateralization in surface records. The three patients became seizure-free following left anterior temporal lobectomy. Ictal spitting is a rare finding in patients with epilepsy, and may be considered a localizing sign of seizure onset in the temporal lobe. It may be observed in seizures originating from the left temporal lobe, and thus should not be considered a lateralizing sign of nondominant TLE.

  9. Visual short-term memory for high resolution associations is impaired in patients with medial temporal lobe damage.

    Science.gov (United States)

    Koen, Joshua D; Borders, Alyssa A; Petzold, Michael T; Yonelinas, Andrew P

    2017-02-01

    The medial temporal lobe (MTL) plays a critical role in episodic long-term memory, but whether the MTL is necessary for visual short-term memory is controversial. Some studies have indicated that MTL damage disrupts visual short-term memory performance whereas other studies have failed to find such evidence. To account for these mixed results, it has been proposed that the hippocampus is critical in supporting short-term memory for high resolution complex bindings, while the cortex is sufficient to support simple, low resolution bindings. This hypothesis was tested in the current study by assessing visual short-term memory in patients with damage to the MTL and controls for high resolution and low resolution object-location and object-color associations. In the location tests, participants encoded sets of two or four objects in different locations on the screen. After each set, participants performed a two-alternative forced-choice task in which they were required to discriminate the object in the target location from the object in a high or low resolution lure location (i.e., the object locations were very close or far away from the target location, respectively). Similarly, in the color tests, participants were presented with sets of two or four objects in a different color and, after each set, were required to discriminate the object in the target color from the object in a high or low resolution lure color (i.e., the lure color was very similar or very different, respectively, to the studied color). The patients were significantly impaired in visual short-term memory, but importantly, they were more impaired for high resolution object-location and object-color bindings. The results are consistent with the proposal that the hippocampus plays a critical role in forming and maintaining complex, high resolution bindings. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

  10. Visual field defects after temporal lobe resection for epilepsy.

    Science.gov (United States)

    Steensberg, Alvilda T; Olsen, Ane Sophie; Litman, Minna; Jespersen, Bo; Kolko, Miriam; Pinborg, Lars H

    2018-01-01

    To determine visual field defects (VFDs) using methods of varying complexity and compare results with subjective symptoms in a population of newly operated temporal lobe epilepsy patients. Forty patients were included in the study. Two patients failed to perform VFD testing. Humphrey Field Analyzer (HFA) perimetry was used as the gold standard test to detect VFDs. All patients performed a web-based visual field test called Damato Multifixation Campimetry Online (DMCO). A bedside confrontation visual field examination ad modum Donders was extracted from the medical records in 27/38 patients. All participants had a consultation by an ophthalmologist. A questionnaire described the subjective complaints. A VFD in the upper quadrant was demonstrated with HFA in 29 (76%) of the 38 patients after surgery. In 27 patients tested ad modum Donders, the sensitivity of detecting a VFD was 13%. Eight patients (21%) had a severe VFD similar to a quadrant anopia, thus, questioning their permission to drive a car. In this group of patients, a VFD was demonstrated in one of five (sensitivity=20%) ad modum Donders and in seven of eight (sensitivity=88%) with DMCO. Subjective symptoms were only reported by 28% of the patients with a VFD and in two of eight (sensitivity=25%) with a severe VFD. Most patients (86%) considered VFD information mandatory. VFD continue to be a frequent adverse event after epilepsy surgery in the medial temporal lobe and may affect the permission to drive a car in at least one in five patients. Subjective symptoms and bedside visual field testing ad modum Donders are not sensitive to detect even a severe VFD. Newly developed web-based visual field test methods appear sensitive to detect a severe VFD but perimetry remains the golden standard for determining if visual standards for driving is fulfilled. Patients consider VFD information as mandatory. Copyright © 2017. Published by Elsevier Ltd.

  11. How FDG-PET helps making decision for surgery in various difficult subgroups of temporal lobe epilepsy?

    Energy Technology Data Exchange (ETDEWEB)

    Tepmongkol, S [Division of Nuclear Medicine, Department of Radiology and Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok (Thailand); Locharernkul, C [Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University and Chulalongkorn Comprehensive Epilepsy Program under the patronage of Professor Doctor HRH Princess Chulabhorn, Bangkok (Thailand); Chaiwatanarat, T; Kingpetch, K; Sirisalipoch, S [Division of Nuclear Medicine, Department of Radiology, Faculty of Medicine, Chulalongkorn University, Bangkok (Thailand); Limotai, C; Loplumlert, J [Chulalongkorn Comprehensive Epilepsy Program under the patronage of Professor Doctor HRH Princess Chulabhorn, Bangkok (Thailand)

    2007-07-01

    Concordant pre-surgical data are the important predictors of good surgical outcome in patients with localization-related epilepsy. Medically intractable temporal lobe epilepsy with hippocampal sclerosis (HS) and concordant pre-surgical data is straightforward and may not need functional imaging. However, in other instances for example, HS with discordant data (HSD), bilateral HS with discordant data (BHSD), temporal lobe epilepsy with dual pathology (DP), non-lesional temporal lobe epilepsy (NL) are the difficult subgroups. In these groups, functional imaging eg. brain perfusion SPECT or brain PET may play a major role for surgical decision making. To our knowledge, there was no previous data in using FDG-PET in different subgroups as mentioned. Only some previous studies in single subgroup without analyzing impact of PET findings on decision-making have been reported. We thus aim to evaluate the usefulness of FDG-PET in these 4 subgroups.

  12. Temporal lobe structures and facial emotion recognition in schizophrenia patients and nonpsychotic relatives.

    Science.gov (United States)

    Goghari, Vina M; Macdonald, Angus W; Sponheim, Scott R

    2011-11-01

    Temporal lobe abnormalities and emotion recognition deficits are prominent features of schizophrenia and appear related to the diathesis of the disorder. This study investigated whether temporal lobe structural abnormalities were associated with facial emotion recognition deficits in schizophrenia and related to genetic liability for the disorder. Twenty-seven schizophrenia patients, 23 biological family members, and 36 controls participated. Several temporal lobe regions (fusiform, superior temporal, middle temporal, amygdala, and hippocampus) previously associated with face recognition in normative samples and found to be abnormal in schizophrenia were evaluated using volumetric analyses. Participants completed a facial emotion recognition task and an age recognition control task under time-limited and self-paced conditions. Temporal lobe volumes were tested for associations with task performance. Group status explained 23% of the variance in temporal lobe volume. Left fusiform gray matter volume was decreased by 11% in patients and 7% in relatives compared with controls. Schizophrenia patients additionally exhibited smaller hippocampal and middle temporal volumes. Patients were unable to improve facial emotion recognition performance with unlimited time to make a judgment but were able to improve age recognition performance. Patients additionally showed a relationship between reduced temporal lobe gray matter and poor facial emotion recognition. For the middle temporal lobe region, the relationship between greater volume and better task performance was specific to facial emotion recognition and not age recognition. Because schizophrenia patients exhibited a specific deficit in emotion recognition not attributable to a generalized impairment in face perception, impaired emotion recognition may serve as a target for interventions.

  13. Insulin Resistance Predicts Medial Temporal Hypermetabolism in Mild Cognitive Impairment Conversion to Alzheimer Disease

    Science.gov (United States)

    Willette, Auriel A.; Modanlo, Nina

    2015-01-01

    Alzheimer disease (AD) is characterized by progressive hypometabolism on [18F]-fluorodeoxyglucose positron emission tomography (FDG-PET) scans. Peripheral insulin resistance (IR) increases AD risk. No studies have examined associations between FDG metabolism and IR in mild cognitive impairment (MCI) and AD, as well as MCI conversion to AD. We studied 26 cognitively normal (CN), 194 MCI (39 MCI-progressors, 148 MCI-stable, 2 years after baseline), and 60 AD subjects with baseline FDG-PET from the Alzheimer’s Disease Neuroimaging Initiative. Mean FDG metabolism was derived for AD-vulnerable regions of interest (ROIs), including lateral parietal and posteromedial cortices, medial temporal lobe (MTL), hippocampus, and ventral prefrontal cortices (vPFC), as well as postcentral gyrus and global cerebrum control regions. The homeostasis model assessment of IR (HOMA-IR) was used to measure IR. For AD, higher HOMA-IR predicted lower FDG in all ROIs. For MCI-progressors, higher HOMA-IR predicted higher FDG in the MTL and hippocampus. Control regions showed no associations. Higher HOMA-IR predicted hypermetabolism in MCI-progressors and hypometabolism in AD in medial temporal regions. Future longitudinal studies should examine the pathophysiologic significance of the shift from MTL hyper- to hypometabolism associated with IR. PMID:25576061

  14. Practical use of visual medial temporal lobe atrophy cut-off scores in Alzheimer's disease: Validation in a large memory clinic population

    International Nuclear Information System (INIS)

    Claus, Jules J.; Holl, Dana C.; Roorda, Jelmen J.; Staekenborg, Salka S.; Schuur, Jacqueline; Koster, Pieter; Tielkes, Caroline E.M.; Scheltens, Philip

    2017-01-01

    To provide age-specific medial temporal lobe atrophy (MTA) cut-off scores for routine clinical practice as marker for Alzheimer's disease (AD). Patients with AD (n = 832, mean age 81.8 years) were compared with patients with subjective cognitive impairment (n = 333, mean age 71.8 years) in a large single-centre memory clinic. Mean of right and left MTA scores was determined with visual rating (Scheltens scale) using CT (0, no atrophy to 4, severe atrophy). Relationships between age and MTA scores were analysed with regression analysis. For various MTA cut-off scores, decade-specific sensitivity and specificity and area under the curve (AUC) values, computed with receiver operator characteristic curves, were determined. MTA strongly increased with age in both groups to a similar degree. Optimal MTA cut-off values for the age ranges <65, 65-74, 75-84 and ≥85 were: ≥1.0, ≥1.5, ≥ 2.0 and ≥2.0. Corresponding values of sensitivity and specificity were 83.3% and 86.4%; 73.7% and 84.6%; 73.7% and 76.2%; and 84.0% and 62.5%. From this large unique memory clinic cohort we suggest decade-specific MTA cut-off scores for clinical use. After age 85 years, however, the practical usefulness of the MTA cut-off is limited. (orig.)

  15. MRI and brain spect findings in patients with unilateral temporal lobe epilepsy and normal CT scan

    Directory of Open Access Journals (Sweden)

    P.G. Carrilho

    1994-06-01

    Full Text Available 26 patients with temporal lobe epilepsy clinically documented by several abnormal interictal surface EEGs with typical unitemporal epileptiform activity and a normal CT scan were studied. Interictal99mTC HMPAO brain SPECT and MRI were performed in all subjects. Abnormalities were shown in 61.5% of MRI (n=16 and 65.4% of SPECT (n=17. Hippocampal atrophy associated to a high signal on T2-weighted MRI slices suggesting mesial temporal sclerosis was the main finding (n=12; 75% of abnormal MRI. MRI correlated well to surface EEG in 50% (n=13. There was also a good correlation between MRI and SPECT in 30.7% (n=8. SPECT and EEG were in agreement in 57.7% (n=l5. MRI, SPECT and EEG were congruent in 26.9% (n=7. These results support the usefulness of interictal brain SPECT and MRI in detecting lateralized abnormalities in temporal lobe epilepsy. On the other hand, in two cases, interictal SPECT correlated poorly with surface EEG. This functional method should not be used isolately in the detection of temporal lobe foci. MRI is more useful than CT as a neuroimaging technique in temporal lobe epilepsy. It may detect small structural lesions and mesial temporal lobe sclerosis which are not easily seen with traditional CT scanning.

  16. Complications after mesial temporal lobe surgery via inferiortemporal gyrus approach.

    Science.gov (United States)

    Vale, Fernando L; Reintjes, Stephen; Garcia, Hermes G

    2013-06-01

    The purpose of this study was to identify the complications associated with the inferior temporal gyrus approach to anterior mesial temporal lobe resection for temporal lobe epilepsy. This retrospective study examined complications experienced by 483 patients during the 3 months after surgery. All surgeries were performed during 1998-2012 by the senior author (F.L.V.). A total of 13 complications (2.7%) were reported. Complications were 8 delayed subdural hematomas (1.6%), 2 superficial wound infections (0.4%), 1 delayed intracranial hemorrhage (0.2%), 1 small lacunar stroke (0.2%), and 1 transient frontalis nerve palsy (0.2%). Three patients with subdural hematoma (0.6%) required readmission and surgical intervention. One patient (0.2%) with delayed intracranial hemorrhage required readmission to the neuroscience intensive care unit for observation. No deaths or severe neurological impairments were reported. Among the 8 patients with subdural hematoma, 7 were older than 40 years (87.5%); however, this finding was not statistically significant (p = 0.198). The inferior temporal gyrus approach to mesial temporal lobe resection is a safe and effective method for treating temporal lobe epilepsy. Morbidity and mortality rates associated with this procedure are lower than those associated with other neurosurgical procedures. The finding that surgical complications seem to be more common among older patients emphasizes the need for early surgical referral of patients with medically refractory epilepsy.

  17. Anterior Temporal Lobe Morphometry Predicts Categorization Ability.

    Science.gov (United States)

    Garcin, Béatrice; Urbanski, Marika; Thiebaut de Schotten, Michel; Levy, Richard; Volle, Emmanuelle

    2018-01-01

    Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  18. Medial temporal lobe damage causes deficits in episodic memory and episodic future thinking not attributable to deficits in narrative construction.

    Science.gov (United States)

    Race, Elizabeth; Keane, Margaret M; Verfaellie, Mieke

    2011-07-13

    The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL involvement in imagining the future and tested the novel hypothesis that the MTL contributes to future thinking by supporting online binding processes related to narrative construction. Human amnesic patients with well characterized MTL damage and healthy controls constructed narratives about (1) future events, (2) past events, and (3) visually presented pictures. While all three tasks place similar demands on narrative construction, only the past and future conditions require memory/future thinking to mentally generate relevant narrative information. Patients produced impoverished descriptions of both past and future events but were unimpaired at producing detailed picture narratives. In addition, future-thinking performance positively correlated with episodic memory performance but did not correlate with picture narrative performance. Finally, future-thinking impairments were present when MTL lesions were restricted to the hippocampus and did not depend on the presence of neural damage outside the MTL. These results indicate that the ability to generate and maintain a detailed narrative is preserved in amnesia and suggest that a common MTL mechanism supports both episodic memory and episodic future thinking.

  19. A structural MRI study: gray matter changes in mesial temporal lobe epilepsy patients with different seizure types

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    Jun-hao XIAO

    2018-04-01

    Full Text Available Objective To observe gray matter volume changes and evaluate the relation between gray matter changes and duration of mesial temporal lobe epilepsy (mTLE patients with different seizure types. Methods A total of 40 patients with mTLE, including 20 with partial seizures (mTLE-PS group and 20 with secondarily generalized seizures (mTLE-sGS group, and 20 sex- and age-matched healthy volunteers (control group were recruited. T1-three-dimensional magnetization-prepared rapid gradient echo (T1-3D-MPRAGE was scanned for voxel.based morphometry (VBM. Bilateral frontal lobes and thalami were selected as regions of interest (ROIs to compare gray matter volume of brain regions among 3 groups. Spearman rank correlation analysis was used to evaluate the correlation between gray matter volume of brain regions and duration. Results There were significant differences in gray matter volumes in bilateral superior frontal gyri, right middle frontal gyrus, right medial frontal gyrus, right angular gyrus, right middle temproral gyrus, right hippocampus, bilateral thalami and bilateral cerebellar hemispheres among 3 groups (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral cerebellar hemispheres, right middle temproral gyrus, right hippocampus and right thalamus in mTLE-PS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with control group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, bilateral cerebellar hemispheres, right angular gyrus, right middle temporal gyrus and right hippocampus in mTLE-sGS group were significantly decreased (P < 0.01, for all; FWE correction. Compared with mTLE-PS group, gray matter volumes in bilateral superior frontal gyri, bilateral thalami, right medial frontal gyrus and right gyrus rectus in mTLE-sGS group were significantly reduced (P < 0.01, for all; FWE correction. Gray matter volumes in left

  20. Hipometabolismo cerebral em pacientes com esclerose mesial temporal demonstrado pelo FDG-PET Brain hypometabolism in patients with mesial-temporal sclerosis demonstrated by FDG-PET

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    PAULO S. DUARTE

    2000-09-01

    Full Text Available O objetivo deste estudo foi avaliar a extensão do hipometabolismo cerebral em pacientes com esclerose mesial temporal (EMT. MÉTODO: Este estudo retrospectivo incluiu 21 pacientes que apresentavam epilepsia parcial complexa refrataria à terapia e que foram selecionados para cirurgia após análise extensa que incluía: EEG de superfície e estudos de neuroimagem (PET, SPECT e ressonância magnética. Todos os pacientes foram submetidos a intervenção cirúrgica e tiveram confirmação histológica de EMT. Uma análise semi-quantitativa foi realizada, utilizando regiões de interesse (ROIs nas seguintes estruturas: lobos frontais, parietais e occipitais, gânglios da base, tálamos, cerebelo e três diferentes regiões nos lobos temporais, que compreendiam o córtex medial, inferior e lateral. Um índice de assimetria (IA foi calculado, comparando as contagens por pixel nas estruturas homólogas em ambos os hemisférios cerebrais. Os IAs das diferentes estruturas foram então correlacionados. RESULTADOS: Uma correlação significativa foi demonstrada entre os IAs do córtex medial dos lobos temporais e aqueles dos lobos frontais, dos lobos parietais, dos gânglios da base e dos tálamos (r = 0,72, 0,62, 0,47 e 0,47 respectivamente com p The purpose of this study was to evaluate the extent of brain hypometabolism in patients with mesial-temporal sclerosis (MTS. METHOD: This retrospective study included 21 patients who had medically refractory complex partial seizures and were selected for surgical therapy after a comprehensive evaluation which included surface EEG recordings and neuroimaging studies (PET, SPECT and MRI. All patients were subjected to surgical intervention and had an histopathological confirmation of MTS. A semi-quantitative analysis of the PET images was performed using regions of interest in the following structures: frontal, parietal and occipital lobes, basal ganglia, thalami, cerebellum and three different regions in the

  1. Radiosurgery in the Management of Intractable Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Peñagarícano, José; Serletis, Demitre

    2015-09-01

    Mesial temporal lobe epilepsy (MTLE) describes recurrent seizure activity originating from the depths of the temporal lobe. MTLE patients who fail two trials of medication now require testing for surgical candidacy at an epilepsy center. For these individuals, temporal lobectomy offers the greatest likelihood for seizure-freedom (up to 80-90%); unfortunately, this procedure remains largely underutilized. Moreover, for select patients unable to tolerate open surgery, novel techniques are emerging for selective ablation of the mesial temporal structures, including stereotactic radiosurgery (SRS). We present here a review of SRS as a potential therapy for MTLE, when open surgery is not an option.

  2. Activations in temporal areas using visual and auditory naming stimuli: A language fMRI study in temporal lobe epilepsy.

    Science.gov (United States)

    Gonzálvez, Gloria G; Trimmel, Karin; Haag, Anja; van Graan, Louis A; Koepp, Matthias J; Thompson, Pamela J; Duncan, John S

    2016-12-01

    Verbal fluency functional MRI (fMRI) is used for predicting language deficits after anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE), but primarily engages frontal lobe areas. In this observational study we investigated fMRI paradigms using visual and auditory stimuli, which predominately involve language areas resected during ATLR. Twenty-three controls and 33 patients (20 left (LTLE), 13 right (RTLE)) were assessed using three fMRI paradigms: verbal fluency, auditory naming with a contrast of auditory reversed speech; picture naming with a contrast of scrambled pictures and blurred faces. Group analysis showed bilateral temporal activations for auditory naming and picture naming. Correcting for auditory and visual input (by subtracting activations resulting from auditory reversed speech and blurred pictures/scrambled faces respectively) resulted in left-lateralised activations for patients and controls, which was more pronounced for LTLE compared to RTLE patients. Individual subject activations at a threshold of T>2.5, extent >10 voxels, showed that verbal fluency activated predominantly the left inferior frontal gyrus (IFG) in 90% of LTLE, 92% of RTLE, and 65% of controls, compared to right IFG activations in only 15% of LTLE and RTLE and 26% of controls. Middle temporal (MTG) or superior temporal gyrus (STG) activations were seen on the left in 30% of LTLE, 23% of RTLE, and 52% of controls, and on the right in 15% of LTLE, 15% of RTLE, and 35% of controls. Auditory naming activated temporal areas more frequently than did verbal fluency (LTLE: 93%/73%; RTLE: 92%/58%; controls: 82%/70% (left/right)). Controlling for auditory input resulted in predominantly left-sided temporal activations. Picture naming resulted in temporal lobe activations less frequently than did auditory naming (LTLE 65%/55%; RTLE 53%/46%; controls 52%/35% (left/right)). Controlling for visual input had left-lateralising effects. Auditory and picture naming activated

  3. Carbamazepine reduces memory induced activation of mesial temporal lobe structures: a pharmacological fMRI-study

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    Okujava Michael

    2001-11-01

    Full Text Available Abstract Background and Purpose It is not known whether carbamazepine (CBZ; a drug widely used in neurology and psychiatry influences the blood oxygenation level dependent (BOLD contrast changes induced by neuronal activation and measured by functional MRI (fMRI. We aimed to investigate the influence of CBZ on memory induced activation of the mesial temporal lobes in patients with symptomatic temporal lobe epilepsy (TLE. Material and Methods Twenty-one individual patients with refractory symptomatic TLE with different CBZ serum levels and 20 healthy controls were studied using BOLD fMRI. Mesial temporal lobe (MTL activation was induced by a task that is based on the retrieval of individually familiar visuo-spatial knowledge. The extent of significant MTL fMRI activation was measured and correlated with the CBZ serum level. Results In TLE patients, the extent of significant fMRI activation over both MTL was negatively correlated to the CBZ serum level (Spearman r = -0.654, P Conclusions In TLE patients, carbamazepine reduces the fMRI-detectable changes within the mesial temporal lobes as induced by effortful memory retrieval. FMRI appears to be suitable to study the effects of chronic drug treatment in patients with epilepsy.

  4. Improved proper name recall in aging after electrical stimulation of the anterior temporal lobes

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    Lars A Ross

    2011-10-01

    Full Text Available Evidence from neuroimaging and neuropsychology suggests that portions of the anterior temporal lobes play a critical role in proper name retrieval. We previously found that anodal transcranial direct current stimulation (tDCS to the anterior temporal lobes improved retrieval of proper names in young adult. Here we extend that finding to older adults who tend to experience greater proper-naming deficits than young adults. The task was to look at pictures of famous faces or landmarks and verbally recall the associated proper name. Our results show a numerical improvement in face naming after left or right anterior temporal lobe stimulation, but a statistically significant effect only after left-lateralized stimulation. The magnitude of the enhancing effect was similar in older and younger adults but the lateralization of the effect differed depending on age. These results provide evidence that tDCS may be a useful tool for the neurorehabilitation of cognitive function in healthy and pathological cognitive decline.

  5. Temporal-lobe morphology differs between healthy adolescents and those with early-onset of depression

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    Mahdi Ramezani

    2014-01-01

    Full Text Available Major depressive disorder (MDD has previously been linked to structural changes in several brain regions, particularly in the medial temporal lobes (Bellani, Baiano, Brambilla, 2010; Bellani, Baiano, Brambilla, 2011. This has been determined using voxel-based morphometry, segmentation algorithms, and analysis of shape deformations (Bell-McGinty et al., 2002; Bergouignan et al., 2009; Posener et al., 2003; Vasic et al., 2008; Zhao et al., 2008: these are methods in which information related to the shape and the pose (the size, and anatomical position and orientation of structures is lost. Here, we incorporate information about shape and pose to measure structural deformation in adolescents and young adults with and without depression (as measured using the Beck Depression Inventory and Diagnostic and Statistical Manual of Mental Disorders criteria. As a hypothesis-generating study, a significance level of p < 0.05, uncorrected for multiple comparisons, was used, so that subtle morphological differences in brain structures between adolescent depressed individuals and control participants could be identified. We focus on changes in cortical and subcortical temporal structures, and use a multi-object statistical pose and shape model to analyze imaging data from 16 females (aged 16–21 and 3 males (aged 18 with early-onset MDD, and 25 female and 1 male normal control participants, drawn from the same age range. The hippocampus, parahippocampal gyrus, putamen, and superior, inferior and middle temporal gyri in both hemispheres of the brain were automatically segmented using the LONI Probabilistic Brain Atlas (Shattuck et al., 2008 in MNI space. Points on the surface of each structure in the atlas were extracted and warped to each participant's structural MRI. These surface points were analyzed to extract the pose and shape features. Pose differences were detected between the two groups, particularly in the left and right putamina, right hippocampus

  6. Hippocampal Atrophy Is Associated with Altered Hippocampus-Posterior Cingulate Cortex Connectivity in Mesial Temporal Lobe Epilepsy with Hippocampal Sclerosis.

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    Shih, Y C; Tseng, C E; Lin, F-H; Liou, H H; Tseng, W Y I

    2017-03-01

    Unilateral mesial temporal lobe epilepsy and hippocampal sclerosis have structural and functional abnormalities in the mesial temporal regions. To gain insight into the pathophysiology of the epileptic network in mesial temporal lobe epilepsy with hippocampal sclerosis, we aimed to clarify the relationships between hippocampal atrophy and the altered connection between the hippocampus and the posterior cingulate cortex in patients with mesial temporal lobe epilepsy with hippocampal sclerosis. Fifteen patients with left mesial temporal lobe epilepsy with hippocampal sclerosis and 15 healthy controls were included in the study. Multicontrast MR imaging, including high-resolution T1WI, diffusion spectrum imaging, and resting-state fMRI, was performed to measure the hippocampal volume, structural connectivity of the inferior cingulum bundle, and intrinsic functional connectivity between the hippocampus and the posterior cingulate cortex, respectively. Compared with controls, patients had decreased left hippocampal volume (volume ratio of the hippocampus and controls, 0.366% ± 0.029%; patients, 0.277% ± 0.063%, corrected P = .002), structural connectivity of the bilateral inferior cingulum bundle (generalized fractional anisotropy, left: controls, 0.234 ± 0.020; patients, 0.193 ± 0.022, corrected P = .0001, right: controls, 0.226 ± 0.022; patients, 0.208 ± 0.017, corrected P = .047), and intrinsic functional connectivity between the left hippocampus and the left posterior cingulate cortex (averaged z-value: controls, 0.314 ± 0.152; patients, 0.166 ± 0.062). The left hippocampal volume correlated with structural connectivity positively (standardized β = 0.864, P = .001), but it had little correlation with intrinsic functional connectivity (standardized β = -0.329, P = .113). On the contralesional side, the hippocampal volume did not show any significant correlation with structural connectivity or intrinsic functional connectivity ( F 2,12 = 0.284, P = .757, R 2

  7. Temporal lobe epilepsy: Comparison of CT and MR in 100 patients

    International Nuclear Information System (INIS)

    Schoerner, W.; Meencke, H.J.; Sander, B.; Henkes, H.; Felix, R.; Klinikum Rudolf Virchow, Berlin

    1989-01-01

    The value of CT and MR was studied in 100 patients with temporal lobe epilepsy. Axial CT scans were obtained before and after contrast injection. Coronary MR scans were carried out with T 1 -(SE 400/30, GE 315/14) and T 2 -weighted sequences (SE 1600/30 + 70). A circumscribed lesion was demonstrated in fifteen patients by CT and in 25 patients by MR. With the exception of a small area of calcification, all lesions seen on CT could also be recognized on MR. Better sensitivity and improved demonstration of the temporal lobes makes MR the method of choice in the diagnosis of temporal lobe epilepsy. (orig./GDG) [de

  8. Verbal memory after temporal lobe epilepsy surgery in children: Do only mesial structures matter?

    Science.gov (United States)

    Law, Nicole; Benifla, Mony; Rutka, James; Smith, Mary Lou

    2017-02-01

    Previous findings have been mixed regarding verbal memory outcome after left temporal lobectomy in children, and there are few studies comparing verbal memory change after lateral versus mesial temporal lobe resections. We compared verbal memory outcome associated with sparing or including the mesial structures in children who underwent left or right temporal lobe resection. We also investigated predictors of postsurgical verbal memory change. We retrospectively assessed verbal memory change approximately 1 year after unilateral temporal lobe epilepsy surgery using a list learning task. Participants included 23 children who underwent temporal lobe surgery with sparing of the mesial structures (13 left), and 40 children who had a temporal lobectomy that included resection of mesial structures (22 left). Children who underwent resection from the left lateral and mesial temporal lobe were the only group to show decline in verbal memory. Furthermore, when we considered language representation in the left temporal resection group, patients with left language representation and spared mesial structures showed essentially no change in verbal memory from preoperative to follow-up, whereas those with left language representation and excised mesial structures showed a decline. Postoperative seizure status had no effect on verbal memory change in children after left temporal lobe surgery. Finally, we found that patients with intact preoperative verbal memory experienced a significant decline compared to those with below average preoperative verbal memory. Our findings provide evidence of significant risk factors for verbal memory decline in children, specific to left mesial temporal lobe epilepsy. Children who undergo left temporal lobe surgery that includes mesial structures may be most vulnerable for verbal memory decline, especially when language representation is localized to the left hemisphere and when preoperative verbal memory is intact. Wiley Periodicals, Inc.

  9. Differential DNA methylation profiles of coding and non-coding genes define hippocampal sclerosis in human temporal lobe epilepsy

    Science.gov (United States)

    Miller-Delaney, Suzanne F.C.; Bryan, Kenneth; Das, Sudipto; McKiernan, Ross C.; Bray, Isabella M.; Reynolds, James P.; Gwinn, Ryder; Stallings, Raymond L.

    2015-01-01

    Temporal lobe epilepsy is associated with large-scale, wide-ranging changes in gene expression in the hippocampus. Epigenetic changes to DNA are attractive mechanisms to explain the sustained hyperexcitability of chronic epilepsy. Here, through methylation analysis of all annotated C-phosphate-G islands and promoter regions in the human genome, we report a pilot study of the methylation profiles of temporal lobe epilepsy with or without hippocampal sclerosis. Furthermore, by comparative analysis of expression and promoter methylation, we identify methylation sensitive non-coding RNA in human temporal lobe epilepsy. A total of 146 protein-coding genes exhibited altered DNA methylation in temporal lobe epilepsy hippocampus (n = 9) when compared to control (n = 5), with 81.5% of the promoters of these genes displaying hypermethylation. Unique methylation profiles were evident in temporal lobe epilepsy with or without hippocampal sclerosis, in addition to a common methylation profile regardless of pathology grade. Gene ontology terms associated with development, neuron remodelling and neuron maturation were over-represented in the methylation profile of Watson Grade 1 samples (mild hippocampal sclerosis). In addition to genes associated with neuronal, neurotransmitter/synaptic transmission and cell death functions, differential hypermethylation of genes associated with transcriptional regulation was evident in temporal lobe epilepsy, but overall few genes previously associated with epilepsy were among the differentially methylated. Finally, a panel of 13, methylation-sensitive microRNA were identified in temporal lobe epilepsy including MIR27A, miR-193a-5p (MIR193A) and miR-876-3p (MIR876), and the differential methylation of long non-coding RNA documented for the first time. The present study therefore reports select, genome-wide DNA methylation changes in human temporal lobe epilepsy that may contribute to the molecular architecture of the epileptic brain. PMID

  10. Neuropsychological results after gamma knife radiosurgery for mesial temporal lobe epilepsy.

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    Vojtěch, Zdeněk; Krámská, Lenka; Malíková, Hana; Stará, Michaela; Liščák, Roman

    2015-01-01

    The aim of this study is to summarize our experience with neuropsychological changes after radiosurgical treatment for mesial temporal lobe epilepsy and subsequent surgery due to insufficient seizure control. Between November 1995 and May 1999, 14 patients underwent radiosurgical entorhinoamygdalohippocampectomy with a marginal dose of 18, 20 or 25 Gy to the 50% isodose. 9 of these patients subsequently underwent surgery. We compared Memory Quotients and Intelligence Quotients before and after the interventions. We found a slight, but nonsignificant decline in intelligence and memory quotients one year after GKRS. Two years after radiosurgery there were no significant changes in any of the quotients. After surgery, we found significant increase in Global and Visual MQ, (pmemory and intelligence performance after surgery. Epilepsy surgery after unsuccessful radiosurgery could lead to improvements in cognitive functions in patients with mesial temporal lobe epilepsy.

  11. Familial temporal lobe epilepsy due to focal cortical dysplasia type IIIa.

    Science.gov (United States)

    Fabera, Petr; Krijtova, Hana; Tomasek, Martin; Krysl, David; Zamecnik, Josef; Mohapl, Milan; Jiruska, Premysl; Marusic, Petr

    2015-09-01

    Focal cortical dysplasia (FCD) represents a common cause of refractory epilepsy. It is considered a sporadic disorder, but its occasional familial occurrence suggests the involvement of genetic mechanisms. Siblings with intractable epilepsy were referred for epilepsy surgery evaluation. Both patients were examined using video-EEG monitoring, MRI examination and PET imaging. They underwent left anteromedial temporal lobe resection. Electroclinical features pointed to left temporal lobe epilepsy and MRI examination revealed typical signs of left-sided hippocampal sclerosis and increased white matter signal intensity in the left temporal pole. PET examination confirmed interictal hypometabolism in the left temporal lobe. Histopathological examination of resected tissue demonstrated the presence FCD type IIIa, i.e. hippocampal sclerosis and focal cortical dysplasia in the left temporal pole. We present a unique case of refractory mesial temporal lobe epilepsy in siblings, characterized by an identical clinical profile and histopathology of FCD type IIIa, who were successfully treated by epilepsy surgery. The presence of such a high concordance between the clinical and morphological data, together with the occurrence of epilepsy and febrile seizures in three generations of the family pedigree points towards a possible genetic nature of the observed FCD type IIIa. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  12. Preoperative visual field deficits in temporal lobe epilepsy

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    Sanjeet S. Grewal

    2017-01-01

    Full Text Available Surgical resection and laser thermoablation have been used to treat drug resistant epilepsy with good results. However, they are not without risk. One of the most commonly reported complications of temporal lobe surgery is contralateral superior homonymous quadrantanopsia. We describe a patient with asymptomatic preoperative quadrantanopsia fortuitously discovered as part of our recently modified protocol to evaluate patients prior to temporal lobe epilepsy surgery. This visual field deficit was subtle and not detected on routine clinical neurological examination. While we understand that this is a single case, we advocate further study for more detailed preoperative visual field examinations to characterize the true incidence of postoperative visual field lesions.

  13. Anterior Temporal Lobe Morphometry Predicts Categorization Ability

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    Béatrice Garcin

    2018-02-01

    Full Text Available Categorization is the mental operation by which the brain classifies objects and events. It is classically assessed using semantic and non-semantic matching or sorting tasks. These tasks show a high variability in performance across healthy controls and the cerebral bases supporting this variability remain unknown. In this study we performed a voxel-based morphometry study to explore the relationships between semantic and shape categorization tasks and brain morphometric differences in 50 controls. We found significant correlation between categorization performance and the volume of the gray matter in the right anterior middle and inferior temporal gyri. Semantic categorization tasks were associated with more rostral temporal regions than shape categorization tasks. A significant relationship was also shown between white matter volume in the right temporal lobe and performance in the semantic tasks. Tractography revealed that this white matter region involved several projection and association fibers, including the arcuate fasciculus, inferior fronto-occipital fasciculus, uncinate fasciculus, and inferior longitudinal fasciculus. These results suggest that categorization abilities are supported by the anterior portion of the right temporal lobe and its interaction with other areas.

  14. Cognitive changes in people with temporal lobe epilepsy over a 13-year period.

    Science.gov (United States)

    Mameniškienė, Rūta; Rimšienė, Justė; Puronaitė, Roma

    2016-10-01

    The aims of our study were to evaluate cognitive decline in people with temporal lobe epilepsy over a period of 13years and to determine what clinical and treatment characteristics may have been associated with these. Thirty-three individuals with temporal lobe epilepsy underwent the same neuropsychological assessment of verbal and nonverbal memory, attention, and executive functions using the same cognitive test battery as one used 13years ago. Long-term verbal and nonverbal memory was tested four weeks later. Results were compared with those carried out 13years earlier. There was no significant change in verbal and verbal-logical memory tests; however, nonverbal memory worsened significantly. Long-term verbal memory declined for 21.9% of participants, long-term verbal-logical memory for 34.4%, and long-term nonverbal memory for 56.3%. Worsening of working verbal and verbal-logical memory was associated with longer epilepsy duration and lower levels of patients' education; worsening of verbal delayed recall and long-term verbal-logical memory was associated with higher seizure frequency. Decline in long-term nonverbal memory had significant association with a longer duration of epilepsy. The worsening of reaction and attention inversely correlated with the symptoms of depression. Over a 13-year period, cognitive functions did not change significantly. Good seizure control and reduced symptoms of depression in this sample of people with temporal lobe epilepsy were associated with better cognitive functioning. The predictors of change of cognitive functions could be complex and require further study. Copyright © 2016 Elsevier Inc. All rights reserved.

  15. Physical activity level and medial temporal health in youth at ultra high-risk for psychosis.

    Science.gov (United States)

    Mittal, Vijay A; Gupta, Tina; Orr, Joseph M; Pelletier-Baldelli, Andrea; Dean, Derek J; Lunsford-Avery, Jessica R; Smith, Ashley K; Robustelli, Briana L; Leopold, Daniel R; Millman, Zachary B

    2013-11-01

    A growing body of evidence suggests that moderate to vigorous activity levels can affect quality of life, cognition, and brain structure in patients diagnosed with schizophrenia. However, physical activity has not been systematically studied during the period immediately preceding the onset of psychosis. Given reports of exercise-based neurogenesis in schizophrenia, understanding naturalistic physical activity levels in the prodrome may provide valuable information for early intervention efforts. The present study examined 29 ultra high-risk (UHR) and 27 matched controls to determine relationships between physical activity level, brain structure (hippocampus and parahippocampal gyrus), and symptoms. Participants were assessed with actigraphy for a 5-day period, MRI, and structured clinical interviews. UHR participants showed a greater percentage of time in sedentary behavior while healthy controls spent more time engaged in light to vigorous activity. There was a strong trend to suggest the UHR group showed less total physical activity. The UHR group exhibited smaller medial temporal volumes when compared with healthy controls. Total level of physical activity in the UHR group was moderately correlated with parahippocampal gyri bilaterally (right: r = .44, left: r = .55) and with occupational functioning (r = -.36; of negative symptom domain), but not positive symptomatology. Results suggest that inactivity is associated with medial temporal lobe health. Future studies are needed to determine if symptoms are driving inactivity, which in turn may be affecting the health of the parahippocampal structure and progression of illness. Although causality cannot be determined from the present design, these findings hold important implications for etiological conceptions and suggest promise for an experimental trial. PsycINFO Database Record (c) 2013 APA, all rights reserved.

  16. Accelerated long-term forgetting in temporal lobe epilepsy: evidence of improvement after left temporal pole lobectomy.

    Science.gov (United States)

    Gallassi, Roberto; Sambati, Luisa; Poda, Roberto; Stanzani Maserati, Michelangelo; Oppi, Federico; Giulioni, Marco; Tinuper, Paolo

    2011-12-01

    Accelerated long term forgetting (ALF) is a characteristic cognitive aspect in patients affected by temporal lobe epilepsy that is probably due to an impairment of memory consolidation and retrieval caused by epileptic activity in hippocampal and parahippocampal regions. We describe a case of a patient with TLE who showed improvement in ALF and in remote memory impairment after an anterior left temporal pole lobectomy including the uncus and amygdala. Our findings confirm that impairment of hippocampal functioning leads to pathological ALF, whereas restoration of hippocampal functioning brings ALF to a level comparable to that of controls. Copyright © 2011 Elsevier Inc. All rights reserved.

  17. Temporal lobe dysfunction in childhood autism: a PET study

    International Nuclear Information System (INIS)

    Boddaert, N.; Poline, J.B.; Brunelle, F.; Zilbovicius, M.; Boddaert, N.; Brunelle, F.; Chabane, N.; Barthelemy, C.; Zilbovicius, M.; Bourgeois, M.; Samson, Y.

    2002-01-01

    Childhood autism is a severe developmental disorder that impairs the acquisition of some of the most important skills in human life. Progress in understanding the neural basis of childhood autism requires clear and reliable data indicating specific neuro-anatomical or neuro-physiological abnormalities. The purpose of the present study was to research localized brain dysfunction in autistic children using functional brain imaging. Regional cerebral blood flow (rCBF) was measured with positron emission tomography (PET) in 21 primary autistic children and 10 age-matched non autistic children. A statistical parametric analysis of rCBF images revealed significant bilateral temporal hypoperfusion in the associative auditory cortex (superior temporal gyrus) and in the multimodal cortex (superior temporal sulcus) in the autistic group (p<0.001). In addition, temporal hypoperfusion was detected individually in 77% of autistic children. These findings provide robust evidence of well localized functional abnormalities in autistic children located in the superior temporal lobe. Such localized abnormalities were not detected with the low resolution PET camera (14-22). This study suggests that high resolution PET camera combined with statistical parametric mapping is useful to understand developmental disorders. (authors)

  18. MR imaging in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Fobben, E.S.; Zimmerman, R.A.; Sperling, M.R.; Kohn, M.I.; Atlas, S.W.; Hackney, D.B.; Goldberg, H.I.; Bilaniuk, L.T.; Grossman, R.I.

    1988-01-01

    MR imaging examinations of 31 patients undergoing temporal lobe resection for refractory partial epilepsy were reviewed retrospectively for the presence of signal abnormalities as well as atrophy. High-signal abnormalities were present in only two of the described 31 patients (6.5%). Pathologically, these represented mesial temporal sclerosis and a hamartoma. Of the remaining 29 cases, 13 showed pathologically varying degrees of mesial temporal sclerosis and gliosis and 16 were pathologically normal. Atrophy, as determined by gross asymmetry, sulcal and temporal horn enlargement, and computer volume measurements, was observed in 23 of 31 patients, correlating with the clinically affected side in 20 and the contralateral side in three. In this series, in contrast to others reported, focal MR signal abnormalities were not detected in the vast majority of patients with mesial temporal sclerosis

  19. Visual rating of medial temporal lobe metabolism in mild cognitive impairment and Alzheimer's disease using FDG-PET

    Energy Technology Data Exchange (ETDEWEB)

    Mosconi, Lisa [New York University School of Medicine, Department of Psychiatry, New York, NY (United States); University of Florence, Department of Clinical Pathophysiology, Nuclear Medicine Unit, Florence (Italy); New York University School of Medicine, Center for Brain Health, New York, NY (United States); Santi, Susan De; Li, Yi; Li, Juan; Zhan, Jiong; Boppana, Madhu [New York University School of Medicine, Department of Psychiatry, New York, NY (United States); Tsui, Wai Hon; Leon, Mony J. de [New York University School of Medicine, Department of Psychiatry, New York, NY (United States); Nathan Kline Institute, Orangeburg, NY (United States); Pupi, Alberto [University of Florence, Department of Clinical Pathophysiology, Nuclear Medicine Unit, Florence (Italy)

    2006-02-01

    This study was designed to examine the utility of visual inspection of medial temporal lobe (MTL) metabolism in the diagnosis of mild cognitive impairment (MCI) and Alzheimer's disease (AD) using FDG-PET scans. Seventy-five subjects [27 normal controls (NL), 26 MCI, and 22 AD] with FDG-PET and MRI scans were included in this study. We developed a four-point visual rating scale to evaluate the presence and severity of MTL hypometabolism on FDG-PET scans. The visual MTL ratings were compared with quantitative glucose metabolic rate (MR{sub glc}) data extracted using regions of interest (ROIs) from the MRI-coregistered PET scans of all subjects. A standard rating evaluation of neocortical hypometabolism was also completed. Logistic regressions were used to determine and compare the diagnostic accuracy of the MTL and cortical ratings. For both MTL and cortical ratings, high intra- and inter-rater reliabilities were found (p values <0.001). The MTL rating was highly correlated with and yielded a diagnostic accuracy equivalent to the ROI MR{sub glc} measures (p values <0.001). The combination of MTL and cortical ratings significantly improved the diagnostic accuracy over the cortical rating alone, with 100% of AD, 77% of MCI, and 85% of NL cases being correctly identified. This study shows that the visual rating of MTL hypometabolism on PET is reliable, yields a diagnostic accuracy equal to the quantitative ROI measures, and is clinically useful and more sensitive than cortical ratings for patients with MCI. We suggest this method be further evaluated for its potential in the early diagnosis of AD. (orig.)

  20. Medial Temporal Lobe Damage Causes Deficits in Episodic Memory and Episodic Future Thinking Not Attributable to Deficits in Narrative Construction

    Science.gov (United States)

    Race, Elizabeth; Keane, Margaret M.; Verfaellie, Mieke

    2015-01-01

    The medial temporal lobe (MTL) makes critical contributions to episodic memory, but its contributions to episodic future thinking remain a matter of debate. By one view, imagining future events relies on MTL mechanisms that also support memory for past events. Alternatively, it has recently been suggested that future thinking is independent of MTL-mediated processes and can be supported by regions outside the MTL. The current study investigated the nature and necessity of MTL involvement in imagining the future and tested the novel hypothesis that the MTL contributes to future thinking by supporting online binding processes related to narrative construction. Human amnesic patients with well-characterized MTL damage and healthy controls constructed narratives about (a) future events, (b) past events, and (c) visually-presented pictures. While all three tasks place similar demands on narrative construction, only the past and future conditions require memory/future thinking to mentally generate relevant narrative information. Patients produced impoverished descriptions of both past and future events but were unimpaired at producing detailed picture narratives. In addition, future-thinking performance positively correlated with episodic memory performance but did not correlate with picture narrative performance. Finally, future-thinking impairments were present when MTL lesions were restricted to the hippocampus and did not depend on the presence of neural damage outside the MTL. These results indicate that the ability to generate and maintain a detailed narrative is preserved in amnesia and suggest that a common MTL mechanism supports both episodic memory and episodic future thinking. PMID:21753003

  1. Interictal rCBF SPECT, MRI and Surgical Outcome of Intractable Temporal Lobe Epilepsy

    International Nuclear Information System (INIS)

    Zeon, Seok Kil; Joo, Yang Goo; Lee, Sang Doe; Son, Eun Ik; Lee, Young Hwan

    1994-01-01

    Interictal single photon emission computed tomography of regional cerebral blood flow (rCBF SPECT) in 18 intractable temporal lobe epilepsy patients (8 male and 10 female patients: average 23.5 years old) were compared with 2.0 T magnetic resonance imaging (MRI). And surgical outcome was analysed with the findings, symptom duration and lateralization of temporal lobe. Preoperatively rCRF SPECT was done in all 18 patients with intravenous injection of 740 MRq 99 m T c-HMPAO. MRI was also done preoperatively in 13 patients. Surgical outcome was classified by Engel's outcome classification (four part classification recommended at the first Palm Desert conference). rCRF SPECT detected correctly lateralising abnormality of temporal lobe hypoperfusion in 13/ 18 (72.2%), contralateral temporal lobe hypoperfusion in 2/18 (11.1%) and showed no definite abnormality in 3/18 (16.7%). The positive predictive value of unilateral temporal lobe hypoperfusion was 87%. MRI detected correct localising abnormality in 8/13 (61.5%), such as hippocampal atrophy (7/13), asymmetric temporal horn (6/13), anterior temporal lobe atrophy (1/13), increased signal intensity from hippocampus (1/13) and calcific density (1/13), and no abnormal finding was noted in 5/13 (38.5%), There was no false positive findings and the positive predictive value of MRI was 100%, Only 2 cases showed same lateralization findings in rCBF SPECT and MRI. There was no significant correlation between symptom duration and no abnormal findings on SPECT or MRI. Surgical outcome showed class I in 15/18 (83.3%), and class II in 2/18 (11.1%). One case of no abnormal finding in both SPECT and MRI showed class III surgical outcome. No class IV surgical out.come was noted. Surgical outcome, lateralization of epileptic focus in temporal lobe and abnormal findings in rCBR SPECT or MRI were not significantly correlated.

  2. Determinants of brain metabolism changes in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Chassoux, Francine; Artiges, Eric; Semah, Franck; Desarnaud, Serge; Laurent, Agathe; Landre, Elisabeth; Gervais, Philippe; Devaux, Bertrand; Helal, Ourkia Badia

    2016-06-01

    To determine the main factors influencing metabolic changes in mesial temporal lobe epilepsy (MTLE) due to hippocampal sclerosis (HS). We prospectively studied 114 patients with MTLE (62 female; 60 left HS; 15- to 56-year-olds) with (18) F-fluorodeoxyglucose-positron emission tomography and correlated the results with the side of HS, structural atrophy, electroclinical features, gender, age at onset, epilepsy duration, and seizure frequency. Imaging processing was performed using statistical parametric mapping. Ipsilateral hypometabolism involved temporal (mesial structures, pole, and lateral cortex) and extratemporal areas including the insula, frontal lobe, perisylvian regions, and thalamus, more extensively in right HS (RHS). A relative increase of metabolism (hypermetabolism) was found in the nonepileptic temporal lobe and in posterior areas bilaterally. Voxel-based morphometry detected unilateral hippocampus atrophy and gray matter concentration decrease in both frontal lobes, more extensively in left HS (LHS). Regardless of the structural alterations, the topography of hypometabolism correlated strongly with the extent of epileptic networks (mesial, anterior-mesiolateral, widespread mesiolateral, and bitemporal according to the ictal spread), which were larger in RHS. Notably, widespread perisylvian and bitemporal hypometabolism was found only in RHS. Mirror hypermetabolism was grossly proportional to the hypometabolic areas, coinciding partly with the default mode network. Gender-related effect was significant mainly in the contralateral frontal lobe, in which metabolism was higher in female patients. Epilepsy duration correlated with the contralateral temporal metabolism, positively in LHS and negatively in RHS. Opposite results were found with age at onset. High seizure frequency correlated negatively with the contralateral metabolism in LHS. Epileptic networks, as assessed by electroclinical correlations, appear to be the main determinant of

  3. Temporal lobe epilepsy: analysis of patients with dual pathology.

    Science.gov (United States)

    Salanova, V; Markand, O; Worth, R

    2004-02-01

    To determine the frequency and types of dual pathology in patients with temporal lobe epilepsy (TLE) and to analyze the clinical manifestations and surgical outcome. A total of 240 patients with TLE underwent temporal resections following a comprehensive pre-surgical evaluation. Thirty-seven (15.4%) of these had hippocampal sclerosis (HS) or temporal lobe gliosis in association with another lesion (dual pathology). Eighteen of 37 patients with dual pathology had heterotopia of the temporal lobe, nine had cortical dysplasia, four had cavernous angiomas or arteriovenous malformations, one had a dysembryoplastic neuroepithelial tumor, one had a contusion and four patients had cerebral infarctions in childhood. 68.5% had abnormal head magnetic resonance imagings, 91.3% had abnormal positron emission tomography scans, and 96% had abnormal ictal SPECT. The intracarotid amobarbital procedure (IAP) showed impaired memory of the epileptogenic side in 72% of the patients. Twenty patients had left and 17 had right-sided en bloc temporal resections, including the lesion and mesial temporal structures. Twenty-six (70.2%) became seizure-free, eight (21.6%) had rare seizures, two (5.4%) had worthwhile seizure reduction and one (2.7%) had no improvement (range of follow-up 1-16 years, mean = 7.4 years). 15.4% had dual pathology. The dual pathology was almost exclusively seen in patients whose lesions were congenital, or occurred early in life, suggesting that the hippocampus is more vulnerable and more readily develops HS in early childhood. Resections, including the lateral and mesial temporal structures led to a favorable outcome with no mortality and little morbidity.

  4. Navigation-assisted trans-inferotemporal cortex selective amygdalohippocampectomy for mesial temporal lobe epilepsy; preserving the temporal stem.

    Science.gov (United States)

    Kishima, Haruhiko; Kato, Amami; Oshino, Satoru; Tani, Naoki; Maruo, Tomoyuki; Khoo, Hui Ming; Yanagisawa, Takufumi; Edakawa, Kotaro; Kobayashi, Maki; Tanaka, Masataka; Hosomi, Koichi; Hirata, Masayuki; Yoshimine, Toshiki

    2017-03-01

    Selective amygdalohippocampectomy (SAH) can be used to obtain satisfactory seizure control in patients with mesial temporal lobe epilepsy (MTLE). Several SAH procedures have been reported to achieve satisfactory outcomes for seizure control, but none yield fully satisfactory outcomes for memory function. We hypothesized that preserving the temporal stem might play an important role. To preserve the temporal stem, we developed a minimally invasive surgical procedure, 'neuronavigation-assisted trans-inferotemporal cortex SAH' (TITC-SAH). TITC-SAH was performed in 23 patients with MTLE (MTLE on the language-non-dominant hemisphere, n = 11). The inferior horn of the lateral ventricle was approached via the inferior or middle temporal gyrus along the inferior temporal sulcus under neuronavigation guidance. The hippocampus was dissected in a subpial manner and resected en bloc together with the parahippocampal gyrus. Seizure control at one year and memory function at 6 months postoperatively were evaluated. One year after TITC-SAH, 20 of the 23 patients were seizure-free (ILAE class 1), 2 were class 2, and 1 was class 3. Verbal memory improved significantly in 13 patients with a diagnosis of hippocampal sclerosis, for whom WMS-R scores were available both pre- and post-operatively. Improvements were seen regardless of whether the SAH was on the language-dominant or non-dominant hemisphere. No major complication was observed. Navigation-assisted TITC-SAH performed for MTLE offers a simple, minimally invasive procedure that appears to yield excellent outcomes in terms of seizure control and preservation of memory function, because this procedure does not damage the temporal stem. TITC-SAH should be one of the feasible surgical procedures for MTLE. SAH: Amygdalohippocampectomy; MTLE: Mesial temporal lobe epilepsy (MTLE); TITC-SAH: Ttrans-inferotemporal cortex SAH; ILAE: International League Against Epilepsy (ILAE); MRI: Magnetic resonance imaging; EEG

  5. Evaluation of Posterior Hippocampal Epileptogenicity During Epilepsy Surgery For Temporal Lobe Cavernoma by the Occipital Approach.

    Science.gov (United States)

    Akiyama, Yukinori; Suzuki, Kengo; Ochi, Satoko; Miyamoto, Susumu; Mikuni, Nobuhiro

    2015-11-01

    Cavernomas frequently are associated with intractable epilepsy. When cavernomas located in the temporal lobe are associated with intractable epilepsy, the hippocampus also may have an epileptic focus. The objective in the present study was to clarify the importance of evaluation of the posterior hippocampal epileptogenicity during epilepsy surgery for posteromedial temporal lobe cavernoma. In this study, we describe 2 rare cases of medically intractable epilepsy in patients with posteromedial temporal lobe cavernomas who underwent surgery via the occipital approach. Using longitudinal insertion of depth electrodes into the hippocampus, we evaluated epileptogenicity in both patients from the cavernoma cavity and its surrounding hemosiderin, as well as from the posterior hippocampus near the cavernoma. We show that the transoccipital approach to the posteromedial temporal lobe is compatible with depth electrode insertion and subdural electrode placement on the temporal lobe, enabling an accurate evaluation of potential epileptogenic zones in the posterior part of the hippocampus. Both patients did not experience any seizures and had no postoperative neurologic deficits, and their cognitive functions were intact. The transoccipital approach enables the optimization of the extent of posterior hippocampectomy while avoiding unnecessary resection for seizure control. We suggest resecting the posterior part of the hippocampus in addition to the cavernoma and surrounding areas in patients with medically refractory epilepsy due to a posteromedial temporal cavernoma. Tailored systematic resection guided by intraoperative electrocorticography and electroencephalography with a depth electrode was important and necessary in the present cases. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Autobiographical memory of the recent past following frontal cortex or temporal lobe excisions.

    Science.gov (United States)

    Thaiss, Laila; Petrides, Michael

    2008-08-01

    Previous research has raised questions regarding the necessity of the frontal cortex in autobiographical memory and the role that it plays in actively retrieving contextual information associated with personally relevant events. Autobiographical memory was studied in patients with unilateral excisions restricted to the frontal cortex or temporal lobe involving the amygdalo-hippocampal region and in normal controls using an event-sampling method. We examined accuracy of free recall, use of strategies during retrieval and memory for specific aspects of the autobiographical events, including temporal order. Patients with temporal lobe excisions were impaired in autobiographical recall. By contrast, patients with frontal cortical excisions exhibited normal autobiographical recall but were less likely to use temporal order spontaneously to organize event retrieval. Instruction to organize retrieval by temporal order failed to improve recall in temporal lobe patients and increased the incidence of plausible intrusion errors in left temporal patients. In contrast, patients with frontal cortical excisions now surpassed control subjects in recall of autobiographical events. Furthermore, the retrieval accuracy for the temporal order of diary events was not impaired in these patients. In a subsequent cued recall test, temporal lobe patients were impaired in their memory for the details of the diary events and their context. In conclusion, a basic impairment in autobiographical memory (including memory for temporal context) results from damage to the temporal lobe and not the frontal cortex. Patients with frontal excisions fail to use organizational strategies spontaneously to aid retrieval but can use these effectively if instructed to do so.

  7. Upper motor neuron predominant degeneration with frontal and temporal lobe atrophy.

    Science.gov (United States)

    Konagaya, M; Sakai, M; Matsuoka, Y; Konagaya, Y; Hashizume, Y

    1998-11-01

    The autopsy findings of a 78-year-old man mimicking primary lateral sclerosis (PLS) are reported. He showed slowly progressive spasticity, pseudobulbar palsy and character change, and died 32 months after the onset of symptoms. Autopsy revealed severe atrophy of the frontal and temporal lobes, remarkable neuronal loss and gliosis in the precentral gyrus, left temporal lobe pole and amygdala, mild degeneration of the Ammon's horn, degeneration of the corticospinal tract, and very mild involvement of the lower motor neurons. The anterior horn cells only occasionally demonstrated Bunina body by cystatin-C staining, and skein-like inclusions by ubiquitin staining. This is a peculiar case with concomitant involvement in the motor cortex and temporal lobe in motor neuron disease predominantly affecting the upper motor neuron.

  8. Late bilateral temporal lobe necrosis after conventional radiotherapy. Case report

    Energy Technology Data Exchange (ETDEWEB)

    Hoshi, Michio; Hayashi, Toshiyuki; Kagami, Hiroshi; Murase, Ikurou; Nakatsukasa, Masashi [Saiseikai Utsunomiya Hospital (Japan)

    2003-04-01

    A 63-year-old woman presented with radionecrosis in the bilateral temporal lobes manifesting as dementia about 30 years after undergoing conventional radiotherapy for pituitary adenoma. Computed tomography and magnetic resonance (MR) imaging showed edema and cystic lesions in both temporal lobes. The mass in the left temporal lobe was excised. MR imaging 12 days after surgery showed reduced edema. Her dementia had improved. Radionecrosis usually occurs between several months and a few years after radiotherapy. The incidence of radionecrosis is estimated as 5%, but may be higher with longer follow-up periods. Clinical reports have suggested that larger total doses of radiation are associated with earlier onset of delayed necrosis and the fractional dose is the most significant factor causing cerebral radionecrosis. Radionecrosis can occur long after conventional radiotherapy or stereotactic radiosurgery using a linac-based system or a gamma knife unit. (author)

  9. Atypical language representation in children with intractable temporal lobe epilepsy.

    Science.gov (United States)

    Maulisova, Alice; Korman, Brandon; Rey, Gustavo; Bernal, Byron; Duchowny, Michael; Niederlova, Marketa; Krsek, Pavel; Novak, Vilem

    2016-05-01

    This study evaluated language organization in children with intractable epilepsy caused by temporal lobe focal cortical dysplasia (FCD) alone or dual pathology (temporal lobe FCD and hippocampal sclerosis, HS). We analyzed clinical, neurological, fMRI, neuropsychological, and histopathologic data in 46 pediatric patients with temporal lobe lesions who underwent excisional epilepsy surgery. The frequency of atypical language representation was similar in both groups, but children with dual pathology were more likely to be left-handed. Atypical receptive language cortex correlated with lower intellectual capacity, verbal abstract conceptualization, receptive language abilities, verbal working memory, and a history of status epilepticus but did not correlate with higher seizure frequency or early seizure onset. Histopathologic substrate had only a minor influence on neuropsychological status. Greater verbal comprehension deficits were noted in children with atypical receptive language representation, a risk factor for cognitive morbidity. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Gene expression profile in temporal lobe epilepsy

    NARCIS (Netherlands)

    Aronica, Eleonora; Gorter, Jan A.

    2007-01-01

    Epilepsy is one of the most common neurological disorders. Temporal lobe epilepsy (TLE) represents the most frequent epilepsy syndrome in adult patients with resistance to pharmacological treatment. In TLE, the origin of seizure activity typically involves the hippocampal formation, which displays

  11. Gene expression profile in temporal lobe epilepsy.

    NARCIS (Netherlands)

    Aronica, E.M.A.; Gorter, J.A.

    2007-01-01

    Epilepsy is one of the most common neurological disorders. Temporal lobe epilepsy (TLE) represents the most frequent epilepsy syndrome in adult patients with resistance to pharmacological treatment. In TLE, the origin of seizure activity typically involves the hippocampal formation, which displays

  12. Processamento auditivo em indivíduos com epilepsia de lobo temporal Auditory processing in patients with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Juliana Meneguello

    2006-08-01

    Full Text Available A epilepsia do lobo temporal ocasiona descargas elétricas excessivas onde a via auditiva tem sua estação final. É uma das formas mais comuns e de mais difícil controle da doença. O correto processamento dos estímulos auditivos necessita da integridade anatômica e funcional de todas as estruturas envolvidas na via auditiva. OBJETIVO: Verificar o Processamento Auditivo de pacientes portadores de epilepsia do lobo temporal quanto aos mecanismos de discriminação de sons em seqüência e de padrões tonais, discriminação da direção da fonte sonora e atenção seletiva para sons verbais e não-verbais. MÉTODO: Foram avaliados oito indivíduos com epilepsia do lobo temporal confirmada e com foco restrito a essa região, através dos testes auditivos especiais: Teste de Localização Sonora, Teste de Padrão de Duração, Teste Dicótico de Dígitos e Teste Dicótico Não-Verbal. O seu desempenho foi comparado ao de indivíduos sem alteração neurológica (estudo caso-controle. RESULTADO: Os sujeitos com epilepsia do lobo temporal apresentaram desempenho semelhante aos do grupo controle quanto ao mecanismo de discriminação da direção da fonte sonora e desempenho inferior quanto aos demais mecanismos avaliados. CONCLUSÃO: Indivíduos com epilepsia do lobo temporal apresentaram maior prejuízo no processamento auditivo que os sem danos corticais, de idades semelhantes.Temporal epilepsy, one of the most common presentation of this pathology, causes excessive electrical discharges in the area where we have the final station of the auditory pathway. Both the anatomical and functional integrity of the auditory pathway structures are essential for the correct processing of auditory stimuli. AIM: to check the Auditory Processing in patients with temporal lobe epilepsy regarding the auditory mechanisms of discrimination from sequential sounds and tone patterns, discrimination of the sound source direction and selective attention to verbal

  13. Practical use of visual medial temporal lobe atrophy cut-off scores in Alzheimer's disease: Validation in a large memory clinic population

    Energy Technology Data Exchange (ETDEWEB)

    Claus, Jules J.; Holl, Dana C.; Roorda, Jelmen J. [Tergooi Hospital, Department of Neurology, Blaricum (Netherlands); Staekenborg, Salka S. [Tergooi Hospital, Department of Neurology, Blaricum (Netherlands); VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam (Netherlands); Schuur, Jacqueline [Tergooi Hospital, Department of Geriatrics, Blaricum (Netherlands); Koster, Pieter [Tergooi Hospital, Department of Radiology, Blaricum (Netherlands); Tielkes, Caroline E.M. [Tergooi Hospital, Department of Medical Psychology, Blaricum (Netherlands); Scheltens, Philip [VU University Medical Center, Department of Neurology, Alzheimer Center, Amsterdam (Netherlands)

    2017-08-15

    To provide age-specific medial temporal lobe atrophy (MTA) cut-off scores for routine clinical practice as marker for Alzheimer's disease (AD). Patients with AD (n = 832, mean age 81.8 years) were compared with patients with subjective cognitive impairment (n = 333, mean age 71.8 years) in a large single-centre memory clinic. Mean of right and left MTA scores was determined with visual rating (Scheltens scale) using CT (0, no atrophy to 4, severe atrophy). Relationships between age and MTA scores were analysed with regression analysis. For various MTA cut-off scores, decade-specific sensitivity and specificity and area under the curve (AUC) values, computed with receiver operator characteristic curves, were determined. MTA strongly increased with age in both groups to a similar degree. Optimal MTA cut-off values for the age ranges <65, 65-74, 75-84 and ≥85 were: ≥1.0, ≥1.5, ≥ 2.0 and ≥2.0. Corresponding values of sensitivity and specificity were 83.3% and 86.4%; 73.7% and 84.6%; 73.7% and 76.2%; and 84.0% and 62.5%. From this large unique memory clinic cohort we suggest decade-specific MTA cut-off scores for clinical use. After age 85 years, however, the practical usefulness of the MTA cut-off is limited. (orig.)

  14. Wisconsin Card Sorting Test performance and impulsivity in patients with temporal lobe epilepsy: suicidal risk and suicide attempts.

    Science.gov (United States)

    Garcia Espinosa, Arlety; Andrade Machado, René; Borges González, Susana; García González, María Eugenia; Pérez Montoto, Ariadna; Toledo Sotomayor, Guillermo

    2010-01-01

    The goal of the study described here was to determine if executive dysfunction and impulsivity are related to risk for suicide and suicide attempts in patients with temporal lobe epilepsy. Forty-two patients with temporal lobe epilepsy were recruited. A detailed medical history, neurological examination, serial EEGs, Mini-International Neuropsychiatric Interview, executive function, and MRI were assessed. Multiple regression analysis was carried out to examine predictive associations between clinical variables and Wisconsin Card Sorting Test measures. Patients' scores on the Risk for Suicide Scale (n=24) were greater than 7, which means they had the highest relative risk for suicide attempts. Family history of psychiatric disease, current major depressive episode, left temporal lobe epilepsy, and perseverative responses and total errors on the Wisconsin Card Sorting Test increased by 6.3 and 7.5 suicide risk and suicide attempts, respectively. Executive dysfunction (specifically perseverative responses and more total errors) contributed greatly to suicide risk. Executive performance has a major impact on suicide risk and suicide attempts in patients with temporal lobe epilepsy. 2009 Elsevier Inc. All rights reserved.

  15. T2 hyperintense signal in patients with temporal lobe epilepsy with MRI signs of hippocampal sclerosis and in patients with temporal lobe epilepsy with normal MRI.

    Science.gov (United States)

    Kubota, Bruno Yukio; Coan, Ana Carolina; Yasuda, Clarissa Lin; Cendes, Fernando

    2015-05-01

    Increased MRI T2 signal is commonly present not only in the hippocampus but also in other temporal structures of patients with temporal lobe epilepsy (TLE), and it is associated with histological abnormalities related to the epileptogenic lesion. This study aimed to verify the distribution of T2 increased signal in temporal lobe structures and its correlations with clinical characteristics of TLE patients with (TLE-HS) or without (TLE-NL) MRI signs of hippocampal sclerosis. We selected 203 consecutive patients: 124 with TLE-HS and 79 with TLE-NL. Healthy controls (N=59) were used as a comparison group/comparative group. T2 multiecho images obtained via a 3-T MRI were evaluated with in-house software. T2 signal decays were computed from five original echoes in regions of interest in the hippocampus, amygdala, and white matter of the anterior temporal lobe. Values higher than 2 standard deviations from the mean of controls were considered as abnormal. T2 signal increase was observed in the hippocampus in 78% of patients with TLE-HS and in 17% of patients with TLE-NL; in the amygdala in 13% of patients with TLE-HS and in 14% of patients with TLE-NL; and in the temporal lobe white matter in 22% of patients with TLE-HS and in 8% of patients with TLE-NL. Group analysis demonstrated a significant difference in the distribution of the T2 relaxation times of the hippocampus (ANOVA, ptemporal lobe white matter (ptemporal lobe white matter (ANOVA, p=0.025) for patients with TLE-NL compared with controls. The average signal from the hippocampus ipsilateral to the epileptogenic zone was significantly higher in patients with no family history of epilepsy (two-sample T-test, p=0.005). Increased T2 signal occurs in different temporal structures of patients with TLE-HS and in patients with TLE-NL. The hippocampal hyperintense signal is more pronounced in patients without family history of epilepsy and is influenced by earlier seizure onset. These changes in T2 signal may be

  16. Mesial temporal lobe epilepsy - An overview of surgical techniques.

    Science.gov (United States)

    Muzumdar, Dattatraya; Patil, Manoj; Goel, Atul; Ravat, Sangeeta; Sawant, Nina; Shah, Urvashi

    2016-12-01

    Mesial temporal lobe epilepsy is one of the commonest indications for epilepsy surgery. Presurgical evaluation for drug resistant epilepsy and identification of appropriate candidates for surgery is essential for optimal seizure freedom. The anatomy of mesial temporal lobe is complex and needs to be understood in the context of the advanced imaging, ictal and interictal Video_EEG monitoring, neuropsychology and psychiatric considerations. The completeness of disconnection of epileptogenic neural networks is paramount and is correlated with the extent of resection of the mesial temporal structures. In the Indian subcontinent, a standard but extended anterior temporal lobectomy is a viable option in view of the diverse socioeconomic, cultural and pathological considerations. The maximum utilization of epilepsy surgery services in this region is also a challenge. There is a need for regional comprehensive epilepsy care teams in a tertiary care academic hospital to form centers of excellence catering to a large population. Copyright © 2016 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.

  17. Interictal brain SPECT in patients with medically refractory temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Andraus, Maria Emilia Cosenza

    2000-06-01

    The brain single photon emission computed tomography (SPECT) is s functional neuroimaging method that can detect localized changes in cerebral blood flow. The temporal lobe epilepsy (TLE) is the most common epileptic syndrome in adults, and more than 50% are medically refractory. The SPECT can contribute to investigation of epileptogenic focus and is one of the methods of pre-surgical evaluation of these patients. (author)

  18. Fluoxetine Restores Spatial Learning but Not Accelerated Forgetting in Mesial Temporal Lobe Epilepsy

    Science.gov (United States)

    Barkas, Lisa; Redhead, Edward; Taylor, Matthew; Shtaya, Anan; Hamilton, Derek A.; Gray, William P.

    2012-01-01

    Learning and memory dysfunction is the most common neuropsychological effect of mesial temporal lobe epilepsy, and because the underlying neurobiology is poorly understood, there are no pharmacological strategies to help restore memory function in these patients. We have demonstrated impairments in the acquisition of an allocentric spatial task,…

  19. Decreased astroglial monocarboxylate transporter 4 expression in temporal lobe epilepsy.

    Science.gov (United States)

    Liu, Bei; Niu, Le; Shen, Ming-Zhi; Gao, Lei; Wang, Chao; Li, Jie; Song, Li-Jia; Tao, Ye; Meng, Qiang; Yang, Qian-Li; Gao, Guo-Dong; Zhang, Hua

    2014-10-01

    Efflux of monocaroxylates like lactate, pyruvate, and ketone bodies from astrocytes through monocarboxylate transporter 4 (MCT4) supplies the local neuron population with metabolic intermediates to meet energy requirements under conditions of increased demand. Disruption of this astroglial-neuron metabolic coupling pathway may contribute to epileptogenesis. We measured MCT4 expression in temporal lobe epileptic foci excised from patients with intractable epilepsy and in rats injected with pilocarpine, an animal model of temporal lobe epilepsy (TLE). Cortical MCT4 expression levels were significantly lower in TLE patients compared with controls, due at least partially to MCT4 promoter methylation. Expression of MCT4 also decreased progressively in pilocarpine-treated rats from 12 h to 14 days post-administration. Underexpression of MCT4 in cultured astrocytes induced by a short hairpin RNA promoted apoptosis. Knockdown of astrocyte MCT4 also suppressed excitatory amino acid transporter 1 (EAAT1) expression. Reduced MCT4 and EAAT1 expression by astrocytes may lead to neuronal hyperexcitability and epileptogenesis in the temporal lobe by reducing the supply of metabolic intermediates and by allowing accumulation of extracellular glutamate.

  20. Subtle pathological changes in neocortical temporal lobe epilepsy.

    Science.gov (United States)

    Ochoa, Juan G; Hentgarden, Diana; Paulzak, Audrey; Ogden, Melissa; Pryson, Richard; Lamle, Markus; Rusyniak, Walter G

    2017-06-01

    This was a prospective observational study to correlate the clinical symptoms, electrophysiology, imaging, and surgical pathology of patients with temporal lobe epilepsy (TLE) without hippocampal sclerosis. We selected consecutive patients with TLE and normal MRI undergoing temporal lobe resection between April and September 2015. Clinical features, imaging, and functional data were reviewed. Intracranial monitoring and language mapping were performed when it was required according to our team recommendation. Prior to hippocampal resection, intraoperative electrocorticography was performed using depth electrodes in the amygdala and the hippocampus. The resected hippocampus was sent for pathological analysis. Five patients with diagnosis with non-lesional TLE were included. We did not find distinctive clinical features that could be a characteristic of non-lesional TLE. The mean follow-up was 13.2months (11-15months); 80% of patients achieved Engel Class I outcome. There was no distinctive electrographic findings in these patients. Histopathologic analysis was negative for mesial temporal sclerosis. A second blinded independent neuropathologist with expertise in epilepsy found ILAE type I focal cortical dysplasia in the parahippocampal gyrus in all patients. A third independent neuropathologist reported changes in layer 2 with larger pyramidal neurons in 4 cases but concluded that none of these cases met the diagnostic criteria of FCD. Subtle pathological changes could be associated with a parahippocampal epileptic zone and should be investigated in patients with MRI-negative TLE. This study also highlights the lack of interobserver reliability for the diagnosis of mild cortical dysplasia. Finally, selective amygdalo-hippocampectomy or laser ablation of the hippocampus may not control intractable epilepsy in this specific population. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. Peri-ictal water drinking: a rare automatic behaviour in temporal lobe epilepsy.

    Science.gov (United States)

    Pietrafusa, Nicola; Trivisano, Marina; de Palma, Luca; Serino, Domenico; Moavero, Romina; Benvenga, Antonella; Cappelletti, Simona; Boero, Giovanni; Vigevano, Federico; La Neve, Angela; Specchio, Nicola

    2015-12-01

    Peri-ictal water drinking (PIWD) has been reported as the action of drinking during or within two minutes of an electroclinical seizure. It is considered a peri-ictal vegetative symptom, evident both during childhood and adulthood epilepsy. The aim of this paper was to describe the clinical and electroencephalographic features of two new adult subjects suffering from symptomatic temporal lobe epilepsy with episodes of PIWD recorded by VIDEO-EEG and to review literature data in order to better define this peculiar event during seizures, a rare and probably underestimated semiological sign. To date, 51 cases with focal epilepsy and seizures associated with PIWD have been reported. All patients presented with temporal lobe epilepsy. All cases but one had symptomatic epilepsy. Most of the patients had an involvement of the right hemisphere. Water drinking was reported as an ictal sign in the majority of patients, and less frequently was reported as postictal. We believe that PIWD might be considered a rare automatic behaviour, like other automatisms. Automatisms are more frequently described in patients with temporal lobe epilepsy. PIWD was reported also to have lateralizing significance in the non-dominant temporal lobe, however, because of its rarity, this finding remains unclear.

  2. The inferior, anterior temporal lobes and semantic memory clarified: novel evidence from distortion-corrected fMRI.

    Science.gov (United States)

    Visser, M; Embleton, K V; Jefferies, E; Parker, G J; Ralph, M A Lambon

    2010-05-01

    The neural basis of semantic memory generates considerable debate. Semantic dementia results from bilateral anterior temporal lobe (ATL) atrophy and gives rise to a highly specific impairment of semantic memory, suggesting that this region is a critical neural substrate for semantic processing. Recent rTMS experiments with neurologically-intact participants also indicate that the ATL are a necessary substrate for semantic memory. Exactly which regions within the ATL are important for semantic memory are difficult to detect from these methods (because the damage in SD covers a large part of the ATL). Functional neuroimaging might provide important clues about which specific areas exhibit activation that correlates with normal semantic performance. Neuroimaging studies, however, have not consistently found anterior temporal lobe activation in semantic tasks. A recent meta-analysis indicates that this inconsistency may be due to a collection of technical limitations associated with previous studies, including a reduced field-of-view and magnetic susceptibility artefacts associated with standard gradient echo fMRI. We conducted an fMRI study of semantic memory using a combination of techniques which improve sensitivity to ATL activations whilst preserving whole-brain coverage. As expected from SD patients and ATL rTMS experiments, this method revealed bilateral temporal activation extending from the inferior temporal lobe along the fusiform gyrus to the anterior temporal regions, bilaterally. We suggest that the inferior, anterior temporal lobe region makes a crucial contribution to semantic cognition and utilising this version of fMRI will enable further research on the semantic role of the ATL. 2010 Elsevier Ltd. All rights reserved.

  3. Sex differences in verbal and nonverbal learning before and after temporal lobe epilepsy surgery.

    Science.gov (United States)

    Berger, Justus; Oltmanns, Frank; Holtkamp, Martin; Bengner, Thomas

    2017-01-01

    Women outperform men in a host of episodic memory tasks, yet the neuroanatomical basis for this effect is unclear. It has been suggested that the anterior temporal lobe might be especially relevant for sex differences in memory. In the current study, we investigated whether temporal lobe epilepsy (TLE) has an influence on sex effects in learning and memory and whether women and men with TLE differ in their risk for memory deficits after epilepsy surgery. 177 patients (53 women and 41 men with left TLE, 42 women and 41 men with right TLE) were neuropsychologically tested before and one year after temporal lobe resection. We found that women with TLE had better verbal, but not figural, memory than men with TLE. The female advantage in verbal memory was not affected by temporal lobe resection. The same pattern of results was found in a more homogeneous subsample of 84 patients with only hippocampal sclerosis who were seizure-free after surgery. Our findings challenge the concept that the anterior temporal lobe plays a central role in the verbal memory advantage for women. Copyright © 2016 Elsevier Inc. All rights reserved.

  4. Evaluation of ictal brain SPET using statistical parametric mapping in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Lee, J.D.; Kim, H.-J.; Jeon, T.J.; Kim, M.J. [Div. of Nuclear Medicine, Yonsei University Medical College, Seoul (Korea); Lee, B.I.; Kim, O.J. [Dept. of Neurology, Yonsei University Medical College, Seoul (Korea)

    2000-11-01

    An automated voxel-based analysis of brain images using statistical parametric mapping (SPM) is accepted as a standard approach in the analysis of activation studies in positron emission tomography and functional magnetic resonance imaging. This study aimed to investigate whether or not SPM would increase the diagnostic yield of ictal brain single-photon emission tomography (SPET) in temporal lobe epilepsy (TLE). Twenty-one patients (age 27.14{+-}5.79 years) with temporal lobe epilepsy (right in 8, left in 13) who had a successful seizure outcome after surgery and nine normal subjects were included in the study. The data of ictal and interictal brain SPET of the patients and baseline SPET of the normal control group were analysed using SPM96 software. The t statistic SPM(t) was transformed to SPM(Z) with various thresholds of P<0.05, 0.005 and 0.001, and corrected extent threshold P value of 0.05. The SPM data were compared with the conventional ictal and interictal subtraction method. On group comparison, ictal SPET showed increased uptake within the epileptogenic mesial temporal lobe. On single case analysis, ictal SPET images correctly lateralized the epileptogenic temporal lobe in 18 cases, falsely lateralized it in one and failed to lateralize it in two as compared with the mean image of the normal group at a significance level of P<0.05. Comparing the individual ictal images with the corresponding interictal group, 15 patients were correctly lateralized, one was falsely lateralized and four were not lateralized. At significance levels of P<0.005 and P<0.001, correct lateralization of the epileptogenic temporal lobe was achieved in 15 and 13 patients, respectively, as compared with the normal group. On the other hand, when comparison was made with the corresponding interictal group, only 7 out of 21 patients were correctly lateralized at the threshold of P<0.005 and five at P<0.001. The result of the subtraction method was close to the single case analysis on

  5. Evaluation of ictal brain SPET using statistical parametric mapping in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Lee, J.D.; Kim, H.-J.; Jeon, T.J.; Kim, M.J.; Lee, B.I.; Kim, O.J.

    2000-01-01

    An automated voxel-based analysis of brain images using statistical parametric mapping (SPM) is accepted as a standard approach in the analysis of activation studies in positron emission tomography and functional magnetic resonance imaging. This study aimed to investigate whether or not SPM would increase the diagnostic yield of ictal brain single-photon emission tomography (SPET) in temporal lobe epilepsy (TLE). Twenty-one patients (age 27.14±5.79 years) with temporal lobe epilepsy (right in 8, left in 13) who had a successful seizure outcome after surgery and nine normal subjects were included in the study. The data of ictal and interictal brain SPET of the patients and baseline SPET of the normal control group were analysed using SPM96 software. The t statistic SPM(t) was transformed to SPM(Z) with various thresholds of P<0.05, 0.005 and 0.001, and corrected extent threshold P value of 0.05. The SPM data were compared with the conventional ictal and interictal subtraction method. On group comparison, ictal SPET showed increased uptake within the epileptogenic mesial temporal lobe. On single case analysis, ictal SPET images correctly lateralized the epileptogenic temporal lobe in 18 cases, falsely lateralized it in one and failed to lateralize it in two as compared with the mean image of the normal group at a significance level of P<0.05. Comparing the individual ictal images with the corresponding interictal group, 15 patients were correctly lateralized, one was falsely lateralized and four were not lateralized. At significance levels of P<0.005 and P<0.001, correct lateralization of the epileptogenic temporal lobe was achieved in 15 and 13 patients, respectively, as compared with the normal group. On the other hand, when comparison was made with the corresponding interictal group, only 7 out of 21 patients were correctly lateralized at the threshold of P<0.005 and five at P<0.001. The result of the subtraction method was close to the single case analysis on

  6. MRI lesion and epileptogenic focus in temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Matsuda, Kazumi; Yagi, Kazuichi; Mihara, Tadahiro; Tottori, Takayasu; Watanabe, Yutaka; Seino, Masakazu

    1989-01-01

    The spatial relationship between a circumscribed lesion in the temporal lobe detected by MRI and an epileptogenic focus identified by ictal depth EEG along with a correlation of the MRI lesion with neuropathological findings were investigated in patients with medically intractable temporal lobe epilepsy but without any focal lesion on CT. Four parameters (an areal ratio of the temporal lobe against the hemisphere, area and calculated T1, T2 values of the hippocampus) were used to determine the abnormal MRI side. An agreement was reached in 67-72% of 18 patients between the abnormal values of the hippocampal area and of calculated T1, T2 and the side of the epileptogenic focus. In 14 of 17 patients, typical hippocampal sclerosis was demonstrated in resected tissue in accordance with the MRI lesions (atrophy and/or prolonged T2 of hippocampus). These results imply: 1)MRI abnormality thus defined may, if not all, indicate the side of the epileptogenic focus, and 2)also the presence of hippocampal sclerosis. It was emphasized that the MRI lesion would be a usable instrument to explore the causal relationship of hippocampal sclerosis to a generation of epileptogenic lesions as well as for presurgical evalution. (author)

  7. Middle fossa arachnoid cyst with temporal lobe agenesis accompanying isodense subdural hematoma -a case report-

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Kyung Soo; Choi, Hyung Sik; Kim, Myung Joon; Yang, Seoung Oh; Kim, Chang Jin [Capital Armed Forces General Hospital, Seongnam (Korea, Republic of)

    1987-12-15

    Cysts overlying the temporal lobes have been well described in literature. These are often associated with agenesis of the temporal lobes, and of major neurosurgical interest due to their frequent association with subdural hematoma, a combination that is rarely seen with cysts in other regions. Full features of plain, angiographic, and CT findings of arachnoid cyst with temporal lobe agenesis accompanying isodense subdural hematoma are presented, being very rare in radiologic literature.

  8. Interictal mood and personality disorders in temporal lobe epilepsy and juvenile myoclonic epilepsy.

    Science.gov (United States)

    Perini, G I; Tosin, C; Carraro, C; Bernasconi, G; Canevini, M P; Canger, R; Pellegrini, A; Testa, G

    1996-01-01

    BACKGROUND: Mood disorders have been described as the commonest psychiatric disorders in patients with temporal lobe epilepsy. Secondary depression in temporal lobe epilepsy could be interpreted either as an adjustment reaction to a chronic disease or as a limbic dysfunction. To clarify this issue, a controlled study of psychiatric disorders was conducted in different forms of epileptic and non-epileptic chronic conditions. METHODS: Twenty outpatients with temporal lobe epilepsy, 18 outpatients with juvenile myoclonic epilepsy--a primary generalised seizure disorder--20 matched type I diabetic patients, and 20 matched normal controls were assessed by a structured interview (SADS) and by self rating scales (Beck depression inventory (BDI) and the state and trait anxiety scales STAIX1 and STAIX2). RESULTS: Sixteen (80%) patients with temporal lobe epilepsy fulfilled the criteria for a psychiatric diagnosis at the SADS interview with a significantly higher frequency than patients with juvenile myoclonic epilepsy (22%) and diabetic patients (10%) (P personality or anxiety disorder. Patients with temporal lobe epilepsy scored significantly higher on BDI, STAIX1, and STAIX2 than the three control groups (P personality disorders, often in comorbidity, than patients with juvenile myoclonic epilepsy and diabetic patients suggesting that these psychiatric disorders are not an adjustment reaction to a chronic disease but rather reflect a limbic dysfunction. PMID:8971108

  9. Low pre-existing gray matter volume in the medial temporal lobe and white matter lesions are associated with postoperative cognitive dysfunction after cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Kengo Maekawa

    Full Text Available OBJECTIVES: Postoperative cognitive dysfunction (POCD is recognized as a complication in the elderly after cardiac surgery. Imaging of the brain provides evidence of neurodegeneration in elderly patients; however, abnormalities in brain structure and their relation to POCD are uncertain. This pilot study investigated whether loss of gray matter in the bilateral medial temporal lobe (MTL, seen in preoperative MRI, was associated with POCD. METHODS: Data were collected prospectively on 28 elderly patients scheduled for elective cardiac surgery. MRI of the brains of all patients were assessed for prior cerebral infarctions, and carotid and intracranial arterial stenosis. Patients also completed six neuropsychological tests of memory, attention and executive function before and after surgery. POCD was defined as an individual decrease in more than two tests of at least 1 standard deviation from the group baseline mean for that test. The degree of gray matter loss in the MTL of each patient was calculated using voxel-based morphometry with three-dimensional, T1-weighted MRI. This represented the degree of gray matter change as a Z score. RESULTS: Postoperative cognitive dysfunction was identified in 8 of the 28 patients (29%. Patients with POCD had significantly more white matter lesions on MRI, and greater loss of gray matter in the bilateral MTL (average Z score 2.0±0.9 than patients without POCD. An analysis by stepwise logistic regression identified gray matter loss in the MTL and cerebral infarctions on MRI as independent predictors of POCD. CONCLUSIONS: These preliminary findings suggested that reduced gray matter in the bilateral MTL and white matter lesions existed in brains of elderly cardiac surgery patients who experienced POCD. Additional studies with larger sample sizes are needed to confirm these findings.

  10. Cognitive impairment and medial temporal lobe structure in young adults with a depressive episode.

    Science.gov (United States)

    Donix, Markus; Haussmann, Robert; Helling, Franziska; Zweiniger, Anne; Lange, Jan; Werner, Annett; Donix, Katharina L; Brandt, Moritz D; Linn, Jennifer; Bauer, Michael; Buthut, Maria

    2018-09-01

    Cognitive deficits are common in patients with a depressive episode although the predictors for their development and severity remain elusive. We investigated whether subjective and objective cognitive impairment in young depressed adults would be associated with cortical thinning in medial temporal subregions. High-resolution magnetic resonance imaging, cortical unfolding data analysis, and comprehensive assessments of subjective and objective cognitive abilities were performed on 27 young patients with a depressive episode (mean age: 29.0 ± 5.8 years) and 23 older participants without a history of a depressive disorder but amnestic mild cognitive impairment (68.5 ± 6.6 years) or normal cognition (65.2 ± 8.7 years). Thickness reductions in parahippocampal, perirhinal and fusiform cortices were associated with subjective memory deficits only among young patients with a depressive episode and a measurable cognitive impairment. Long-term longitudinal data would be desirable to determine the trajectories of cognitive impairment associated with depression in patients with or without cortical structure changes. The presence of clinically significant cognitive deficits in young people with a depressive episode may identify a patient population with extrahippocampal cortical thinning. Copyright © 2018 Elsevier B.V. All rights reserved.

  11. Dose–Volume Relationships Associated With Temporal Lobe Radiation Necrosis After Skull Base Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    McDonald, Mark W., E-mail: markmcdonaldmd@gmail.com [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Indiana University Health Proton Therapy Center, Bloomington, Indiana (United States); Linton, Okechukwu R. [Department of Radiation Oncology, Indiana University School of Medicine, Indianapolis, Indiana (United States); Calley, Cynthia S.J. [Department of Biostatistics, Indiana University School of Medicine, Indianapolis, Indiana (United States)

    2015-02-01

    Purpose: We evaluated patient and treatment parameters correlated with development of temporal lobe radiation necrosis. Methods and Materials: This was a retrospective analysis of a cohort of 66 patients treated for skull base chordoma, chondrosarcoma, adenoid cystic carcinoma, or sinonasal malignancies between 2005 and 2012, who had at least 6 months of clinical and radiographic follow-up. The median radiation dose was 75.6 Gy (relative biological effectiveness [RBE]). Analyzed factors included gender, age, hypertension, diabetes, smoking status, use of chemotherapy, and the absolute dose:volume data for both the right and left temporal lobes, considered separately. A generalized estimating equation (GEE) regression analysis evaluated potential predictors of radiation necrosis, and the median effective concentration (EC50) model estimated dose–volume parameters associated with radiation necrosis. Results: Median follow-up time was 31 months (range 6-96 months) and was 34 months in patients who were alive. The Kaplan-Meier estimate of overall survival at 3 years was 84.9%. The 3-year estimate of any grade temporal lobe radiation necrosis was 12.4%, and for grade 2 or higher radiation necrosis was 5.7%. On multivariate GEE, only dose–volume relationships were associated with the risk of radiation necrosis. In the EC50 model, all dose levels from 10 to 70 Gy (RBE) were highly correlated with radiation necrosis, with a 15% 3-year risk of any-grade temporal lobe radiation necrosis when the absolute volume of a temporal lobe receiving 60 Gy (RBE) (aV60) exceeded 5.5 cm{sup 3}, or aV70 > 1.7 cm{sup 3}. Conclusions: Dose–volume parameters are highly correlated with the risk of developing temporal lobe radiation necrosis. In this study the risk of radiation necrosis increased sharply when the temporal lobe aV60 exceeded 5.5 cm{sup 3} or aV70 > 1.7 cm{sup 3}. Treatment planning goals should include constraints on the volume of temporal lobes receiving

  12. Cognitive and functional correlates of accelerated long-term forgetting in temporal lobe epilepsy.

    Science.gov (United States)

    Audrain, Samantha; McAndrews, Mary P

    2018-03-30

    While we know that hippocampal dysfunction is responsible for the memory deficits that patients with temporal lobe epilepsy exhibit at relatively short study-test delays, the role of this region in accelerated long-term forgetting (ALF) is not yet clear. In the present study, we probed the role of the hippocampus in ALF by directly comparing memory for associations to memory that could be supported by item recognition during a forced choice recognition task over delays ranging from 15-min to 72-h. We additionally examined resting-state functional connectivity between the hippocampus and cortical regions known to be involved in processing these types of stimuli, as well as the relationship between ALF and various clinical variables including structural abnormality in the hippocampus, lateralization of epileptic focus, presence of seizures across the retention period, and standardized composite memory scores. We found evidence of accelerated forgetting for item stimuli (but not associative stimuli) by 6 h post-learning, which became statistically reliable by 72-h. This finding suggests that unlike controls, patients were unable to utilize novelty to reject the incorrect object-scene pair. While none of the examined clinical variables were related to long-term forgetting, reduced resting-state functional connectivity between the affected anterior hippocampus and unaffected lateral temporal cortex predicted forgetting of item stimuli over the 72-h delay. Implications for the role of the hippocampus in accelerated long-term forgetting, and existing theories of systems consolidation in this context are discussed. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  13. Quantification of mu and non-mu opiate receptors in temporal lobe epilepsy using positron emission tomography.

    Science.gov (United States)

    Mayberg, H S; Sadzot, B; Meltzer, C C; Fisher, R S; Lesser, R P; Dannals, R F; Lever, J R; Wilson, A A; Ravert, H T; Wagner, H N

    1991-07-01

    Alterations in a variety of neurotransmitter systems have been identified in experimental models of epilepsy and in brain tissue from patients with intractable temporal lobe seizures. The availability of new high-affinity radioligands permits the study of some neuroreceptors in vivo with positron emission tomography (PET). We previously characterized the in vivo binding of 11C-carfentanil, a potent and selective mu opiate receptor agonist, and described increases in 11C-carfentanil binding in the temporal neocortex of patients with unilateral temporal lobe epilepsy. These studies have been extended to 11C-diprenorphine, which labels mu, kappa, and delta opiate receptor subtypes. Paired measurements of opiate receptor binding were performed with PET using 11C-carfentanil and 11C-diprenorphine in patients with unilateral temporal lobe seizures. Carfentanil binding, reflecting changes in mu opiate receptors, was increased in the temporal neocortex and decreased in the amygdala on the side of the epileptic focus. Diprenorphine binding, reflecting mu as well as non-mu opiate subtypes, was not significantly different among regions in the focus and nonfocus temporal lobes. Regional glucose metabolism, measured using 18F-2-fluoro-2-deoxyglucose, was decreased in the mesial and lateral aspects of the temporal lobe ipsilateral to the epileptogenic focus. The variation in pattern of carfentanil and diprenorphine binding supports a differential regulation of opiate subtypes in unilateral temporal lobe epilepsy.

  14. Unique and shared areas of cognitive function in children with intractable frontal or temporal lobe epilepsy.

    Science.gov (United States)

    Law, Nicole; Widjaja, Elysa; Smith, Mary Lou

    2018-03-01

    Previous findings have been mixed in terms of identifying a distinct pattern of neuropsychological deficits in children with frontal lobe epilepsy (FLE) and in those with temporal lobe epilepsy (TLE). The current study investigated the neuropsychological similarities and differences across these two pediatric medically intractable localization-related epilepsies. Thirty-eight children with FLE, 20 children with TLE, and 40 healthy children (HC) participated in this study. A comprehensive battery of standardized tests assessed five neuropsychological domains including intelligence, language, memory, executive function, and motor function. A principal component analysis (PCA) was used to distill our neuropsychological measures into latent components to compare between groups. Principal component analysis extracted 5 latent components: executive function (F1), verbal semantics (F2), motor (F3), nonverbal cognition/impulsivity (F4), and verbal cognition/attention (F5). The group with FLE differed from the HC group on F1, F2, F4, and F5, and had worse performance than the group with TLE on F1; the group with TLE had lower performance relative to the HC group on F2. Our findings suggest that, in comparison with neurotypically developing children, children with medically intractable FLE have more widespread neuropsychological impairments than do children with TLE. The differences between the two patient groups were greatest for the factor score most clearly related to executive function. The results provide mixed support for the concept of specificity in neuropsychological dysfunction among different subtypes of localization-related medically intractable childhood epilepsies. Copyright © 2018 Elsevier Inc. All rights reserved.

  15. Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

    Energy Technology Data Exchange (ETDEWEB)

    Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio [Fukushima Medical Coll. (Japan)

    1998-02-01

    In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, pfunction. (author)

  16. Comparison of IMP-SPECT findings to subtest scores of Wechsler intelligence adult Scale-Revised in temporal lobe epilepsy patients

    International Nuclear Information System (INIS)

    Kan, Rumiko; Uejima, Masahiko; Kaneko, Yuko; Miyamoto, Yuriko; Watabe, Manabu; Takahashi, Ruriko; Niwa, Shin-ichi; Shishido, Fumio

    1998-01-01

    In this study, 40 temporal lobe epilepsy patients were assessed, using the Laterality Index (LI) of ROI values in IMP-SPECT findings, Wechsler adult intelligence Scale-Revised (WAIS-R) and subtest scores. LIs of the frontal, temporal and occipital lobes were calculated as follows: the ROI values on the right side were subtracted from those on the left, and the results was divided by the sum of the ROI values on the right and left sides. The individual subtest scores on WAIS-R were standardized by all evaluation scores in order to exclude the influence of differences in intelligence level as much as possible. The results were as follows: there was a positive correlation (r=0.74, p<0.001) between LI values and the performance in Arithmetic in the left temporal lobe hypoperfusion group. And there was a positive correlation (r=0.50, p<0.02) between LI values and the performance in Vocabulary in the left temporal lobe hypoperfusion group. In the right occipital lobe hypoperfusion group, there was a negative correlation (r=-O.44, p< O.05) between LI values and the performance in Coding. It is suggested that decreased blood flow areas detected by SPECT might influence brain function. (author)

  17. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    Energy Technology Data Exchange (ETDEWEB)

    Rademacher, J.; Seitz, R.J. [Department of Neurology, Heinrich-Heine University Duesseldorf (Germany); Aulich, A. [Department of Radiology, Heinrich-Heine University, Duesseldorf (Germany); Reifenberger, G. [Department of Neuropathology, Heinrich-Heine University, Duesseldorf (Germany); Kiwit, J.C.W. [Department of Neurosurgery, Heinrich-Heine University, Duesseldorf (Germany); Langen, K.J.; Schmidt, D. [Institute of Medicine, Research Center Juelich, Heinrich-Heine University, Duesseldorf (Germany)

    2000-06-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[{sup 123}I]iodo-{alpha}-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  18. Focal cortical dysplasia of the temporal lobe with late-onset partial epilepsy: serial quantitative MRI

    International Nuclear Information System (INIS)

    Rademacher, J.; Seitz, R.J.; Aulich, A.; Reifenberger, G.; Kiwit, J.C.W.; Langen, K.J.; Schmidt, D.

    2000-01-01

    We describe serial studies of focal cortical dysplasia causing temporal lobe seizures and progressive aphasia in a 54-year-old woman. Initially, MRI volumetry of the temporal lobes showed significant left cortical thickening corresponding to an elevated aminoacid uptake in the left temporoparietal and inferior frontal cortex on SPECT using 3-[ 123 I]iodo-α-methyl-l-tyrosine (IMT). After 1 year there was severe shrinkage of the left temporal lobe, possibly the result of recurrent complex partial seizures. (orig.)

  19. Differences in graph theory functional connectivity in left and right temporal lobe epilepsy.

    Science.gov (United States)

    Chiang, Sharon; Stern, John M; Engel, Jerome; Levin, Harvey S; Haneef, Zulfi

    2014-12-01

    To investigate lateralized differences in limbic system functional connectivity between left and right temporal lobe epilepsy (TLE) using graph theory. Interictal resting state fMRI was performed in 14 left TLE patients, 11 right TLE patients, and 12 controls. Graph theory analysis of 10 bilateral limbic regions of interest was conducted. Changes in edgewise functional connectivity, network topology, and regional topology were quantified, and then left and right TLE were compared. Limbic edgewise functional connectivity was predominantly reduced in both left and right TLE. More regional connections were reduced in right TLE, most prominently involving reduced interhemispheric connectivity between the bilateral insula and bilateral hippocampi. A smaller number of limbic connections were increased in TLE, more so in left than in right TLE. Topologically, the most pronounced change was a reduction in average network betweenness centrality and concurrent increase in left hippocampal betweenness centrality in right TLE. In contrast, left TLE exhibited a weak trend toward increased right hippocampal betweenness centrality, with no change in average network betweenness centrality. Limbic functional connectivity is predominantly reduced in both left and right TLE, with more pronounced reductions in right TLE. In contrast, left TLE exhibits both edgewise and topological changes that suggest a tendency toward reorganization. Network changes in TLE and lateralized differences thereof may have important diagnostic and prognostic implications. Published by Elsevier B.V.

  20. Temporal lobe epilepsy with varying severity: MRI study of 222 patients

    International Nuclear Information System (INIS)

    Lehericy, S.; Hasboun, D.; Dormont, D.; Marsault, C.; Semah, F.; Baulac, M.; Clemenceau, S.; Granat, O.

    1997-01-01

    MRI was performed in 222 consecutive adult patients with temporal lobe epilepsy of varying severity from January 1991 to May 1993. The diagnosis of hippocampal sclerosis was established visually by three independent observers. The accuracy of visual assessment of hippocampal asymmetry was compared with volumetric measurements. Neuropathological correlations were obtained in 63 patients with refractory seizures. Temporal lobe abnormalities were observed in 180 patients (81 %) as follows: hippocampal sclerosis in 122 (55 %); developmental abnormalities in 16 (7.2 %); tumours in 15 (6.8 %); scars in 11 (5 %); cavernous angiomas in 10 (4.5 %); miscellaneous lesions in 6. MRI was normal or showed unrelated changes in 42 patients (19 %). Visual assessment correctly lateralised hippocampal sclerosis in 79 of the 84 patients measured (94 %). Temporal lobectomy confirmed the MRI data (side and aetiology) in all 63 operated patients. Patients with normal MRI had an older age of seizure onset and were more often drug-responsive than patients with hippocampal sclerosis. MRI showed temporal lobe abnormalities in 81 % of epileptic patients with varying severity with good neuropathological correlation. Patients with normal MRI had a less severe form of the disease. (orig.)

  1. Medial temporal and neocortical contributions to remote memory for semantic narratives: evidence from amnesia.

    Science.gov (United States)

    Verfaellie, Mieke; Bousquet, Kathryn; Keane, Margaret M

    2014-08-01

    Studies of remote memory for semantic facts and concepts suggest that hippocampal lesions lead to a temporally graded impairment that extends no more than ten years prior to the onset of amnesia. Such findings have led to the notion that once consolidated, semantic memories are represented neocortically and are no longer dependent on the hippocampus. Here, we examined the fate of well-established semantic narratives following medial temporal lobe (MTL) lesions. Seven amnesic patients, five with lesions restricted to the MTL and two with lesions extending into lateral temporal cortex (MTL+), were asked to recount fairy tales and bible stories that they rated as familiar. Narratives were scored for number and type of details, number of main thematic elements, and order in which the main thematic elements were recounted. In comparison to controls, patients with MTL lesions produced fewer details, but the number and order of main thematic elements generated was intact. By contrast, patients with MTL+ lesions showed a pervasive impairment, affecting not only the generation of details, but also the generation and ordering of main steps. These findings challenge the notion that, once consolidated, semantic memories are no longer dependent on the hippocampus for retrieval. Possible hippocampal contributions to the retrieval of detailed semantic narratives are discussed. Published by Elsevier Ltd.

  2. Expression of Toll-like receptor 4 in hippocampus of rat model with temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    PAN Li-ping

    2013-12-01

    Full Text Available Objective To investigate the expression of Toll-like receptor 4 (TLR4 protein in hippocampus of rat model with temporal lobe epilepsy after status epilepticus (SE and explore its function in the pathogenesis of temporal lobe epilepsy. Methods Rat model with temporal lobe epilepsy was induced by lithium chloride (LiCl-pilocarpine. Total protein was extracted from hippocampus and rat brain slices were obtained at different time points (0, 1, 6, 12, 24, 48 h and 7, 10, 30, 50 d after SE. Western blotting and immunohistochemical staining were used for detection of the expression of TLR4 in the hippocampus. Results The results of Western blotting showed the TLR4 protein expression at 0, 1, 6, 12, 24, 48 h and 7, 10, 30 d after SE was higher than that in the control group (P 0.05. Conclusion TLR4 protein was mainly expressed in cytoplasm of pyramidal cells in CA3 area of hippocampus. TLR4 protein expression in the hippocampus was increased in varying degrees at different observation time points after SE, indicating that TLR4 may play an important role in the development of epilepsy.

  3. Intralaminar and medial thalamic influence on cortical synchrony, information transmission and cognition

    Directory of Open Access Journals (Sweden)

    Yuri B Saalmann

    2014-05-01

    Full Text Available The intralaminar and medial thalamic nuclei are part of the higher-order thalamus, which receives little sensory input, and instead forms extensive cortico-thalamo-cortical pathways. The large mediodorsal thalamic nucleus predominantly connects with the prefrontal cortex, the adjacent intralaminar nuclei connect with fronto-parietal cortex, and the midline thalamic nuclei connect with medial prefrontal cortex and medial temporal lobe. Taking into account this connectivity pattern, it is not surprising that the intralaminar and medial thalamus has been implicated in a variety of cognitive functions, including memory processing, attention and orienting, as well as reward-based behavior. This review addresses how the intralaminar and medial thalamus may regulate information transmission in cortical circuits. A key neural mechanism may involve intralaminar and medial thalamic neurons modulating the degree of synchrony between different groups of cortical neurons according to behavioral demands. Such a thalamic-mediated synchronization mechanism may give rise to large-scale integration of information across multiple cortical circuits, consequently influencing the level of arousal and consciousness. Overall, the growing evidence supports a general role for the higher-order thalamus in the control of cortical information transmission and cognitive processing.

  4. Right anterior temporal lobe dysfunction underlies theory of mind impairments in semantic dementia.

    Science.gov (United States)

    Irish, Muireann; Hodges, John R; Piguet, Olivier

    2014-04-01

    Semantic dementia is a progressive neurodegenerative disorder characterized by the amodal and profound loss of semantic knowledge attributable to the degeneration of the left anterior temporal lobe. Although traditionally conceptualized as a language disorder, patients with semantic dementia display significant alterations in behaviour and socioemotional functioning. Recent evidence points to an impaired capacity for theory of mind in predominantly left-lateralized cases of semantic dementia; however, it remains unclear to what extent semantic impairments contribute to these deficits. Further the neuroanatomical signature of such disturbance remains unknown. Here, we sought to determine the neural correlates of theory of mind performance in patients with left predominant semantic dementia (n=11), in contrast with disease-matched cases with behavioural-variant frontotemporal dementia (n=10) and Alzheimer's disease (n=10), and healthy older individuals (n=14) as control participants. Participants completed a simple cartoons task, in which they were required to describe physical and theory of mind scenarios. Irrespective of subscale, patients with semantic dementia exhibited marked impairments relative to control subjects; however, only theory of mind deficits persisted when we covaried for semantic comprehension. Voxel-based morphometry analyses revealed that atrophy in right anterior temporal lobe structures, including the right temporal fusiform cortex, right inferior temporal gyrus, bilateral temporal poles and amygdalae, correlated significantly with theory of mind impairments in the semantic dementia group. Our results point to the marked disruption of cognitive functions beyond the language domain in semantic dementia, not exclusively attributable to semantic processing impairments. The significant involvement of right anterior temporal structures suggests that with disease evolution, the encroachment of pathology into the contralateral hemisphere heralds the

  5. Recurrent diarrhea as a manifestation of temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Tomohiko Murai

    2014-01-01

    Full Text Available A woman with temporal lobe epilepsy manifesting with repeated episodes of sudden diarrhea and loss of consciousness is reported. A 63-year-old, right-handed female presented with chief complaints of sudden diarrhea and loss of consciousness for almost three decades. The first attack occurred in her 30s, and similar attacks repeated several times in a year. Her attacks comprised abrupt abdominal discomfort, diarrhea, sudden emergence of old memories relating to when she had played with her brother in her childhood, and loss of consciousness during defecation. She had no convulsion or automatism and fully recovered in a few minutes. Every time she was transferred to emergency hospital by ambulance, she had examinations such as blood test, head computed tomography, electrocardiogram, abdominal ultrasound, and electroencephalography (EEG, but no specific diagnosis was made. On admission to our hospital, vital signs, neurological examination, and blood tests did not show abnormal findings. During long-term video-EEG monitoring for 40 h, she had no habitual event. Interictal EEG showed intermittent irregular delta waves and sharp regional transients in the left anterio-midtemporal area. Sharp transients were not as outstanding from background activities as to be defined as epileptiform discharges, but they were reproducible in morphology and distribution and appeared not only in sleep but also in wakefulness. Brain magnetic resonance imaging was unremarkable. Single-photon emission computed tomography showed a decrease of blood flow in the left frontal and temporal lobes. Wechsler Adult Intelligence Scale—III showed a decline of verbal comprehension. We concluded that the patient was suffering from partial epilepsy originating from the left temporal lobe. Carbamazepine markedly improved her seizures. Temporal lobe epilepsy can manifest with diverse autonomic symptoms and signs. Abdominal sensations often herald the onset of epileptic seizures

  6. Decreasing Temporal Lobe Dose With Five-Field Intensity-Modulated Radiotherapy for Treatment of Pituitary Macroadenomas

    International Nuclear Information System (INIS)

    Parhar, Preeti K.; Duckworth, Tamara; Shah, Parinda; DeWyngaert, J. Keith; Narayana, Ashwatha; Formenti, Silvia C.; Shah, Jinesh N.

    2010-01-01

    Purpose: To compare temporal lobe dose delivered by three pituitary macroadenoma irradiation techniques: three-field three-dimensional conformal radiotherapy (3D-CRT), three-field intensity-modulated radiotherapy (3F IMRT), and a proposed novel alternative of five-field IMRT (5F IMRT). Methods and Materials: Computed tomography-based external beam radiotherapy planning was performed for 15 pituitary macroadenoma patients treated at New York University between 2002 and 2007 using: 3D-CRT (two lateral, one midline superior anterior oblique [SAO] beams), 3F IMRT (same beam angles), and 5F IMRT (same beam angles with additional right SAO and left SAO beams). Prescription dose was 45 Gy. Target volumes were: gross tumor volume (GTV) = macroadenoma, clinical target volume (CTV) = GTV, and planning target volume = CTV + 0.5 cm. Structure contouring was performed by two radiation oncologists guided by an expert neuroradiologist. Results: Five-field IMRT yielded significantly decreased temporal lobe dose delivery compared with 3D-CRT and 3F IMRT. Temporal lobe sparing with 5F IMRT was most pronounced at intermediate doses: mean V25Gy (% of total temporal lobe volume receiving ≥25 Gy) of 13% vs. 28% vs. 29% for right temporal lobe and 14% vs. 29% vs. 30% for left temporal lobe for 5F IMRT, 3D-CRT, and 3F IMRT, respectively (p -7 for 5F IMRT vs. 3D-CRT and 5F IMRT vs. 3F IMRT). Five-field IMRT plans did not compromise target coverage, exceed normal tissue dose constraints, or increase estimated brain integral dose. Conclusions: Five-field IMRT irradiation technique results in a statistically significant decrease in the dose to the temporal lobes and may thus help prevent neurocognitive sequelae in irradiated pituitary macroadenoma patients.

  7. Insular epilepsy: similarities to temporal lobe epilepsy case report Epilepsia insular: similaridades à epilepsia do lobo temporal - relato de caso

    Directory of Open Access Journals (Sweden)

    ARTHUR CUKIERT

    1998-03-01

    Full Text Available Insular epilepsy has been rarely reported and its clinical and electrographic features are poorly understood. The electrographic study of the insula is difficult since it is hidden from the brain surface by the frontal and temporal lobe. A 48 years-old woman started having simple partial autonomic and complex partial seizures with automatisms and ictal left arm paresis 8 years prior to admission. Seizure's frequency was 1 per week. Pre-operative EEG showed a right temporal lobe focus. Neuropsychological testing disclosed right fronto-temporal dysfunction. MRI showed a right anterior insular cavernous angioma. Intraoperative ECoG obtained after spliting of the sylvian fissure showed independent spiking from the insula and temporal lobe and insular spikes that spread to the temporal lobe. The cavernous angioma and the surrounding gliotic tissue were removed and the temporal lobe was left in place. Post-resection ECoG still disclosed independent temporal and insular spiking with a lower frequency. The patient has been seizure-free since surgery. Insular epilepsy may share many clinical and electroencephalographic features with temporal lobe epilepsy.A epilepsia insular tem sido raramente relatada e suas características clínicas e eletrencefalográficas são pobremente conhecidas. O estudo eletrográfico da ínsula é difícil já que ela se encontra recoberta pelos lobos frontal e temporal. Uma paciente, de 48 anos, começou a ter crises parciais simples autonômicas e crises parciais complexas com automatismos e paresia crítica de membro superior esquerdo 8 anos antes desta internação. A frequência de crises era de 1/semana . O EEG pré-operatório mostrou foco temporal direito. Testagem neuropsicológica demonstrou disfunção fronto-temporal direita. RMN demonstrou cavernoma insular anterior direito. A eletrocorticografia intraoperatória obtida após a abertura da fissura sylviana demonstrou a presença de espículas independentes na

  8. Changes in frontal lobe function before and after surgery in patients with unruptured intracranial aneurysm

    International Nuclear Information System (INIS)

    Ozaki, Saya; Kumon, Yoshiaki; Igase, Keiji; Watanabe, Hideaki; Ohnishi, Takanori

    2008-01-01

    We evaluated neuropsychological function in 18 patients with unruptured cerebral aneurysm who showed good postoperative outcomes. We paid particular attention to frontal lobe function. We also investigated relationships between cerebral blood flow (CBF) and frontal lobe function. Patients were examined using digit span, word fluency (WF), Stroop and trail-making tests to clarify frontal lobe function before and 1-2 months after surgery. We also used the mini-mental state examination (MMSE), Raven's colored progressive matrices (RCPM) and revised Wechsler adult intelligence scale (WAIS-R) to examine cognitive function. CBF was measured using 133 Xe-single photon emission computed tomography (SPECT) before and 1-2 months after surgery. Tests revealed that the patients' postoperative neuropsychological status was improved compared to the preoperative status for MMSE, RCPM and WAIS-R. Among the tests of frontal lobe function, WF results had deteriorated significantly after surgery. Resting CBF in the frontal lobe was significantly decreased. Regional CBF in the frontal lobe was decreased significantly in comparison with values in the parietal and temporal lobes in patients showing deterioration of WF. Deterioration of WF correlated with CBF changes in the frontal lobe. These results suggest that surgery for unruptured cerebral aneurysm exerts detrimental effects on frontal lobe function that may be related to CBF changes. (author)

  9. Seizure Control and Memory Impairment Are Related to Disrupted Brain Functional Integration in Temporal Lobe Epilepsy.

    Science.gov (United States)

    Park, Chang-Hyun; Choi, Yun Seo; Jung, A-Reum; Chung, Hwa-Kyoung; Kim, Hyeon Jin; Yoo, Jeong Hyun; Lee, Hyang Woon

    2017-01-01

    Brain functional integration can be disrupted in patients with temporal lobe epilepsy (TLE), but the clinical relevance of this disruption is not completely understood. The authors hypothesized that disrupted functional integration over brain regions remote from, as well as adjacent to, the seizure focus could be related to clinical severity in terms of seizure control and memory impairment. Using resting-state functional MRI data acquired from 48 TLE patients and 45 healthy controls, the authors mapped functional brain networks and assessed changes in a network parameter of brain functional integration, efficiency, to examine the distribution of disrupted functional integration within and between brain regions. The authors assessed whether the extent of altered efficiency was influenced by seizure control status and whether the degree of altered efficiency was associated with the severity of memory impairment. Alterations in the efficiency were observed primarily near the subcortical region ipsilateral to the seizure focus in TLE patients. The extent of regional involvement was greater in patients with poor seizure control: it reached the frontal, temporal, occipital, and insular cortices in TLE patients with poor seizure control, whereas it was limited to the limbic and parietal cortices in TLE patients with good seizure control. Furthermore, TLE patients with poor seizure control experienced more severe memory impairment, and this was associated with lower efficiency in the brain regions with altered efficiency. These findings indicate that the distribution of disrupted brain functional integration is clinically relevant, as it is associated with seizure control status and comorbid memory impairment.

  10. Temporal lobe and inferior frontal gyrus dysfunction in patients with schizophrenia during face-to-face conversation: a near-infrared spectroscopy study.

    Science.gov (United States)

    Takei, Yuichi; Suda, Masashi; Aoyama, Yoshiyuki; Yamaguchi, Miho; Sakurai, Noriko; Narita, Kosuke; Fukuda, Masato; Mikuni, Masahiko

    2013-11-01

    Schizophrenia (SC) is marked by poor social-role performance and social-skill deficits that are well reflected in daily conversation. Although the mechanism underlying these impairments has been investigated by functional neuroimaging, technical limitations have prevented the investigation of brain activation during conversation in typical clinical situations. To fill this research gap, this study investigated and compared frontal and temporal lobe activation in patients with SC during face-to-face conversation. Frontal and temporal lobe activation in 29 patients and 31 normal controls (NC) (n = 60) were measured during 180-s conversation periods by using near-infrared spectroscopy (NIRS). The grand average values of oxyhemoglobin concentration ([oxy-Hb]) changes during task performance were analyzed to determine their correlation with clinical variables and Positive and Negative Syndrome Scale (PANSS) subscores. Compared to NCs, patients with SC exhibited decreased performance in the conversation task and decreased activation in both the temporal lobes and the right inferior frontal gyrus (IFG) during task performance, as indicated by the grand average of [oxy-Hb] changes. The decreased activation in the left temporal lobe was negatively correlated with the PANSS disorganization and negative symptoms subscores and that in the right IFG was negatively correlated with illness duration, PANSS disorganization, and negative symptom subscores. These findings indicate that brain dysfunction in SC during conversation is related to functional deficits in both the temporal lobes and the right IFG and manifests primarily in the form of disorganized thinking and negative symptomatology. Copyright © 2013 Elsevier Ltd. All rights reserved.

  11. Experimentally induced thyrotoxicosis leads to increased connectivity in temporal lobe structures: a resting state fMRI study.

    Science.gov (United States)

    Göttlich, Martin; Heldmann, Marcus; Göbel, Anna; Dirk, Anna-Luise; Brabant, Georg; Münte, Thomas F

    2015-06-01

    Adult onset hyperthyroidism may impact on different cognitive domains, including attention and concentration, memory, perceptual function, language and executive function. Previous PET studies implicated changed functionality of limbic regions, the temporal and frontal lobes in hyperthyroidism, whereas it is unknown whether cognitive effects of hyperthyroidism may be due to changed brain connectivity. This study aimed to investigate the effect of experimentally induced short-term hyperthyroidism thyrotoxicosis on resting-state functional connectivity using functional magnetic resonance imaging. Twenty-nine healthy male right-handed subjects were examined twice, once prior and once after 8 weeks of oral administration of 250 μg levothyroxine per day. Resting-state fMRI was subjected to graph-theory based analysis methods to investigate whole-brain intrinsic functional connectivity. Despite a lack of subjective changes noticed by the subjects significant thyrotoxicosis was confirmed in all subjects. This induced a significant increase in resting-state functional connectivity specifically in the rostral temporal lobes (0.05 FDR corrected at the cluster level), which is caused by an increased connectivity to the cognitive control network. The increased connectivity between temporal poles and the cognitive control network shown here under experimental conditions supports an important function of thyroid hormones in the regulation of paralimbic structures. Copyright © 2015 Elsevier Ltd. All rights reserved.

  12. Cognitive impairments in patients with intractable temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Mahgol Tavakoli

    2011-01-01

    Conclusions: These findings indicated that WMS-III and WAIS-R can differentiate patients with refractory temporal lobe epilepsy from normal subjects. However, the obtained cognitive profile could not differentiate between the right and the left TLE.

  13. Multimodality medical image database for temporal lobe epilepsy

    Science.gov (United States)

    Siadat, Mohammad-Reza; Soltanian-Zadeh, Hamid; Fotouhi, Farshad A.; Elisevich, Kost

    2003-05-01

    This paper presents the development of a human brain multi-modality database for surgical candidacy determination in temporal lobe epilepsy. The focus of the paper is on content-based image management, navigation and retrieval. Several medical image-processing methods including our newly developed segmentation method are utilized for information extraction/correlation and indexing. The input data includes T1-, T2-Weighted and FLAIR MRI and ictal/interictal SPECT modalities with associated clinical data and EEG data analysis. The database can answer queries regarding issues such as the correlation between the attribute X of the entity Y and the outcome of a temporal lobe epilepsy surgery. The entity Y can be a brain anatomical structure such as the hippocampus. The attribute X can be either a functionality feature of the anatomical structure Y, calculated with SPECT modalities, such as signal average, or a volumetric/morphological feature of the entity Y such as volume or average curvature. The outcome of the surgery can be any surgery assessment such as non-verbal Wechsler memory quotient. A determination is made regarding surgical candidacy by analysis of both textual and image data. The current database system suggests a surgical determination for the cases with relatively small hippocampus and high signal intensity average on FLAIR images within the hippocampus. This indication matches the neurosurgeons expectations/observations. Moreover, as the database gets more populated with patient profiles and individual surgical outcomes, using data mining methods one may discover partially invisible correlations between the contents of different modalities of data and the outcome of the surgery.

  14. Left or right? Lateralizing temporal lobe epilepsy by dynamic amygdala fMRI.

    Science.gov (United States)

    Ives-Deliperi, Victoria; Butler, James Thomas; Jokeit, Hennric

    2017-05-01

    In this case series, the findings of 85 functional MRI studies employing a dynamic fearful face paradigm are reported. Previous findings have shown the paradigm to generate bilateral amygdala activations in healthy subjects and unilateral activations in patients with MTLE, in the contralateral hemisphere to seizure origin. Such findings suggest ipsilateral limbic pathology and offer collateral evidence in lateralizing MTLE. The series includes 60 patients with TLE, 12 patients with extra-temporal lobe epilepsy, and 13 healthy controls. Functional MRI studies using a 1.5T scanner were conducted over a three-year period at a single epilepsy center and individual results were compared with EEG findings. In the cohort of unilateral TLE patients, lateralized activations of the amygdala were concordant with EEG findings in 76% of patients (77% lTLE, 74% rTLE). The differences in the mean lateralized indices of the lTLE, rTLE, and healthy control groups were all statistically significant. Lateralized amygdala activations were concordant with EEG findings in only 31% of the 12 patients with extra-temporal lobe epilepsy and bilateral amygdala activations were generated in all but one of the healthy control subjects. This case series further endorses the utility of the dynamic fearful face functional MRI paradigm using the widely available 1.5T as an adjunctive investigation to lateralize TLE. Copyright © 2017 Elsevier Inc. All rights reserved.

  15. Dissociating basal forebrain and medial temporal amnesic syndromes: insights from classical conditioning.

    Science.gov (United States)

    Myer, Catherine E; Bryant, Deborah; DeLuca, John; Gluck, Mark A

    2002-01-01

    In humans, anterograde amnesia can result from damage to the medial temporal (MT) lobes (including hippocampus), as well as to other brain areas such as basal forebrain. Results from animal classical conditioning studies suggest that there may be qualitative differences in the memory impairment following MT vs. basal forebrain damage. Specifically, delay eyeblink conditioning is spared after MT damage in animals and humans, but impaired in animals with basal forebrain damage. Recently, we have likewise shown delay eyeblink conditioning impairment in humans with amnesia following anterior communicating artery (ACoA) aneurysm rupture, which damages the basal forebrain. Another associative learning task, a computer-based concurrent visual discrimination, also appears to be spared in MT amnesia while ACoA amnesics are slower to learn the discriminations. Conversely, animal and computational models suggest that, even though MT amnesics may learn quickly, they may learn qualitatively differently from controls, and these differences may result in impaired transfer when familiar information is presented in novel combinations. Our initial data suggests such a two-phase learning and transfer task may provide a double dissociation between MT amnesics (spared initial learning but impaired transfer) and ACoA amnesics (slow initial learning but spared transfer). Together, these emerging data suggest that there are subtle but dissociable differences in the amnesic syndrome following damage to the MT lobes vs. basal forebrain, and that these differences may be most visible in non-declarative tasks such as eyeblink classical conditioning and simple associative learning.

  16. Right fronto-limbic atrophy is associated with reduced empathy in refractory unilateral mesial temporal lobe epilepsy.

    Science.gov (United States)

    Toller, Gianina; Adhimoolam, Babu; Rankin, Katherine P; Huppertz, Hans-Jürgen; Kurthen, Martin; Jokeit, Hennric

    2015-11-01

    Refractory mesial temporal lobe epilepsy (MTLE) is the most frequent focal epilepsy and is often accompanied by deficits in social cognition including emotion recognition, theory of mind, and empathy. Consistent with the neuronal networks that are crucial for normal social-cognitive processing, these impairments have been associated with functional changes in fronto-temporal regions. However, although atrophy in unilateral MTLE also affects regions of the temporal and frontal lobes that underlie social cognition, little is known about the structural correlates of social-cognitive deficits in refractory MTLE. In the present study, a psychometrically validated empathy questionnaire was combined with whole-brain voxel-based morphometry (VBM) to investigate the relationship between self-reported affective and cognitive empathy and gray matter volume in 55 subjects (13 patients with right MTLE, 9 patients with left MTLE, and 33 healthy controls). Consistent with the brain regions underlying social cognition, our results show that lower affective and cognitive empathy was associated with smaller volume in predominantly right fronto-limbic regions, including the right hippocampus, parahippocampal gyrus, thalamus, fusiform gyrus, inferior temporal gyrus, dorsomedial and dorsolateral prefrontal cortices, and in the bilateral midbrain. The only region that was associated with both affective and cognitive empathy was the right mesial temporal lobe. These findings indicate that patients with right MTLE are at increased risk for reduced empathy towards others' internal states and they shed new light on the structural correlates of impaired social cognition frequently accompanying refractory MTLE. In line with previous evidence from patients with neurodegenerative disease and stroke, the present study suggests that empathy depends upon the integrity of right fronto-limbic and brainstem regions and highlights the importance of the right mesial temporal lobe and midbrain

  17. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    International Nuclear Information System (INIS)

    Rodrigo, S.; Oppenheim, C.; Meder, J.F.; Chassoux, F.; Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D.

    2007-01-01

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  18. Uncinate fasciculus fiber tracking in mesial temporal lobe epilepsy. Initial findings

    Energy Technology Data Exchange (ETDEWEB)

    Rodrigo, S.; Oppenheim, C.; Meder, J.F. [Universite Paris-Descartes, Faculte de Medecine, Centre Hospitalier Sainte-Anne, Departement d' Imagerie Morphologique et Fonctionnelle, Paris (France); Chassoux, F. [Universite Paris-Descartes, Faculte de Medecine, Service de Neurochirurgie, Centre Hospitalier Sainte-Anne, Paris (France); Golestani, N.; Cointepas, Y.; Poupon, C.; Semah, F.; Mangin, J.F.; Le Bihan, D. [Service Hospitalier Frederic Joliot, CEA, Orsay (France)

    2007-07-15

    In temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS), ictal discharge spread to the frontal and insulo-perisylvian cortex is commonly observed. The implication of white matter pathways in this propagation has not been investigated. We compared diffusion tensor imaging (DTI) measurements along the uncinate fasciculus (UF), a major tract connecting the frontal and temporal lobes, in patients and controls. Ten right-handed patients referred for intractable TLE due to a right HS were investigated on a 1.5-T MR scanner including a DTI sequence. All patients had interictal fluorodeoxyglucose PET showing an ipsilateral temporal hypometabolism associated with insular and frontal or perisylvian hypometabolism. The controls consisted of ten right-handed healthy subjects. UF fiber tracking was performed, and its fractional anisotropy (FA) values were compared between patients and controls, separately for the right and left UF. The left-minus-right FA UF asymmetry index was computed to test for intergroup differences. Asymmetries were found in the control group with right-greater-than-left FA. This asymmetrical pattern was lost in the patient group. Right FA values were lower in patients with right HS versus controls. Although preliminary, these findings may be related to the preferential pathway of seizure spread from the mesial temporal lobe to frontal and insulo-perisylvian areas. (orig.)

  19. Ictal hyperperfusion of cerebellum and basal ganglia in temporal lobe epilepsy: SPECT subtraction

    Energy Technology Data Exchange (ETDEWEB)

    Shin, Won Chul; Hong, Seung Bong; Tae, Woo Suk; Seo, Dae Won; Kim, Sang Eun [School of Medicine, Sungkyunkwan, Seoul (Korea, Republic of)

    2001-02-01

    The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring. SPGR MRI, and SPECT subtraction with MRI co-registration. The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH( 60.0%) and three bilateral hemispheric CH( 12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (15/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1 %). The basal ganglia hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH.

  20. Ictal hyperperfusion of cerebellum and basal ganglia in temporal lobe epilepsy: SPECT subtraction

    International Nuclear Information System (INIS)

    Shin, Won Chul; Hong, Seung Bong; Tae, Woo Suk; Seo, Dae Won; Kim, Sang Eun

    2001-01-01

    The ictal perfusion patterns of cerebellum and basal ganglia have not been systematically investigated in patients with temporal lobe epilepsy (TLE). Their ictal perfusion patterns were analyzed in relation with temporal lobe and frontal lobe hyperperfusion during TLE seizures using SPECT subtraction. Thirty-three TLE patients had interictal and ictal SPECT, video-EEG monitoring. SPGR MRI, and SPECT subtraction with MRI co-registration. The vermian cerebellar hyperperfusion (CH) was observed in 26 patients (78.8%) and hemispheric CH in 25 (75.8%). Compared to the side of epileptogenic temporal lobe, there were seven ipsilateral hemispheric CH (28.0%), fifteen contralateral hemispheric CH( 60.0%) and three bilateral hemispheric CH( 12.0%). CH was more frequently observed in patients with additional frontal hyperperfusion (15/15, 93.3%) than in patients without frontal hyperperfusion (11/18, 61.1 %). The basal ganglia hyperperfusion (14/15, 93.3%) than in patients without frontal hyperperfusion (BGH) was seen in 11 of the 15 patients with frontotemporal hyperperfusion (73.3%) and 11 of the 18 with temporal hyperperfusion only (61.1%). In 17 patients with unilateral BGH, contralateral CH to the BGH was observed in 14 (82.5%) and ipsilateral CH to BGH in 2 (11.8%) and bilateral CH in 1 (5.9%). The cerebellar hyperperfusion and basal ganglia hyperperfusion during seizures of TLE can be contralateral, ipsilateral or bilateral to the seizure focus. The presence of additional frontal or basal ganglia hyperperfusion was more frequently associated with contralateral hemispheric CH to their sides. However, temporal lobe hyperperfusion appears to be related with both ipsilateral and contralateral hemispheric CH

  1. Imaging of odor perception delineates functional disintegration of the limbic circuits in mesial temporal lobe epilepsy.

    Science.gov (United States)

    Ciumas, Carolina; Lindström, Per; Aoun, Bernard; Savic, Ivanka

    2008-01-15

    Metabolic and neuro-receptor abnormalities within the extrafocal limbic circuits are established in mesial temporal lobe epilepsy (MTLE). However, very little is known about how these circuits process external stimuli. We tested whether odor activation can help delineate limbic functional disintegration in MTLE, and measured cerebral blood flow with PET during birhinal smelling of familiar and unfamiliar odors, using smelling of odorless air as the baseline condition. Patients with MTLE (13 left-sided, 10 right-sided) and 21 controls were investigated. In addition to odor activation, the analysis included functional connectivity, using right and left piriform cortex as seed regions. Healthy controls activated the amygdala, piriform, anterior insular, and cingulate cortices on both sides. Smelling of familiar odors engaged, in addition, the right parahippocampus, and the left Brodmann Area (BA) 44, 45, 47. Patients failed to activate the amygdala, piriform and the anterior insular cortex in the epileptogenic hemisphere. Furthermore, those with left MTLE did not activate the left BA 44, 45 and 47 with familiar odors, which they perceived as less familiar than controls. Congruent with the activation data each seed region was in patients functionally disconnected with the contralateral amygdala+piriform+insular cortex. The functional disintegration in patients exceeded the reduced activation, and included the contralateral temporal neocortex, and in subjects with right MTLE also the right orbitofrontal cortex. Imaging of odor perception may be used to delineate functional disintegration of the limbic networks in MTLE. It shows an altered response in several regions, which may underlie some interictal behavioral problems associated with this condition.

  2. Graph theoretical analysis reveals disrupted topological properties of whole brain functional networks in temporal lobe epilepsy.

    Science.gov (United States)

    Wang, Junjing; Qiu, Shijun; Xu, Yong; Liu, Zhenyin; Wen, Xue; Hu, Xiangshu; Zhang, Ruibin; Li, Meng; Wang, Wensheng; Huang, Ruiwang

    2014-09-01

    Temporal lobe epilepsy (TLE) is one of the most common forms of drug-resistant epilepsy. Previous studies have indicated that the TLE-related impairments existed in extensive local functional networks. However, little is known about the alterations in the topological properties of whole brain functional networks. In this study, we acquired resting-state BOLD-fMRI (rsfMRI) data from 26 TLE patients and 25 healthy controls, constructed their whole brain functional networks, compared the differences in topological parameters between the TLE patients and the controls, and analyzed the correlation between the altered topological properties and the epilepsy duration. The TLE patients showed significant increases in clustering coefficient and characteristic path length, but significant decrease in global efficiency compared to the controls. We also found altered nodal parameters in several regions in the TLE patients, such as the bilateral angular gyri, left middle temporal gyrus, right hippocampus, triangular part of left inferior frontal gyrus, left inferior parietal but supramarginal and angular gyri, and left parahippocampus gyrus. Further correlation analysis showed that the local efficiency of the TLE patients correlated positively with the epilepsy duration. Our results indicated the disrupted topological properties of whole brain functional networks in TLE patients. Our findings indicated the TLE-related impairments in the whole brain functional networks, which may help us to understand the clinical symptoms of TLE patients and offer a clue for the diagnosis and treatment of the TLE patients. Copyright © 2014 International Federation of Clinical Neurophysiology. Published by Elsevier Ireland Ltd. All rights reserved.

  3. Reproducibility of qualitative assessments of temporal lobe atrophy in MRI studies.

    Science.gov (United States)

    Sarria-Estrada, S; Acevedo, C; Mitjana, R; Frascheri, L; Siurana, S; Auger, C; Rovira, A

    2015-01-01

    To determine the reproducibility of the Scheltens visual rating scale in establishing atrophy of the medial temporal lobe. We used coronal T1-weighted inversion recovery sequences on a 1.5 Tesla MRI scanner to study 25 patients with clinically diagnosed Alzheimer's disease or mild cognitive decline and 25 subjects without cognitive decline. Five neuroradiologists trained to apply the Scheltens visual rating scale analyzed the images. We used the interclass correlation coefficient to evaluate interrater and intrarater agreement. Raters scored 20 (80%) of the 25 patients with mild cognitive decline or Alzheimer's disease between 2 and 4; by contrast, they scored 21 (84%) of the 25 subjects without cognitive decline between 0 and 1. The interrater agreement was consistently greater than 0.82, with a 95% confidence interval of (0.7-0.9). The intrarater agreement ranged from 0.82 to 0.87, with a 95% confidence interval of (0.56-0.93). The Scheltens visual rating scale is reproducible among observers, and this finding supports its use in clinical practice. Copyright © 2013 SERAM. Published by Elsevier España, S.L.U. All rights reserved.

  4. Dietary influences on cognitive function with aging: from high-fat diets to healthful eating.

    Science.gov (United States)

    Parrott, Matthew D; Greenwood, Carol E

    2007-10-01

    Human epidemiologic studies provide convincing evidence that dietary patterns practiced during adulthood are important contributors to age-related cognitive decline and dementia risk. Diets high in fat, especially trans and saturated fats, adversely affect cognition, while those high in fruits, vegetables, cereals, and fish are associated with better cognitive function and lower risk of dementia. While the precise physiologic mechanisms underlying these dietary influences are not completely understood, modulation of brain insulin activity and neuroinflammation likely contribute. Not surprisingly, deficits in cognitive functions, especially those dependent on the medial temporal lobes, are apparent in type 2 diabetes mellitus (T2DM). Special care in food selection at meals should be exercised by those with T2DM since ingestion of rapidly absorbed, high-glycemic index carbohydrate foods further impairs medial temporal lobe function, with food-induced increases in oxidative stress and cytokine release likely explaining the association between food ingestion and reduction in cognitive function in those with T2DM.

  5. Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Xing, Wu; Wang, Xiaoyi; Xie, Fangfang; Liao, Weihua [Dept. of Radiology, Xiangya Hospital of Central South Univ., Changsha (China)], e-mail: doctoring@sina.com

    2013-02-15

    Background: Accurately locatithe epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were pared between the two groups. Results: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 {+-} 0.32, right 1.57 {+-} 0.28) or rCBF (left 99.00 {+-} 24.61, right 100.38 {+-} 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 {+-} 0.64 and 96.35 {+-} 22.63, respectively) were markedly lower than those of the contralateral side (2.01 {+-} 0.79 and 108.56 {+-} 26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03 {+-} 10.33) and the AI of the rCBF (AIrCBF; 11.24 {+-} 8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55 {+-} 3.74, AIrCBF 5.12 {+-} 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion: In

  6. A Novel Functional Magnetic Resonance Imaging Paradigm for the Preoperative Assessment of Auditory Perception in a Musician Undergoing Temporal Lobe Surgery.

    Science.gov (United States)

    Hale, Matthew D; Zaman, Arshad; Morrall, Matthew C H J; Chumas, Paul; Maguire, Melissa J

    2018-03-01

    Presurgical evaluation for temporal lobe epilepsy routinely assesses speech and memory lateralization and anatomic localization of the motor and visual areas but not baseline musical processing. This is paramount in a musician. Although validated tools exist to assess musical ability, there are no reported functional magnetic resonance imaging (fMRI) paradigms to assess musical processing. We examined the utility of a novel fMRI paradigm in an 18-year-old left-handed pianist who underwent surgery for a left temporal low-grade ganglioglioma. Preoperative evaluation consisted of neuropsychological evaluation, T1-weighted and T2-weighted magnetic resonance imaging, and fMRI. Auditory blood oxygen level-dependent fMRI was performed using a dedicated auditory scanning sequence. Three separate auditory investigations were conducted: listening to, humming, and thinking about a musical piece. All auditory fMRI paradigms activated the primary auditory cortex with varying degrees of auditory lateralization. Thinking about the piece additionally activated the primary visual cortices (bilaterally) and right dorsolateral prefrontal cortex. Humming demonstrated left-sided predominance of auditory cortex activation with activity observed in close proximity to the tumor. This study demonstrated an fMRI paradigm for evaluating musical processing that could form part of preoperative assessment for patients undergoing temporal lobe surgery for epilepsy. Copyright © 2017 Elsevier Inc. All rights reserved.

  7. Correlation between memory, proton magnetic resonance spectroscopy, and interictal epileptiform discharges in temporal lobe epilepsy related to mesial temporal sclerosis.

    Science.gov (United States)

    Mantoan, Marcele Araújo Silva; Caboclo, Luís Otávio Sales Ferreira; de Figueiredo Ferreira Guilhoto, Laura Maria; Lin, Katia; da Silva Noffs, Maria Helena; de Souza Silva Tudesco, Ivanda; Belzunces, Erich; Carrete, Henrique; Bussoletti, Renato Tavares; Centeno, Ricardo Silva; Sakamoto, Américo Ceiki; Yacubian, Elza Márcia Targas

    2009-11-01

    The aim of the study described here was to examine the relationship between memory function, proton magnetic resonance spectroscopy ((1)H-MRS) abnormalities, and interictal epileptiform discharge (IED) lateralization in patients with temporal lobe epilepsy (TLE) related to unilateral mesial temporal sclerosis. We assessed performance on tests of memory function and intelligence quotient (IQ) in 29 right-handed outpatients and 24 controls. IEDs were assessed on 30-minute-awake and 30-minute-sleep EEG samples. Patients had (1)H-MRS at 1.5 T. There was a negative correlation between IQ (P=0.031) and Rey Auditory Verbal Learning Test results (P=0.022) and epilepsy duration; between(1)H-MRS findings and epilepsy duration (P=0.027); and between N-acetylaspartate (NAA) levels and IEDs (P=0.006) in contralateral mesial temporal structures in the left MTS group. (1)H-MRS findings, IEDs, and verbal function were correlated. These findings suggest that IEDs and NAA/(Cho+Cr) ratios reflecting neural metabolism are closely related to verbal memory function in mesial temporal sclerosis. Higher interictal activity on the EEG was associated with a decline in total NAA in contralateral mesial temporal structures.

  8. Spatial memory for asymmetrical dot locations predicts lateralization among patients with presurgical mesial temporal lobe epilepsy.

    Science.gov (United States)

    Brown, Franklin C; Hirsch, Lawrence J; Spencer, Dennis D

    2015-11-01

    This study examined the ability of an asymmetrical dot location memory test (Brown Location Test, BLT) and two verbal memory tests (Verbal Selective Reminding Test (VSRT) and California Verbal Learning Test, Second Edition (CVLT-II)) to correctly lateralize left (LTLE) or right (RTLE) mesial temporal lobe epilepsy that was confirmed with video-EEG. Subjects consisted of 16 patients with medically refractory RTLE and 13 patients with medically refractory LTLE who were left hemisphere language dominant. Positive predictive values for lateralizing TLE correctly were 87.5% for the BLT, 72.7% for the VSRT, and 80% for the CVLT-II. Binary logistic regression indicated that the BLT alone correctly classified 76.9% of patients with left temporal lobe epilepsy and 87.5% of patients with right temporal lobe epilepsy. Inclusion of the verbal memory tests improved this to 92.3% of patients with left temporal lobe epilepsy and 100% correct classification of patients with right temporal lobe epilepsy. Though of a limited sample size, this study suggests that the BLT alone provides strong laterality information which improves with the addition of verbal memory tests. Copyright © 2015 Elsevier Inc. All rights reserved.

  9. Neuropsychology Outcomes Following Trephine Epilepsy Surgery: The Inferior Temporal Gyrus Approach for Amygdalohippocampectomy in Medically Refractory Mesial Temporal Lobe Epilepsy.

    Science.gov (United States)

    Schoenberg, Mike R; Clifton, William E; Sever, Ryan W; Vale, Fernando L

    2017-06-08

    Surgery is indicated in cases of mesial temporal lobe epilepsy(MTLE) that are refractory to medical management. The inferior temporal gyrus (ITG) approach provides access to the mesial temporal lobe (MTL) structures with minimal tissue disruption. Reported neuropsychology outcomes following this approach are limited. To report neuropsychological outcomes using an ITG approach to amygdalohippocampectomy (AH) in patients with medically refractory MTLE based on a prospective design. Fifty-four participants had Engel class I/II outcome following resection of MTL using the ITG approach. All participants had localization-related epilepsy confirmed by long-term surface video-electroencephalography and completed pre/postsurgical evaluations that included magnetic resonance imaging (MRI), Wada test or functional MRI, and neuropsychology assessment. Clinical semiology/video-electroencephalography indicated that of the 54 patients, 28 (52%) had left MTLE and 26 (48%) had right MTLE. Dominant hemisphere resections were performed on 23 patients (43%), nondominant on 31(57%). Twenty-nine (29) had pathology-confirmed mesial temporal sclerosis (MTS). Group level analyses found declines in verbal memory for patients with language-dominant resections ( P .05). Neuropsychology outcomes of an ITG approach for selective mesial temporal resection are comparable to other selective AH techniques showing minimal adverse cognitive effects. These data lend support to the ITG approach for selective AH as an option for MTLE. © Congress of Neurological Surgeons 2017.

  10. Temporal lobe origin is common in patients who have undergone epilepsy surgery for hypermotor seizures.

    Science.gov (United States)

    Arain, Amir M; Azar, Nabil J; Lagrange, Andre H; McLean, Michael; Singh, Pradumna; Sonmezturk, Hasan; Konrad, Peter; Neimat, Joseph; Abou-Khalil, Bassel

    2016-11-01

    Hypermotor seizures are most often reported from the frontal lobe but may also have temporal, parietal, or insular origin. We noted a higher proportion of patients with temporal lobe epilepsy in our surgical cohort who had hypermotor seizures. We evaluated the anatomic localization and surgical outcome in patient with refractory hypermotor seizures who had epilepsy surgery in our center. We identified twenty three patients with refractory hypermotor seizures from our epilepsy surgery database. We analyzed demographics, presurgical evaluation including semiology, MRI, PET scan, interictal/ictal scalp video-EEG, intracranial recording, and surgical outcomes. We evaluated preoperative variables as predictors of outcome. Most patients (65%) had normal brain MRI. Intracranial EEG was required in 20 patients (86.9%). Based on the presurgical evaluation, the resection was anterior temporal in fourteen patients, orbitofrontal in four patients, cingulate in four patients, and temporoparietal in one patient. The median duration of follow-up after surgery was 76.4months. Fourteen patients (60%) had been seizure free at the last follow up while 3 patients had rare disabling seizures. Hypermotor seizures often originated from the temporal lobe in this series of patients who had epilepsy surgery. This large proportion of temporal lobe epilepsy may be the result of a selection bias, due to easier localization and expected better outcome in temporal lobe epilepsy. With extensive presurgical evaluation, including intracranial EEG when needed, seizure freedom can be expected in the majority of patients. Copyright © 2016. Published by Elsevier Inc.

  11. Medial Occipital Lobe Hyperperfusion Identified by Arterial Spin-Labeling: A Poor Prognostic Sign in Patients with Hypoxic-Ischemic Encephalopathy.

    Science.gov (United States)

    de Havenon, A; Sultan-Qurraie, A; Tirschwell, D; Cohen, W; Majersik, J; Andre, J B

    2015-12-01

    Hypoxic-ischemic encephalopathy carries an uncertain prognosis. We sought to retrospectively assess the prognostic value of arterial spin-labeling MR imaging in 22 adult patients diagnosed with hypoxic-ischemic encephalopathy. Quantitative CBF maps were generated from the M0 map, and arterial spin-labeling data on a per-voxel basis were regionally interrogated via visual inspection and ROI placement. Hyperperfusion was defined as regional increases in CBF of >20% (relative to global CBF) and/or >100 mL/100 g/min. Eleven of 22 patients had prominent bilateral medial occipital lobe hyperperfusion, all of whom died before hospital discharge. One patient who had nondistinct arterial spin-labeling hyperperfusion and restricted diffusion survived. Medial occipital lobe hyperperfusion is a distinctive pattern that merits prospective investigation in a cohort of patients with moderate hypoxic-ischemic encephalopathy to determine its predictive ability in patients with a higher likelihood of survival. © 2015 by American Journal of Neuroradiology.

  12. Temporal lobe epilepsy in patients with nonlesional MRI and normal memory: an SEEG study.

    Science.gov (United States)

    Suresh, Suraj; Sweet, Jennifer; Fastenau, Philip S; Lüders, Hans; Landazuri, Patrick; Miller, Jonathan

    2015-12-01

    Temporal lobe epilepsy (TLE) in the absence of MRI abnormalities and memory deficits is often presumed to have an extramesial or even extratemporal source. In this paper the authors report the results of a comprehensive stereoelectroencephalography (SEEG) analysis in patients with TLE with normal MRI images and memory scores. Eighteen patients with medically refractory epilepsy who also had unremarkable MR images and normal verbal and visual memory scores on neuropsychological testing were included in the study. All patients had seizure semiology and video electroencephalography (EEG) findings suggestive of TLE. A standardized SEEG investigation was performed for each patient with electrodes implanted into the mesial and lateral temporal lobe, temporal tip, posterior temporal neocortex, orbitomesiobasal frontal lobe, posterior cingulate gyrus, and insula. This information was used to plan subsequent surgical management. Interictal SEEG abnormalities were observed in the mesial temporal structures in 17 patients (94%) and in the temporal tip in 6 (33%). Seizure onset was exclusively from mesial structures in 13 (72%), exclusively from lateral temporal cortex and/or temporal tip structures in 2 (11%), and independently from mesial and neocortical foci in 3 (17%). No seizure activity was observed arising from any extratemporal location. All patients underwent surgical intervention targeting the temporal lobe and tailored to the SEEG findings, and all experienced significant improvement in seizure frequency with a postoperative follow-up observation period of at least 1 year. This study demonstrates 3 important findings: 1) normal memory does not preclude mesial temporal seizure onset; 2) onset of seizures exclusively from mesial temporal structures without early neocortical involvement is common, even in the absence of memory deficits; and 3) extratemporal seizure onset is rare when video EEG and semiology are consistent with focal TLE.

  13. Emotion recognition and social cognition in temporal lobe epilepsy and the effect of epilepsy surgery.

    Science.gov (United States)

    Amlerova, Jana; Cavanna, Andrea E; Bradac, Ondrej; Javurkova, Alena; Raudenska, Jaroslava; Marusic, Petr

    2014-07-01

    The abilities to identify facial expression from another person's face and to attribute mental states to others refer to preserved function of the temporal lobes. In the present study, we set out to evaluate emotion recognition and social cognition in presurgical and postsurgical patients with unilateral refractory temporal lobe epilepsy (TLE). The aim of our study was to investigate the effects of TLE surgery and to identify the main risk factors for impairment in these functions. We recruited 30 patients with TLE for longitudinal data analysis (14 with right-sided and 16 with left-sided TLE) and 74 patients for cross-sectional data analysis (37 with right-sided and 37 with left-sided TLE) plus 20 healthy controls. Besides standard neuropsychological assessment, we administered an analog of the Ekman and Friesen test and the Faux Pas Test to assess emotion recognition and social cognition, respectively. Both emotion recognition and social cognition were impaired in the group of patients with TLE, irrespective of the focus side, compared with healthy controls. The performance in both tests was strongly dependent on the intelligence level. Beyond intelligence level, earlier age at epilepsy onset, longer disease duration, and history of early childhood brain injury predicted social cognition problems in patients with TLE. Epilepsy surgery within the temporal lobe seems to have neutral effect on patients' performances in both domains. However, there are a few individual patients who appear to be at risk of postoperative decline, even when seizure freedom is achieved following epilepsy surgery. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. Measuring the volume of temporal lobe in healthy Chinese adults of the Han nationality on the high-resolution MRI

    International Nuclear Information System (INIS)

    Jia Kefeng; Wu Li; Duan Hui; Han Dan; Chen Nan; Li Kuncheng

    2010-01-01

    Objective: To explore the morphological features of temporal lobe of healthy Chinese Han adults on the high-resolution MRI and provide morphological data of temporal lobe for the construction of database for Chinese Standard Brain. Methods: This is a clinical multi-center study. Three hundred healthy Chinese volunteers (male 150, and female 150) recruited from 15 hospitals were divided equally into five groups according to their age, i.e., 18-30 (Group A), 31-40 (Group B), 41-50 (Group C), 51- 60(Group D), 61-70(Group E). All subjects were scanned using T 1 WI 3D MPRAGE sequence and volumes of standardized temporal lobe were collected. The bilateral volumes of standardized temporal lobe were compared by variance analysis between male and female subjects and among five age groups. Results: The mean volumes of left and right temporal lobe were (97 126±15 703) mm 3 and (97 015 ± 15 545) mm 3 respectively for men, and (95 123 ± 14 564) mm 3 and (96 423 ± 13 407) mm 3 for women. The difference temporal lobe volume between male and female wasn't significant on the same side (F=1.336, 0.127, P= 0.249, 0.722). The left temporal lobe volumes of Group A-E were (93 873±13 351), (95 566± 11 964), (10 1890 ± 14 511), (93 972 ± 14 050) and (95 636 ± 19 864) mm 3 respectively, and those on the right side were (93 409 ± 10 984), (98 158 ± 16 392), (102 079 ± 15 112), (95 448 ± 11 123) and (94 658 ± 16 928) mm 3 . There were significant differences among 5 groups between left and right temporal lobe volume(F=2.940, 3.514, P=0.021, 0.008). Further pairwise comparison revealed that left and right temporal lobe volume in Group C is higher than those of Group A and D (P 0.05). Conclusion: High-resolution MRI could offer detailed images and precise morphological data of temporal lobe, which provides morphological data of temporal lobe for the construction of database for Chinese Standard Brain. (authors)

  15. Temporal-spatial characteristics of phase-amplitude coupling in electrocorticogram for human temporal lobe epilepsy.

    Science.gov (United States)

    Zhang, Ruihua; Ren, Ye; Liu, Chunyan; Xu, Na; Li, Xiaoli; Cong, Fengyu; Ristaniemi, Tapani; Wang, YuPing

    2017-09-01

    Neural activity of the epileptic human brain contains low- and high-frequency oscillations in different frequency bands, some of which have been used as reliable biomarkers of the epileptogenic brain areas. However, the relationship between the low- and high-frequency oscillations in different cortical areas during the period from pre-seizure to post-seizure has not been completely clarified. We recorded electrocorticogram data from the temporal lobe and hippocampus of seven patients with temporal lobe epilepsy. The modulation index based on the Kullback-Leibler distance and the phase-amplitude coupling co-modulogram were adopted to quantify the coupling strength between the phase of low-frequency oscillations (0.2-10Hz) and the amplitude of high-frequency oscillations (11-400Hz) in different seizure epochs. The time-varying phase-amplitude modulogram was used to analyze the phase-amplitude coupling pattern during the entire period from pre-seizure to post-seizure in both the left and right temporal lobe and hippocampus. Channels with strong modulation index were compared with the seizure onset channels identified by the neurosurgeons and the resection channels in the clinical surgery. The phase-amplitude coupling strength (modulation index) increased significantly in the mid-seizure epoch and decrease significantly in seizure termination and post-seizure epochs (ptemporal cortex and hippocampus. The "fall-max" phase-amplitude modulation pattern, i.e., high-frequency amplitudes were largest in the low-frequency phase range [-π, 0], which corresponded to the falling edges of low-frequency oscillations, appeared in the middle period of the seizures at epileptic focus channels. Channels with strong modulation index appeared on the corresponding left or right temporal cortex of surgical resection and overlapped with the clinical resection zones in all patients. The "fall-max" pattern between the phase of low-frequency oscillation and amplitude of high

  16. Disentangling the cognitive components supporting Austin Maze performance in left versus right temporal lobe epilepsy.

    Science.gov (United States)

    Hocking, Julia; Thomas, Hannah J; Dzafic, Ilvana; Williams, Rebecca J; Reutens, David C; Spooner, Donna M

    2013-12-01

    Neuropsychological tests requiring patients to find a path through a maze can be used to assess visuospatial memory performance in temporal lobe pathology, particularly in the hippocampus. Alternatively, they have been used as a task sensitive to executive function in patients with frontal lobe damage. We measured performance on the Austin Maze in patients with unilateral left and right temporal lobe epilepsy (TLE), with and without hippocampal sclerosis, compared to healthy controls. Performance was correlated with a number of other neuropsychological tests to identify the cognitive components that may be associated with poor Austin Maze performance. Patients with right TLE were significantly impaired on the Austin Maze task relative to patients with left TLE and controls, and error scores correlated with their performance on the Block Design task. The performance of patients with left TLE was also impaired relative to controls; however, errors correlated with performance on tests of executive function and delayed recall. The presence of hippocampal sclerosis did not have an impact on maze performance. A discriminant function analysis indicated that the Austin Maze alone correctly classified 73.5% of patients as having right TLE. In summary, impaired performance on the Austin Maze task is more suggestive of right than left TLE; however, impaired performance on this visuospatial task does not necessarily involve the hippocampus. The relationship of the Austin Maze task with other neuropsychological tests suggests that differential cognitive components may underlie performance decrements in right versus left TLE. © 2013.

  17. Frontal, Striatal, and Medial Temporal Sensitivity to Value Distinguishes Risk-Taking from Risk-Aversive Older Adults during Decision Making.

    Science.gov (United States)

    Goh, Joshua O S; Su, Yu-Shiang; Tang, Yong-Jheng; McCarrey, Anna C; Tereshchenko, Alexander; Elkins, Wendy; Resnick, Susan M

    2016-12-07

    Aging compromises the frontal, striatal, and medial temporal areas of the reward system, impeding accurate value representation and feedback processing critical for decision making. However, substantial variability characterizes age-related effects on the brain so that some older individuals evince clear neurocognitive declines whereas others are spared. Moreover, the functional correlates of normative individual differences in older-adult value-based decision making remain unclear. We performed a functional magnetic resonance imaging study in 173 human older adults during a lottery choice task in which costly to more desirable stakes were depicted using low to high expected values (EVs) of points. Across trials that varied in EVs, participants decided to accept or decline the offered stakes to maximize total accumulated points. We found that greater age was associated with less optimal decisions, accepting stakes when losses were likely and declining stakes when gains were likely, and was associated with increased frontal activity for costlier stakes. Critically, risk preferences varied substantially across older adults and neural sensitivity to EVs in the frontal, striatal, and medial temporal areas dissociated risk-aversive from risk-taking individuals. Specifically, risk-averters increased neural responses to increasing EVs as stakes became more desirable, whereas risk-takers increased neural responses with decreasing EV as stakes became more costly. Risk preference also modulated striatal responses during feedback with risk-takers showing more positive responses to gains compared with risk-averters. Our findings highlight the frontal, striatal, and medial temporal areas as key neural loci in which individual differences differentially affect value-based decision-making ability in older adults. Frontal, striatal, and medial temporal functions implicated in value-based decision processing of rewards and costs undergo substantial age-related changes. However, age

  18. Thalamic glucose metabolism in temporal lobe epilepsy measured with 18F-FDG positron emission tomography (PET)

    NARCIS (Netherlands)

    Khan, N; Leenders, KL; Hajek, M; Maguire, P; Missimer, J; Wieser, HG

    1997-01-01

    Thalamic glucose metabolism has been studied in 24 patients suffering from temporal lobe epilepsy (TLE) using interictal F-18-fluorodeoxyglucose (FDG) positron emission tomography (PET). A total of 17 patients had a unilateral TL seizure onset, 11 of these patients had a mesial temporal lobe

  19. Semantic and episodic memory in children with temporal lobe epilepsy: do they relate to literacy skills?

    Science.gov (United States)

    Lah, Suncica; Smith, Mary Lou

    2014-01-01

    Children with temporal lobe epilepsy are at risk for deficits in new learning (episodic memory) and literacy skills. Semantic memory deficits and double dissociations between episodic and semantic memory have recently been found in this patient population. In the current study we investigate whether impairments of these 2 distinct memory systems relate to literacy skills. 57 children with unilateral temporal lobe epilepsy completed tests of verbal memory (episodic and semantic) and literacy skills (reading and spelling accuracy, and reading comprehension). For the entire group, semantic memory explained over 30% of variance in each of the literacy domains. Episodic memory explained a significant, but rather small proportion (memory impairments (intact semantic/impaired episodic, intact episodic/impaired semantic) were compared, significant reductions in literacy skills were evident only in children with semantic memory impairments, but not in children with episodic memory impairments relative to the norms and to children with temporal lobe epilepsy who had intact memory. Our study provides the first evidence for differential relations between episodic and semantic memory impairments and literacy skills in children with temporal lobe epilepsy. As such, it highlights the urgent need to consider semantic memory deficits in management of children with temporal lobe epilepsy and undertake further research into the nature of reading difficulties of children with semantic memory impairments.

  20. Time reversibility of intracranial human EEG recordings in mesial temporal lobe epilepsy

    Science.gov (United States)

    van der Heyden, M. J.; Diks, C.; Pijn, J. P. M.; Velis, D. N.

    1996-02-01

    Intracranial electroencephalograms from patients suffering from mesial temporal lobe epilepsy were tested for time reversibility. If the recorded time series is irreversible, the input of the recording system cannot be a realisation of a linear Gaussian random process. We confirmed experimentally that the measurement equipment did not introduce irreversibility in the recorded output when the input was a realisation of a linear Gaussian random process. In general, the non-seizure recordings are reversible, whereas the seizure recordings are irreversible. These results suggest that time reversibility is a useful property for the characterisation of human intracranial EEG recordings in mesial temporal lobe epilepsy.

  1. Cerebral infarction secondary to temporal lobe herniation in head trauma: a CT study

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Jae Hyoung; Park, Eui Dong; Kim, Hyung Jin; Han, Jong Woo; Chung, Sung Hoon; Ha, Choong Kun; Kim, Jae Il [College of Medicine, Gyeongsang National University, Jinju (Korea, Republic of)

    1992-11-15

    Cerebral infarction is a known complication of temporal lobe herniation caused by a traumatic intracranial lesion. To ascertain the frequency, time of recognition, and influence on mortality of posttraumatic cerebral infarction secondary to temporal lobe herniation, we retrospectively reviewed brain CT scans and clinical records of 55 patients who had CT and clinical signs of temporal lobe herniation on admission date. Cerebral infarctions were recognized in seven (12.7%) patients on CT scans taken within two days after admission (mean: 1.3 days). Cerebral infarctions were in the terrtiories of the posterior cerebral artery in all seven patients, two of whom had infarctions of the anterior choroidal artery as well. Mortality (71.4%) for these seven patients was not statistically significant from that (50%) of patients without cerebral infarction admitted with the same range of Glasgow Coma Scale score. The result suggests that such cerebral infarction dose not greatly influence patient's mortality.

  2. Triple pathological findings in a surgically amenable patient with mesial temporal lobe epilepsy

    Directory of Open Access Journals (Sweden)

    Fumin Tong

    2015-01-01

    Full Text Available Mesial temporal sclerosis (MTS is a well-recognized cause of intractable epilepsy; however, coexistence with focal cortical dysplasia (FCD is less common. Middle fossa epidermoid cysts are rare and may involve the temporal lobe. Most epidermoids are clinically silent, slow-growing, and seldom associated with overt symptomatology, including seizures. We describe a patient with multiple comorbidities including left MTS and a large epidermoid cyst involving the left quadrigeminal plate cistern compressing upon the cerebellar vermis and tail of the left hippocampus, resulting in refractory left temporal lobe epilepsy. The patient underwent left anterior temporal lobectomy. The surgical pathology demonstrated a third pathological finding of left temporal FCD type Ia. The patient has been seizure-free since the surgery. This case provides additional information with regard to the understanding of epileptogenicity and surgical planning in patients with MTS and epidermoid cysts.

  3. Gray, White Matter Concentration Changes and Their Correlation with Heterotopic Neurons in Temporal Lobe Epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Tae, Woo Suk; Joo, Eun Yun; Kim, Sung Tae; Hong, Seung Bong [Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul (Korea, Republic of)

    2010-02-15

    To identify changes in gray and white matter concentrations (GMC, WMC), and their relation to heterotopic neuron numbers in mesial temporal lobe epilepsy (mTLE). The gray matter or white matter concentrations of 16 left and 15 right mTLE patients who achieved an excellent surgical outcome were compared with those of 24 healthy volunteers for the left group and with 23 healthy volunteers for the right group, by optimized voxel-based morphometry using unmodulated and modulated images. A histologic count of heterotopic neurons was obtained in the white matter of the anterior temporal lobe originating from the patients' surgical specimens. In addition, the number of heterotopic neurons were tested to determine if there was a correlation with the GMC or WMC. The GMCs of the left and right mTLE groups were reduced in the ipsilateral hippocampi, bilateral thalami, precentral gyri, and in the cerebellum. The WMCs were reduced in the ipsilateral white matter of the anterior temporal lobe, bilateral parahippocampal gyri, and internal capsules, but increased in the pons and bilateral precentral gyri. The heterotopic neuron counts in the left mTLE group showed a positive correlation (r = 0.819, p < 0.0001) with GMCs and a negative correlation (r = - 0.839, p < 0.0001) with WMCs in the white matter of the anterior temporal lobe. The present study shows the abnormalities of the cortico-thalamo- hippocampal network including a gray matter volume reduction in the anterior frontal lobes and an abnormality of brain tissue concentration in the pontine area. Furthermore, heterotopic neuron numbers were significantly correlated with GMC or WMC in the left white matter of anterior temporal lobe.

  4. Autobiographical memory in temporal lobe epilepsy: role of hippocampal and temporal lateral structures.

    Science.gov (United States)

    Herfurth, Kirsten; Kasper, Burkhard; Schwarz, Michael; Stefan, Hermann; Pauli, Elisabeth

    2010-11-01

    The present study was aimed at investigating the impact of hippocampal and temporal cortical lesions on remote autobiographical memories in temporal lobe epilepsy (TLE). Episodic specificity, episodic richness, and personal semantic memory from different life periods were assessed using a modified version of the Autobiographical Memory Interview (AMI) (M.D. Kopelman, A.E. Wilson, A. Baddeley, The autobiographical memory interview. Bury St. Edmunds: Thames Valley Test Co.; 1990) in 47 patients with unilateral mesial or lateral TLE and 38 healthy controls. Patients with TLE performed significantly more poorly than controls. Patients with left and right mTLE were equally moderately impaired, but patients with left lateral TLE had the most severe episodic memory deficits, particularly for childhood memories. With respect to personal semantic memory, patients with left TLE were significantly more impaired than those with right TLE, most pronounced for childhood memories. Both autobiographical memory aspects, episodic and personal semantic memory, were significantly intercorrelated, but both did not correlate with anterograde memory, indicating a structural dissociation between both functions. Copyright © 2010 Elsevier Inc. All rights reserved.

  5. Application of dynamic susceptibility contrast-enhanced perfusion in temporal lobe epilepsy

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    Xing, Wu; Wang, Xiaoyi; Xie, Fangfang; Liao, Weihua

    2013-01-01

    Background: Accurately locatithe epileptogenic focus in temporal lobe epilepsy (TLE) is important in clinical practice. Single-photon emission computed tomography (SPECT) and positron-emission tomography (PET) have been widely used in the lateralization of TLE, but both have limitations. Magnetic resonance perfusion imaging can accurately and reliably reflect differences in cerebral blood flow and volume. Purpose: To investigate the diagnostic value of dynamic susceptibility contrast-enhanced (DSC) perfusion magnetic resonance imaging (MRI) in the lateralization of the epileptogenic focus in TLE. Material and Methods: Conventional MRI and DSC-MRI scanning was performed in 20 interictal cases of TLE and 20 healthy volunteers. The relative cerebral blood volume (rCBV) and relative cerebral blood flow (rCBF) of the bilateral mesial temporal lobes of the TLE cases and healthy control groups were calculated. The differences in the perfusion asymmetry indices (AIs), derived from the rCBV and rCBF of the bilateral mesial temporal lobes, were pared between the two groups. Results: In the control group, there were no statistically significant differences between the left and right sides in terms of rCBV (left 1.55 ± 0.32, right 1.57 ± 0.28) or rCBF (left 99.00 ± 24.61, right 100.38 ± 23.46) of the bilateral mesial temporal lobes. However, in the case group the ipsilateral rCBV and rCBF values (1.75 ± 0.64 and 96.35 ± 22.63, respectively) were markedly lower than those of the contralateral side (2.01 ± 0.79 and 108.56 ± 26.92; P < 0.05). Both the AI of the rCBV (AIrCBV; 13.03 ± 10.33) and the AI of the rCBF (AIrCBF; 11.24 ± 8.70) of the case group were significantly higher than that of the control group (AIrCBV 5.55 ± 3.74, AIrCBF 5.12 ± 3.48; P < 0.05). The epileptogenic foci of nine patients were correctly lateralized using the 95th percentile of the AIrCBV and AIrCBF of the control group as the normal upper limits. Conclusion: In patients with TLE interictal

  6. AN INVESTIGATION OF IMPLICIT MEMORY THROUGH LEFT TEMPORAL LOBECTOMY FOR EPILEPSY

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    Tracy, Joseph I.; Osipowicz, Karol; Godofsky, Samuel; Shah, Atif; Khan, Waseem; Sharan, Ashwini; Sperling, Michael R.

    2012-01-01

    Temporal lobe epilepsy patients have demonstrated a relative preservation in the integrity of implicit memory procedures. We examined performance in a verbal implicit and explicit memory task in left anterior temporal lobectomy patients (LATL) and healthy normal controls (NC) while undergoing fMRI. We hypothesized that despite the relative integrity of implicit memory in both the LATL patients and normal controls, the two groups would show distinct functional neuroanatomic profiles during implicit memory. LATLs and NCs performed Jacoby’s Process Dissociation Process (PDP) procedure during fMRI, requiring completion of word stems based on the previously studied words or new/unseen words. Measures of automaticity and recollection provided uncontaminated indices of implicit and explicit memory, respectively. The behavioral data showed that in the face of temporal lobe pathology implicit memory can be carried out, suggesting implicit verbal memory retrieval is non-mesial temporal in nature. Compared to NCs, the LATL patients showed reliable activation, not deactivation, during implicit (automatic) responding. The regions mediating this response were cortical (left medial frontal and precuneus) and striatal. The active regions in LATL patients have the capacity to implement associative, conditioned responses that might otherwise be carried out by a healthy temporal lobe, suggesting this represented a compensatory activity. Because the precuneus has also been implicated in explicit memory, the data suggests this structure may have a highly flexible functionality, capable of supporting implementation of either explicit memory, or automatic processes such as implicit memory retrieval. Our data suggest that a healthy mesial/anterior temporal lobe may be needed for generating the posterior deactivation perceptual priming response seen in normals. PMID:22981890

  7. Bostezo y epilepsia del lóbulo temporal Yawning and temporal lobe epilepsy

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    S. Muchnik

    2003-04-01

    particular de epilepsia temporal.Temporal lobe epilepsy is a partial epileptic disorder in which mesial structures are responsible for the principal ictal symptoms. Its characteristic feature is the recurrence of simple and complex partial seizures, associated with postictal confusion and amnesia of the event. The facilitating effect of NREM sleep on the propagation of the seizure, as well as the sleep abnormalities provoked by epilepsy were evident in our two patients. Yawning is a physiological reflex induced by arousal and drowsiness and may appear in different neurological conditions. Its relation with epilepsy of limbic origen has been rarely reported. We describe in a 95 year old male patient, the occurrence of yawning followed by complex partial seizure during a state of drowsiness. His EEG showed independent bilateral interictal foci of temporal sharp waves and after being medicated with carbamazepine 400mg/day, the episode did not recur. Another patient, a 17 year old female, displayed complex partial seizures and secondarily generalized seizures with yawning during the posictal period, after naps. The EEG was normal and her polysomnography showed bilateral synchronous temporal spikes and slow waves with secondarily generalization during stage 2 of NREM sleep that produce paroxysmal microarousals and increased stages 1 and 2 of NREM sleep and REM sleep diminished. After being medicated with divalproex sodium 750 mg/day, she suffered no futher seizures. Temporal lobe epilepsy, sleep- wake cycles and yawning seem not only to share the same anatomic structures but also the same neurochemical mechanisms. The fact that endogenous opiods are considered as part of a protective system that stop and prevent seizures may allow us to postulate that yawning would be the expression of the endogenous opiods induced mechanisms that stop and prevent the recurrence of the temporal lobe epilepsy. Another hypothesis may be that this is only a particular form of temporal lobe epilepsy.

  8. Long-term effects of neonatal medial temporal ablations on socioemotional behavior in monkeys

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    Málková, Ludise; Mishkin, Mortimer; Suomi, Stephen J.; Bachevalier, Jocelyne

    2010-01-01

    Socioemotional abnormalities, including low levels of social interaction and high levels of self-directed activity, were reported when rhesus monkeys with neonatal ablations of either the medial temporal lobe (AH) or the inferior temporal cortex (TE) were paired with unoperated peers at two and six months of age, though these abnormalities were more severe in the AH group (Bachevalier et al., 2001). As they reached adulthood (Experiment 1), the same monkeys were re-evaluated in the same dyads and their reactivity to novel toys, social status, and reactions to separation from age-matched peers were also assessed. Group TE now showed few if any of the abnormal behaviors observed when they were infants. By contrast, Group AH continued to display low levels of social interaction, high levels of self-directed activity and submissive behavior, and reduced responses to separation, although they reacted normally to novel toys. To determine whether this degree of socioemotional impairment was less severe than that produced by the same damage in adulthood, we assessed dyadic social interactions of monkeys raised until adulthood in laboratory conditions similar to those of the earlier groups and then given the AH ablation (Experiment 2). Two months postoperatively these adult-lesioned monkeys showed a small reduction in social interactions that became more pronounced six months postoperatively, yet remained less severe than that seen in the infant-lesioned monkeys. Also, except for an increase in food and water consumption throughout this 6-month period, they showed no other socioemotional effects. The finding that neonatal AH lesions produce more severe socioemotional disturbances than the same lesion in adulthood is the reverse of the effect commonly reported for other cognitive functions after cerebral damage. PMID:21133531

  9. Usefulness of medial temporal lobe atrophy visual rating scale in detecting Alzheimer′s disease: Preliminary study

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    Jae-Hyeok Heo

    2013-01-01

    Full Text Available Background: The Korean version of Mini-Mental Status Examination (K-MMSE and the Korean version of Addenbrooke Cognitive Examination (K-ACE have been validated as quick neuropsychological tests for screening dementia in various clinical settings. Medial temporal atrophy (MTA is an early pathological characteristic of Alzheimer′s disease (AD. We aimed to assess the diagnostic validity of the fusion of the neuropsychological test and visual rating scale (VRS of MTA in AD. Materials and Methods: A total of fifty subjects (25 AD, 25 controls were included. The neuropsychological tests used were the K-MMSE and the K-ACE. T1 axial imaging visual rating scale (VRS was applied for assessing the grade of MTA. We calculated the fusion score with the difference of neuropsychological test and VRS of MTA. The receiver operating characteristics (ROC curve was used to determine optimal cut-off score, sensitivity and specificity of the fusion scores in screening AD. Results: No significant differences in age, gender and education were found between AD and control group. The values of K-MMSE, K-ACE, CDR, VRS and cognitive function test minus VRS were significantly lower in the AD group than control group. The AUC (Area under the curve, sensitivity and specificity for K-MMSE minus VRS were 0.857, 84% and 80% and for K-ACE minus VRS were 0.884, 80% and 88%, respectively. Those for K-MMSE only were 0.842, 76% and 72% and for K-ACE only were 0.868, 80% and 88%, respectively. Conclusions: The fusion of the neuropsychological test and VRS suggested clinical usefulness in their easy and superiority over neuropsychological test only. However, this study failed to find any difference. This may be because of small numbers in the study or because there is no true difference.

  10. Anatomical pathways for auditory memory II: information from rostral superior temporal gyrus to dorsolateral temporal pole and medial temporal cortex.

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    Muñoz-López, M; Insausti, R; Mohedano-Moriano, A; Mishkin, M; Saunders, R C

    2015-01-01

    Auditory recognition memory in non-human primates differs from recognition memory in other sensory systems. Monkeys learn the rule for visual and tactile delayed matching-to-sample within a few sessions, and then show one-trial recognition memory lasting 10-20 min. In contrast, monkeys require hundreds of sessions to master the rule for auditory recognition, and then show retention lasting no longer than 30-40 s. Moreover, unlike the severe effects of rhinal lesions on visual memory, such lesions have no effect on the monkeys' auditory memory performance. The anatomical pathways for auditory memory may differ from those in vision. Long-term visual recognition memory requires anatomical connections from the visual association area TE with areas 35 and 36 of the perirhinal cortex (PRC). We examined whether there is a similar anatomical route for auditory processing, or that poor auditory recognition memory may reflect the lack of such a pathway. Our hypothesis is that an auditory pathway for recognition memory originates in the higher order processing areas of the rostral superior temporal gyrus (rSTG), and then connects via the dorsolateral temporal pole to access the rhinal cortex of the medial temporal lobe. To test this, we placed retrograde (3% FB and 2% DY) and anterograde (10% BDA 10,000 mW) tracer injections in rSTG and the dorsolateral area 38 DL of the temporal pole. Results showed that area 38DL receives dense projections from auditory association areas Ts1, TAa, TPO of the rSTG, from the rostral parabelt and, to a lesser extent, from areas Ts2-3 and PGa. In turn, area 38DL projects densely to area 35 of PRC, entorhinal cortex (EC), and to areas TH/TF of the posterior parahippocampal cortex. Significantly, this projection avoids most of area 36r/c of PRC. This anatomical arrangement may contribute to our understanding of the poor auditory memory of rhesus monkeys.

  11. Anatomical pathways for auditory memory II: Information from rostral superior temporal gyrus to dorsolateral temporal pole and medial temporal cortex.

    Directory of Open Access Journals (Sweden)

    Monica eMunoz-Lopez

    2015-05-01

    Full Text Available Auditory recognition memory in non-human primates differs from recognition memory in other sensory systems. Monkeys learn the rule for visual and tactile delayed matching-to-sample within a few sessions, and then show one-trial recognition memory lasting 10-20 minutes. In contrast, monkeys require hundreds of sessions to master the rule for auditory recognition, and then show retention lasting no longer than 30-40 seconds. Moreover, unlike the severe effects of rhinal lesions on visual memory, such lesions have no effect on the monkeys’ auditory memory performance. It is possible, therefore, that the anatomical pathways differ. Long-term visual recognition memory requires anatomical connections from the visual association area TE with areas 35 and 36 of the perirhinal cortex (PRC. We examined whether there is a similar anatomical route for auditory processing, or that poor auditory recognition memory may reflect the lack of such a pathway. Our hypothesis is that an auditory pathway for recognition memory originates in the higher order processing areas of the rostral superior temporal gyrus (rSTG, and then connects via the dorsolateral temporal pole to access the rhinal cortex of the medial temporal lobe. To test this, we placed retrograde (3% FB and 2% DY and anterograde (10% BDA 10,000 MW tracer injections in rSTG and the dorsolateral area 38DL of the temporal pole. Results showed that area 38DL receives dense projections from auditory association areas Ts1, TAa, TPO of the rSTG, from the rostral parabelt and, to a lesser extent, from areas Ts2-3 and PGa. In turn, area 38DL projects densely to area 35 of PRC, entorhinal cortex, and to areas TH/TF of the posterior parahippocampal cortex. Significantly, this projection avoids most of area 36r/c of PRC. This anatomical arrangement may contribute to our understanding of the poor auditory memory of rhesus monkeys.

  12. Temporal lobe developmental malformations and epilepsy: dual pathology and bilateral hippocampal abnormalities.

    Science.gov (United States)

    Ho, S S; Kuzniecky, R I; Gilliam, F; Faught, E; Morawetz, R

    1998-03-01

    Temporal lobe developmental malformations (TLDM) with focal cortical dysplasia and balloon cells may coexist with mesial temporal sclerosis. The true incidence of this dual pathology is unknown. Our aim was to assess the frequency of amygdala (AM)-hippocampal abnormality in a homogeneous population with this specific developmental malformation. MRI-based volumetry of the AM and hippocampal formation (HF) in 30 patients with unilateral TLDM and intractable partial epilepsy was performed. A volume normalization process defined a normal range of HF and AM volumes in control subjects, and enabled the detection of bilateral volume loss. Normalized volumes detected HF atrophy in 26 patients (nine unilateral and 17 bilateral) and AM atrophy in 18 patients (three unilateral and 15 bilateral). Visual analysis detected unilateral HF abnormality in 21 patients and bilateral abnormality in two. When compared with a group of patients with temporal lobe epilepsy and pure hippocampal sclerosis (N = 92), where volumetry revealed bilateral HF atrophy in 18%, a significant difference in the frequency of bilateral HF atrophy was found (p Dual pathology is frequent in patients with TLDM (87%), and the AM-HF abnormality is often bilateral (57%). Our data suggest that more widespread and potentially epileptogenic lesions coexist with visibly detectable unilateral TLDM. This has implications for the selection of patients for temporal lobe surgery and may influence surgical strategies.

  13. Temporal anteroinferior encephalocele: An underrecognized etiology of temporal lobe epilepsy?

    Science.gov (United States)

    Saavalainen, Taavi; Jutila, Leena; Mervaala, Esa; Kälviäinen, Reetta; Vanninen, Ritva; Immonen, Arto

    2015-10-27

    To report the increasing frequency with which temporal anteroinferior encephalocele is a cause of adult temporal lobe epilepsy, to illustrate the clinical and imaging characteristics of this condition, and to report its surgical treatment in a series of 23 adult patients. Epilepsy patients diagnosed with temporal anteroinferior encephalocele from January 2006 to December 2013 in a national epilepsy reference center were included in this noninterventional study. Twenty-three epilepsy patients (14 female, mean age 43.8 years) were diagnosed with temporal anteroinferior encephalocele in our institute. Thirteen patients had ≥2 encephaloceles; 7 cases presented bilaterally. The estimated frequency of this condition was 0.3% among MRI examinations performed due to newly diagnosed epilepsy (n = 6) and 1.9% among drug-resistant patients referred to our center (n = 17). Nine patients with local encephalocele disconnection (n = 4) or anterior temporal lobectomy and amygdalohippocampectomy (n = 5) have become seizure-free (Engel 1) for a mean 2.8 years (range 3 months-6.2 years) of follow-up. Three patients with local encephalocele disconnection were almost seizure-free or exhibited worthwhile improvement. Histologically, all 12 surgical patients had gliosis at the base of the encephalocele; some had cortical laminar disorganization (n = 5) or mild hippocampal degeneration (n = 1). The possibility of a temporal encephalocele should be considered when interpreting MRI examinations of patients with medically intractable focal epilepsy. These patients can significantly benefit from unitemporal epilepsy surgery, even in cases with bilateral encephaloceles. © 2015 American Academy of Neurology.

  14. Different types of working memory binding in epilepsy patients with unilateral anterior temporal lobectomy.

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    van Geldorp, Bonnie; Bouman, Zita; Hendriks, Marc P H; Kessels, Roy P C

    2014-03-01

    The medial temporal lobe is an important structure for long-term memory formation, but its role in working memory is less clear. Recent studies have shown hippocampal involvement during working memory tasks requiring binding of information. It is yet unclear whether this is limited to tasks containing spatial features. The present study contrasted three binding conditions and one single-item condition in patients with unilateral anterior temporal lobectomy. A group of 43 patients with temporal lobectomy (23 left; 20 right) and 20 matched controls were examined with a working memory task assessing spatial relational binding (object-location), non-spatial relational binding (object-object), conjunctive binding (object-colour) and working memory for single items. We varied the delay period (3 or 6s), as there is evidence showing that delay length may modulate working memory performance. The results indicate that performance was worse for patients than for controls in both relational binding conditions, whereas patients were unimpaired in conjunctive binding. Single-item memory was found to be marginally impaired, due to a deficit on long-delay trials only. In conclusion, working memory binding deficits are found in patients with unilateral anterior temporal lobectomy. The role of the medial temporal lobe in working memory is not limited to tasks containing spatial features. Rather, it seems to be involved in relational binding, but not in conjunctive binding. The medial temporal lobe gets involved when working memory capacity does not suffice, for example when relations have to be maintained or when the delay period is long. Copyright © 2014 Elsevier Inc. All rights reserved.

  15. Semiautomated volumetry of the cerebrum, cerebellum-brain stem, and temporal lobe on brain magnetic resonance images

    International Nuclear Information System (INIS)

    Hayashi, Norio; Matsuura, Yukihiro; Kawahara, Kazuhiro; Tsujii, Hideo; Yamamoto, Tomoyuki; Sanada, Shigeru; Suzuki, Masayuki; Matsui, Osamu

    2008-01-01

    The aim of this study was to develop an automated method of segmenting the cerebrum, cerebellum-brain stem, and temporal lobe simultaneously on magnetic resonance (MR) images. We obtained T1-weighted MR images from 10 normal subjects and 19 patients with brain atrophy. To perform automated volumetry from MR images, we performed the following three steps: segmentation of the brain region; separation between the cerebrum and the cerebellum-brain stem; and segmentation of the temporal lobe. Evaluation was based on the correctly recognized region (CRR) (i.e., the region recognized by both the automated and manual methods). The mean CRRs of the normal and atrophic brains were 98.2% and 97.9% for the cerebrum, 87.9% and 88.5% for the cerebellum-brain stem, and 76.9% and 85.8% for the temporal lobe, respectively. We introduce an automated volumetric method for the cerebrum, cerebellum-brain stem, and temporal lobe on brain MR images. Our method can be applied to not only the normal brain but also the atrophic brain. (author)

  16. Characterization of neurons in the cortical white matter in human temporal lobe epilepsy.

    Science.gov (United States)

    Richter, Zsófia; Janszky, József; Sétáló, György; Horváth, Réka; Horváth, Zsolt; Dóczi, Tamás; Seress, László; Ábrahám, Hajnalka

    2016-10-01

    The aim of the present work was to characterize neurons in the archi- and neocortical white matter, and to investigate their distribution in mesial temporal sclerosis. Immunohistochemistry and quantification of neurons were performed on surgically resected tissue sections of patients with therapy-resistant temporal lobe epilepsy. Temporal lobe tissues of patients with tumor but without epilepsy and that from autopsy were used as controls. Neurons were identified with immunohistochemistry using antibodies against NeuN, calcium-binding proteins, transcription factor Tbr1 and neurofilaments. We found significantly higher density of neurons in the archi- and neocortical white matter of patients with temporal lobe epilepsy than in that of controls. Based on their morphology and neurochemical content, both excitatory and inhibitory cells were present among these neurons. A subset of neurons in the white matter was Tbr-1-immunoreactive and these neurons coexpressed NeuN and neurofilament marker SMI311R. No colocalization of Tbr1 was observed with the inhibitory neuronal markers, calcium-binding proteins. We suggest that a large population of white matter neurons comprises remnants of the subplate. Furthermore, we propose that a subset of white matter neurons was arrested during migration, highlighting the role of cortical maldevelopment in epilepsy associated with mesial temporal sclerosis. Copyright © 2016 IBRO. Published by Elsevier Ltd. All rights reserved.

  17. Memory, Metamemory and Their Dissociation in Temporal Lobe Epilepsy

    Science.gov (United States)

    Howard, Charlotte E.; Andres, Pilar; Broks, Paul; Noad, Rupert; Sadler, Martin; Coker, Debbie; Mazzoni, Giuliana

    2010-01-01

    Patients with temporal-lobe epilepsy (TLE) present with memory difficulties. The aim of the current study was to determine to what extent these difficulties could be related to a metamemory impairment. Fifteen patients with TLE and 15 matched healthy controls carried out a paired-associates learning task. Memory recall was measured at intervals of…

  18. Neuromagnetic vistas into typical and atypical development of frontal lobe functions

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    Margot J Taylor

    2014-06-01

    Full Text Available The frontal lobes are involved in many higher-order cognitive functions such as social cognition executive functions and language and speech. These functions are complex and follow a prolonged developmental course from childhood through to early adulthood. Magnetoencephalography (MEG is ideal for the study of development of these functions, due to its combination of temporal and spatial resolution which allows the determination of age-related changes in both neural timing and location. There are several challenges for MEG developmental studies: to design tasks appropriate to capture the neurodevelopmental trajectory of these cognitive functions, and to develop appropriate analysis strategies to capture various aspects of neuromagnetic frontal lobe activity. Here, we review our MEG research on social and executive functions, and speech in typically developing children and in two clinical groups – children with ASD and children born very preterm. The studies include facial emotional processing, inhibition, visual short-term memory, speech production and resting-state networks. We present data from event-related analyses as well as on oscillations and connectivity analyses and review their contributions to understanding frontal lobe cognitive development. We also discuss the challenges of testing young children in the MEG and the development of age-appropriate technologies and paradigms.

  19. IMAGING OF BRAIN FUNCTION BASED ON THE ANALYSIS OF FUNCTIONAL CONNECTIVITY - IMAGING ANALYSIS OF BRAIN FUNCTION BY FMRI AFTER ACUPUNCTURE AT LR3 IN HEALTHY INDIVIDUALS.

    Science.gov (United States)

    Zheng, Yu; Wang, Yuying; Lan, Yujun; Qu, Xiaodong; Lin, Kelin; Zhang, Jiping; Qu, Shanshan; Wang, Yanjie; Tang, Chunzhi; Huang, Yong

    2016-01-01

    This Study observed the relevant brain areas activated by acupuncture at the Taichong acupoint (LR3) and analyzed the functional connectivity among brain areas using resting state functional magnetic resonance imaging (fMRI) to explore the acupoint specificity of the Taichong acupoint. A total of 45 healthy subjects were randomly divided into the Taichong (LR3) group, sham acupuncture group and sham acupoint group. Subjects received resting state fMRI before acupuncture, after true (sham) acupuncture in each group. Analysis of changes in connectivity among the brain areas was performed using the brain functional connectivity method. The right cerebrum temporal lobe was selected as the seed point to analyze the functional connectivity. It had a functional connectivity with right cerebrum superior frontal gyrus, limbic lobe cingulate gyrus and left cerebrum inferior temporal gyrus (BA 37), inferior parietal lobule compared by before vs. after acupuncture at LR3, and right cerebrum sub-lobar insula and left cerebrum middle frontal gyrus, medial frontal gyrus compared by true vs. sham acupuncture at LR3, and right cerebrum occipital lobe cuneus, occipital lobe sub-gyral, parietal lobe precuneus and left cerebellum anterior lobe culmen by acupuncture at LR3 vs. sham acupoint. Acupuncture at LR3 mainly specifically activated the brain functional network that participates in visual function, associative function, and emotion cognition, which are similar to the features on LR3 in tradition Chinese medicine. These brain areas constituted a neural network structure with specific functions that had specific reference values for the interpretation of the acupoint specificity of the Taichong acupoint.

  20. Chronic inflammation in refractory hippocampal sclerosis-related temporal lobe epilepsy.

    Science.gov (United States)

    Gales, Jordan M; Prayson, Richard A

    2017-10-01

    Emerging evidence suggests chronic inflammation may play a role in hippocampal sclerosis-associated temporal lobe epilepsy. We sought to systematically evaluate for its presence in a group of 315 patients who underwent surgery for medically-refractory epilepsy and who had hippocampal sclerosis. Upon histologic review of hematoxylin and eosin stained tissue sections, 95 (41%) cases demonstrated the presence of lymphocytes within the perivascular region and diffusely within the brain parenchyma. Those cases with chronic inflammation evident on hematoxylin and eosin staining were significantly more likely to experience a post-operative seizure recurrence than those without it (p=0.03). In 9 cases of hippocampi with chronic inflammation observed on hematoxylin and eosin stained sections, there was a mixture of both T (CD3+) and B (CD20+) lymphocytes located around blood vessels and interspersed within the brain parenchyma and a predominance of CD4 positive T cells versus CD8 positive cells. Ten hippocampi, apparently devoid of chronic inflammation upon inspection with hematoxylin and eosin stained sections, were stained with the lymphocyte common antigen CD45. In all 10 cases, scattered lymphoid cells were observed in the brain parenchyma, suggesting some level of chronic inflammation may be present in more cases than casual inspection might suggest. This study was the first to evaluate the incidence of chronic inflammation within a large temporal lobe epilepsy population. The study findings suggest chronic inflammation may be a more common component of hippocampal sclerosis -associated temporal lobe epilepsy than previously believed. Copyright © 2017 Elsevier Inc. All rights reserved.

  1. [A case of crossed aphasia with echolalia after the resection of tumor in the right medial frontal lobe].

    Science.gov (United States)

    Endo, K; Suzuki, K; Yamadori, A; Kumabe, T; Seki, K; Fujii, T

    2001-03-01

    aphasia with markedly decreased speech and severe comprehension deficit. A patient with a similar lesion in the right medial frontal lobe had aspontaneity in general and language function per se could not be examined properly. Echolalia related to the medial frontal lesion in the language dominant hemisphere was described as a compulsive speech response, because some other 'echoing' phenomena or compulsive behavior were also observed in these patients. On the other hand, some patients with a large lesion in the right hemisphere tended to respond to stimuli directed to other patients, so called 'response-to-next-patient-stimulation'. This behavior was explained by disinhibited shift of attention or perseveration of the set. Both compulsive speech responses and 'response-to-next-patient-stimulation' like phenomena may have contributed to the echolalia phenomena of the present case.

  2. Memory Outcomes Following Selective versus Nonselective Temporal Lobe Removal: A Systematic Review

    Science.gov (United States)

    Girgis, Fady

    2012-01-01

    The surgical removal of brain tissue for the treatment of temporal lobe epilepsy can be either nonselective, as with an anterior temporal lobectomy (ATL), or selective, as with a selective amygdalohippocampectomy (SAH). Although seizure outcomes are similar with both procedures, cognitive and memory outcomes remain a matter of debate. This study…

  3. De novo 12q22.q23.3 duplication associated with temporal lobe epilepsy.

    Science.gov (United States)

    Vari, Maria Stella; Traverso, Monica; Bellini, Tommaso; Madia, Francesca; Pinto, Francesca; Minetti, Carlo; Striano, Pasquale; Zara, Federico

    2017-08-01

    Temporal lobe epilepsy (TLE) is the most common form of focal epilepsy and may be associated with acquired central nervous system lesions or could be genetic. Various susceptibility genes and environmental factors are believed to be involved in the aetiology of TLE, which is considered to be a heterogeneous, polygenic, and complex disorder. Rare point mutations in LGI1, DEPDC5, and RELN as well as some copy number variations (CNVs) have been reported in families with TLE patients. We perform a genetic analysis by Array-CGH in a patient with dysmorphic features and temporal lobe epilepsy. We report a de novo duplication of the long arm of chromosome 12. We confirm that 12q22-q23.3 is a candidate locus for familial temporal lobe epilepsy with febrile seizures and highlight the role of chromosomal rearrangements in patients with epilepsy and intellectual disability. Copyright © 2017 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  4. Alterations of pH and Pi in seizure foci of temporal lobe epilepsy

    International Nuclear Information System (INIS)

    Hubesch, B.; Sappey-Marinier, D.; Laxer, K.; Weiner, M.W.

    1989-01-01

    Previous investigations with positron-emission tomography have demonstrated that glucose uptake is diminished in seizure foci. This paper reports on P-31 MR studies performed on patients with temporal lobe epilepsy in order to determine if metabolic alterations were detectablein seizure foci. In seven of eight patients, the pH of the seizure foci was significantly higher than the pH of the control temporal lobe. In addition, the inorganic phosphate (Pi) concentration was significantly higher in the seizure foci. These metabolic changes indicate that P-31 MR spectroscopymight be useful in the investigation of epilepsy

  5. Gender and hemispheric differences in temporal lobe epilepsy: a VBM study.

    Science.gov (United States)

    Santana, Maria Teresa Castilho Garcia; Jackowski, Andrea Parolin; Britto, Fernanda Dos Santos; Sandim, Gabriel Barbosa; Caboclo, Luís Otávio Sales Ferreira; Centeno, Ricardo Silva; Carrete, Henrique; Yacubian, Elza Márcia Targas

    2014-04-01

    Gender differences are recognized in the functional and anatomical organization of the human brain. Differences between genders are probably expressed early in life, when differential rates of cerebral maturation occur. Sexual dimorphism has been described in temporal lobe epilepsy with mesial temporal sclerosis (TLE-MTS). Several voxel-based morphometry (VBM) studies have shown that TLE-MTS extends beyond mesial temporal structures, and that there are differences in the extent of anatomical damage between hemispheres, although none have approached gender differences. Our aim was to investigate gender differences and anatomical abnormalities in TLE-MTS. VBM5 was employed to analyze gender and hemispheric differences in 120 patients with TLE-MTS and 50 controls. VBM abnormalities were more widespread in left-TLE; while in women changes were mostly seen in temporal areas, frontal regions were more affected in men. Our study confirmed that gender and laterality are important factors determining the nature and severity of brain damage in TLE-MTS. Differential rates of maturation between gender and hemispheres may explain the distinct areas of anatomical damage in men and women. Copyright © 2013 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.

  6. Apolipoprotein E in Temporal Lobe Epilepsy: A Case-Control Study

    Directory of Open Access Journals (Sweden)

    Amit Kumar

    2006-01-01

    Full Text Available Purpose: To investigate the relationship of apolipoprotein E (apoE genotype, plasma levels of apoE and lipids in temporal lobe epilepsy (TLE patients in Asian Indians. Status of plasma levels of Apo E in epilepsy patients has not been reported till date.

  7. Electroclinical findings of minor motor events during sleep in temporal lobe epilepsy.

    Science.gov (United States)

    Giuliano, Loretta; Uccello, Denise; Fatuzzo, Daniela; Mainieri, Greta; Zappia, Mario; Sofia, Vito

    2017-07-01

    It is well known that sleep-related motor seizures can originate from the temporal lobe. However, little is known about the clinical features of minor motor manifestations during sleep in patients with temporal lobe epilepsy. The main objective of our study was to verify the existence of minor motor events during sleep in patients with mesial temporal lobe epilepsy (MTLE) and to define their clinical features and electroencephalography (EEG) correlations. We enrolled in the study patients with diagnosis of symptomatic MTLE and a group of healthy controls. All patients and controls underwent long-term video -EEG monitoring, including at least one night of nocturnal sleep. We analyzed all the movements recorded during nocturnal sleep of patients and controls and their electroencephalographic correlations. We analyzed the nocturnal sleep of 15 patients with symptomatic MTLE (8 males and 7 females; mean age ± standard deviation [SD]31.8 ± 14.9 years) and of 15 healthy controls (6 males and 9 females; mean age ± SD 32.8 ± 11.2 years). The analysis of movements during sleep revealed significant differences between groups, with the patients presenting significantly more movements in sleep than healthy controls (56.7 ± 39.2 vs. 15 ± 6.1; p Epilepsy.

  8. Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging

    Energy Technology Data Exchange (ETDEWEB)

    Kodama, Fumiko; Ogawa, Toshihide; Sugihara, Shuji; Kamba, Masayuki; Kinoshita, Toshibumi [Department of Radiology, Faculty of Medicine' ' Tottori University, 36-1 Nishi-cho, 683-8504, Yonago, Tottori (Japan); Kohaya, Norimasa; Kondo, Shinji [Department of Neurosurgery, Faculty of Medicine' ' Tottori University, 36-1 Nishi-cho, 683-8504, Yonago, Tottori (Japan)

    2003-09-01

    The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal degeneration. In 17 of the 34 patients, MR images were also analyzed after selective amygdalo-hippocampectomy. Atrophy of the fornix, mamillary body, mamillothalamic tract (MTT), and thalamus ipsilateral to the epileptic focus was demonstrated on MR images in 14.7, 17.6, 8.8, and 11.8% of the 34 patients, respectively. Focal hyperintensity of the thalamus was found on T2-weighted images in 8.8% of the 34 patients. In 17 patients who were evaluated before and after surgery, transneuronal degeneration was seen more frequently after surgery: fornix (11.8 vs 29.4%), mamillary body (11.8 vs 52.9%), MTT (5.9 vs 11.8%), and thalamus (11.8 vs 11.8%). Transneuronal degeneration of the limbic system is clearly demonstrated by MR imaging in patients with temporal lobe epilepsy, and surgical intervention induces transneuronal degeneration more frequently. (orig.)

  9. Transneuronal degeneration in patients with temporal lobe epilepsy: evaluation by MR imaging

    International Nuclear Information System (INIS)

    Kodama, Fumiko; Ogawa, Toshihide; Sugihara, Shuji; Kamba, Masayuki; Kinoshita, Toshibumi; Kohaya, Norimasa; Kondo, Shinji

    2003-01-01

    The aim of this study was to assess the MR imaging findings of transneuronal degeneration of limbic system in the patients with temporal lobe epilepsy, and to detect the influence of surgery on the anatomy of the limbic system. Axial and coronal T1- and T2-weighted MR images were retrospectively analyzed in 34 patients with temporal lobe epilepsy, focusing on transneuronal degeneration. In 17 of the 34 patients, MR images were also analyzed after selective amygdalo-hippocampectomy. Atrophy of the fornix, mamillary body, mamillothalamic tract (MTT), and thalamus ipsilateral to the epileptic focus was demonstrated on MR images in 14.7, 17.6, 8.8, and 11.8% of the 34 patients, respectively. Focal hyperintensity of the thalamus was found on T2-weighted images in 8.8% of the 34 patients. In 17 patients who were evaluated before and after surgery, transneuronal degeneration was seen more frequently after surgery: fornix (11.8 vs 29.4%), mamillary body (11.8 vs 52.9%), MTT (5.9 vs 11.8%), and thalamus (11.8 vs 11.8%). Transneuronal degeneration of the limbic system is clearly demonstrated by MR imaging in patients with temporal lobe epilepsy, and surgical intervention induces transneuronal degeneration more frequently. (orig.)

  10. Prenatal ultrasound and MRI findings of temporal and occipital lobe dysplasia in a twin with achondroplasia.

    Science.gov (United States)

    Pugash, D; Lehman, A M; Langlois, S

    2014-09-01

    Thanatophoric dysplasia, hypochondroplasia and achondroplasia are all caused by FGFR3 (fibroblast growth factor receptor 3) mutations. Neuropathological findings of temporal lobe dysplasia are found in thanatophoric dysplasia, and temporal and occipital lobe abnormalities have been described recently in brain imaging studies of children with hypochondroplasia. We describe twins discordant for achondroplasia, in one of whom the prenatal diagnosis was based on ultrasound and fetal MRI documentation of temporal and occipital lobe abnormalities characteristic of hypochondroplasia, in addition to the finding of short long bones. Despite the intracranial findings suggestive of hypochondroplasia, achondroplasia was confirmed following postnatal clinical and genetic testing. These intracranial abnormalities have not been previously described in a fetus with achondroplasia. Copyright © 2014 ISUOG. Published by John Wiley & Sons Ltd.

  11. Material specific lateralization of medial temporal lobe function: An fMRI investigation.

    Science.gov (United States)

    Dalton, Marshall A; Hornberger, Michael; Piguet, Olivier

    2016-03-01

    The theory of material specific lateralization of memory function posits that left and right MTL regions are asymmetrically involved in mnemonic processing of verbal and nonverbal material respectively. Lesion and functional imaging (fMRI) studies provide robust evidence for a left MTL asymmetry in the verbal memory domain. Evidence for a right MTL/nonverbal asymmetry is not as robust. A handful of fMRI studies have investigated this issue but have generally utilised nonverbal stimuli which are amenable to semantic elaboration. This fMRI study aimed to investigate the neural correlates of recognition memory processing in 20 healthy young adults (mean age = 26 years) for verbal stimuli and nonverbal stimuli that were specifically designed to minimize verbalisation. Analyses revealed that the neural correlates of recognition memory processing for verbal and nonverbal stimuli were differentiable and asymmetrically recruited the left and right MTL respectively. The right perirhinal cortex and hippocampus were preferentially involved in successful recognition memory of items devoid of semantic information. In contrast, the left anterior hippocampus was preferentially involved in successful recognition memory of stimuli which contained semantic meaning. These results suggest that the left MTL is preferentially involved in mnemonic processing of verbal/semantic information. In contrast, the right MTL is preferentially involved in visual/non-semantic mnemonic processing. We propose that during development, the left MTL becomes specialised for verbal mnemonic processing due to its proximity with left lateralised cortical language processing areas while visual/non-semantic mnemonic processing gets 'crowded out' to become predominantly, but not completely, the domain of the right MTL. © 2015 Wiley Periodicals, Inc.

  12. Memory Functioning in Children with Epilepsy: Frontal Lobe Epilepsy, Childhood Absence Epilepsy, and Benign Epilepsy with Centrotemporal Spikes

    OpenAIRE

    Lopes, Ana Filipa; Monteiro, José Paulo; Fonseca, Maria José; Robalo, Conceição; Simões, Mário Rodrigues

    2014-01-01

    Specific cognitive deficits have been identified in children with epilepsy irrespective of results on intelligence tests. Memory deficits are traditionally attributed to temporal lobe epilepsy, whereas the impact of frontal lobe epilepsy on memory functions has remained controversial. The aim of this study was the examination of memory abilities in other childhood common epilepsy syndromes (frontal lobe epilepsy (FLE), childhood absence epilepsy (CAE), and benign epilepsy with centrotemporal ...

  13. Association fiber pathways to the frontal cortex from the superior temporal region in the rhesus monkey

    International Nuclear Information System (INIS)

    Petrides, M.; Pandya, D.N.

    1988-01-01

    The projections to the frontal cortex that originate from the various areas of the superior temporal region of the rhesus monkey were investigated with the autoradiographic technique. The results demonstrated that the rostral part of the superior temporal gyrus (areas Pro, Ts1, and Ts2) projects to the proisocortical areas of the orbital and medial frontal cortex, as well as to the nearby orbital areas 13, 12, and 11, and to medial areas 9, 10, and 14. These fibers travel to the frontal lobe as part of the uncinate fascicle. The middle part of the superior temporal gyrus (areas Ts3 and paAlt) projects predominantly to the lateral frontal cortex (areas 12, upper 46, and 9) and to the dorsal aspect of the medial frontal lobe (areas 9 and 10). Only a small number of these fibers terminated within the orbitofrontal cortex. The temporofrontal fibers originating from the middle part of the superior temporal gyrus occupy the lower portion of the extreme capsule and lie just dorsal to the fibers of the uncinate fascicle. The posterior part of the superior temporal gyrus projects to the lateral frontal cortex (area 46, dorsal area 8, and the rostralmost part of dorsal area 6). Some of the fibers from the posterior superior temporal gyrus run initially through the extreme capsule and then cross the claustrum as they ascend to enter the external capsule before continuing their course to the frontal lobe. A larger group of fibers curves round the caudalmost Sylvian fissure and travels to the frontal cortex occupying a position just above and medial to the upper branch of the circular sulcus. This latter pathway constitutes a part of the classically described arcuate fasciculus

  14. Association fiber pathways to the frontal cortex from the superior temporal region in the rhesus monkey.

    Science.gov (United States)

    Petrides, M; Pandya, D N

    1988-07-01

    The projections to the frontal cortex that originate from the various areas of the superior temporal region of the rhesus monkey were investigated with the autoradiographic technique. The results demonstrated that the rostral part of the superior temporal gyrus (areas Pro, Ts1, and Ts2) projects to the proisocortical areas of the orbital and medial frontal cortex, as well as to the nearby orbital areas 13, 12, and 11, and to medial areas 9, 10, and 14. These fibers travel to the frontal lobe as part of the uncinate fascicle. The middle part of the superior temporal gyrus (areas Ts3 and paAlt) projects predominantly to the lateral frontal cortex (areas 12, upper 46, and 9) and to the dorsal aspect of the medial frontal lobe (areas 9 and 10). Only a small number of these fibers terminated within the orbitofrontal cortex. The temporofrontal fibers originating from the middle part of the superior temporal gyrus occupy the lower portion of the extreme capsule and lie just dorsal to the fibers of the uncinate fascicle. The posterior part of the superior temporal gyrus projects to the lateral frontal cortex (area 46, dorsal area 8, and the rostralmost part of dorsal area 6). Some of the fibers from the posterior superior temporal gyrus run initially through the extreme capsule and then cross the claustrum as they ascend to enter the external capsule before continuing their course to the frontal lobe. A larger group of fibers curves round the caudalmost Sylvian fissure and travels to the frontal cortex occupying a position just above and medial to the upper branch of the circular sulcus. This latter pathway constitutes a part of the classically described arcuate fasciculus.

  15. Association fiber pathways to the frontal cortex from the superior temporal region in the rhesus monkey

    Energy Technology Data Exchange (ETDEWEB)

    Petrides, M.; Pandya, D.N.

    1988-07-01

    The projections to the frontal cortex that originate from the various areas of the superior temporal region of the rhesus monkey were investigated with the autoradiographic technique. The results demonstrated that the rostral part of the superior temporal gyrus (areas Pro, Ts1, and Ts2) projects to the proisocortical areas of the orbital and medial frontal cortex, as well as to the nearby orbital areas 13, 12, and 11, and to medial areas 9, 10, and 14. These fibers travel to the frontal lobe as part of the uncinate fascicle. The middle part of the superior temporal gyrus (areas Ts3 and paAlt) projects predominantly to the lateral frontal cortex (areas 12, upper 46, and 9) and to the dorsal aspect of the medial frontal lobe (areas 9 and 10). Only a small number of these fibers terminated within the orbitofrontal cortex. The temporofrontal fibers originating from the middle part of the superior temporal gyrus occupy the lower portion of the extreme capsule and lie just dorsal to the fibers of the uncinate fascicle. The posterior part of the superior temporal gyrus projects to the lateral frontal cortex (area 46, dorsal area 8, and the rostralmost part of dorsal area 6). Some of the fibers from the posterior superior temporal gyrus run initially through the extreme capsule and then cross the claustrum as they ascend to enter the external capsule before continuing their course to the frontal lobe. A larger group of fibers curves round the caudalmost Sylvian fissure and travels to the frontal cortex occupying a position just above and medial to the upper branch of the circular sulcus. This latter pathway constitutes a part of the classically described arcuate fasciculus.

  16. Surgical Management and Long-Term Seizure Outcome After Surgery for Temporal Lobe Epilepsy Associated with Cerebral Cavernous Malformations.

    Science.gov (United States)

    Yang, Peng-Fan; Pei, Jia-Sheng; Jia, Yan-Zeng; Lin, Qiao; Xiao, Hui; Zhang, Ting-Ting; Zhong, Zhong-Hui

    2018-02-01

    Operative strategies for cerebral cavernous malformation (CCM)-associated temporal lobe epilepsy and timing of surgical intervention continue to be debated. This study aimed to establish an algorithm to evaluate the efficacy of surgical intervention strategies, to maximize positive surgical outcomes and minimize postsurgical neurologic deficits. 47 patients having undergone operation for CCM-associated temporal lobe epilepsy were retrospectively reviewed. They had received a diagnostic series for seizure localization, including long-term video electroencephalography (vEEG), high-resolution magnetic resonance imaging (MRI), and positron emission tomography-computed tomography (PET-CT). In patients with mesial temporal lobe CCMs, the involved structures (amygdala, hippocampus, or parahippocampal gyrus) were resected in addition to the lesions. Patients with neocortical epileptogenic CCM underwent extended lesionectomy guided by intraoperative electrocorticography; further performance of amygdalohippocampectomy depended on the extent of hippocampal epileptogenicity. The study cohort contained 28 patients with drug-resistant epilepsy (DRE), 12 with chronic epilepsy (CE), and 7 with sporadic seizure (SS). Normal temporal lobe metabolism was seen in 7/7 patients of the SS group. Hypometabolism was found in all patients with chronic disease except for those with posterior inferior and middle temporal gyrus cavernous malformations (CMs). Of the 31 patients with superficial neocortical CCM, 7 had normal PET without hippocampal sclerosis, 14 had ipsilateral temporal lobe hypometabolism without hippocampal sclerosis, and 10 had obvious hippocampal sclerosis and hypometabolism. Seizure freedom in DRE, CE, and SS was 82.1%, 75%, and 100%, respectively. A significant difference was found between lesion laterality and postoperative seizure control; the rate was lower in left-sided cases because of less aggressive resection. Our study demonstrates that the data from the

  17. Resting-state functional connectivity predicts the strength of hemispheric lateralization for language processing in temporal lobe epilepsy and normals.

    Science.gov (United States)

    Doucet, Gaëlle E; Pustina, Dorian; Skidmore, Christopher; Sharan, Ashwini; Sperling, Michael R; Tracy, Joseph I

    2015-01-01

    In temporal lobe epilepsy (TLE), determining the hemispheric specialization for language before surgery is critical to preserving a patient's cognitive abilities post-surgery. To date, the major techniques utilized are limited by the capacity of patients to efficiently realize the task. We determined whether resting-state functional connectivity (rsFC) is a reliable predictor of language hemispheric dominance in right and left TLE patients, relative to controls. We chose three subregions of the inferior frontal cortex (pars orbitalis, pars triangularis, and pars opercularis) as the seed regions. All participants performed both a verb generation task and a resting-state fMRI procedure. Based on the language task, we computed a laterality index (LI) for the resulting network. This revealed that 96% of the participants were left-hemisphere dominant, although there remained a large degree of variability in the strength of left lateralization. We tested whether LI correlated with rsFC values emerging from each seed. We revealed a set of regions that was specific to each group. Unique correlations involving the epileptic mesial temporal lobe were revealed for the right and left TLE patients, but not for the controls. Importantly, for both TLE groups, the rsFC emerging from a contralateral seed was the most predictive of LI. Overall, our data depict the broad patterns of rsFC that support strong versus weak left hemisphere language laterality. This project provides the first evidence that rsFC data may potentially be used on its own to verify the strength of hemispheric dominance for language in impaired or pathologic populations. © 2014 Wiley Periodicals, Inc.

  18. Individual variation in the propensity for prospective thought is associated with functional integration between visual and retrosplenial cortex.

    Science.gov (United States)

    Villena-Gonzalez, Mario; Wang, Hao-Ting; Sormaz, Mladen; Mollo, Giovanna; Margulies, Daniel S; Jefferies, Elizabeth A; Smallwood, Jonathan

    2018-02-01

    It is well recognized that the default mode network (DMN) is involved in states of imagination, although the cognitive processes that this association reflects are not well understood. The DMN includes many regions that function as cortical "hubs", including the posterior cingulate/retrosplenial cortex, anterior temporal lobe and the hippocampus. This suggests that the role of the DMN in cognition may reflect a process of cortical integration. In the current study we tested whether functional connectivity from uni-modal regions of cortex into the DMN is linked to features of imaginative thought. We found that strong intrinsic communication between visual and retrosplenial cortex was correlated with the degree of social thoughts about the future. Using an independent dataset, we show that the same region of retrosplenial cortex is functionally coupled to regions of primary visual cortex as well as core regions that make up the DMN. Finally, we compared the functional connectivity of the retrosplenial cortex, with a region of medial prefrontal cortex implicated in the integration of information from regions of the temporal lobe associated with future thought in a prior study. This analysis shows that the retrosplenial cortex is preferentially coupled to medial occipital, temporal lobe regions and the angular gyrus, areas linked to episodic memory, scene construction and navigation. In contrast, the medial prefrontal cortex shows preferential connectivity with motor cortex and lateral temporal and prefrontal regions implicated in language, motor processes and working memory. Together these findings suggest that integrating neural information from visual cortex into retrosplenial cortex may be important for imagining the future and may do so by creating a mental scene in which prospective simulations play out. We speculate that the role of the DMN in imagination may emerge from its capacity to bind together distributed representations from across the cortex in a

  19. [Neural Mechanisms Underlying the Processing of Temporal Information in Episodic Memory and Its Disturbance].

    Science.gov (United States)

    Iwata, Saeko; Tsukiura, Takashi

    2017-11-01

    Episodic memory is defined as memory for personally experienced events, and includes memory content and contextual information of time and space. Previous neuroimaging and neuropsychological studies have demonstrated three possible roles of the temporal context in episodic memory. First, temporal information contributes to the arrangement of temporal order for sequential events in episodic memory, and this process is involved in the lateral prefrontal cortex. The second possible role of temporal information in episodic memory is the segregation between memories of multiple events, which are segregated by cues of different time information. The role of segregation is associated with the orbitofrontal regions including the orbitofrontal cortex and basal forebrain region. Third, temporal information in episodic memory plays an important role in the integration of multiple components into a coherent episodic memory, in which episodic components in the different modalities are combined by temporal information as an index. The role of integration is mediated by the medial temporal lobe including the hippocampus and parahippocampal gyrus. Thus, temporal information in episodic memory could be represented in multiple stages, which are involved in a network of the lateral prefrontal, orbitofrontal, and medial temporal lobe regions.

  20. Evaluation of refractory temporal lobe epilepsy of nontumorous origin with qualitative and quantitative MR imaging

    International Nuclear Information System (INIS)

    Tanna, N.K.; Zimmerman, R.A.; Sperling, M.R.; Kohn, M.I.

    1990-01-01

    This paper reports that although MR imaging is superior to CT in the detection of focal lesions in refractory temporal lobe epilepsy (TLE), its role in the detection of mesial temporal sclerosis remains controversial. This is significant, as the latter represents a frequent cause of TLE and manifests with only subtle atrophic changes and occasional high signal abnormalities. PReoperative MR images of 47 patients who had undergone temporal lobectomy for nontumoral TLE and of 20 control subjects were valuated for focal atrophy and hippocampal high signal abnormalities. Quantitative measurements were performed in 33 patients and 20 control subjects with use of a new brain volumetric analysis program to determine volumes of temporal lobes

  1. Temporal lobe deficits in murderers: EEG findings undetected by PET.

    Science.gov (United States)

    Gatzke-Kopp, L M; Raine, A; Buchsbaum, M; LaCasse, L

    2001-01-01

    This study evaluates electroencephalography (EEG) and positron emission tomography (PET) in the same subjects. Fourteen murderers were assessed by using both PET (while they were performing the continuous performance task) and EEG during a resting state. EEG revealed significant increases in slow-wave activity in the temporal, but not frontal, lobe in murderers, in contrast to prior PET findings that showed reduced prefrontal, but not temporal, glucose metabolism. Results suggest that resting EEG shows empirical utility distinct from PET activation findings.

  2. Benign mesial temporal lobe epilepsy: A clinical cohort and literature review.

    Science.gov (United States)

    AlQassmi, Amal; Burneo, Jorge G; McLachlan, Richard S; Mirsattari, Seyed M

    2016-12-01

    We present a single-center retrospective study of benign mesial temporal lobe epilepsy (bMTLE) between 1995 and 2014. Hospital records and clinic charts were reviewed. The clinical, Eelectroencephalographic (EEG), imaging features, and response to treatment with antiepileptic drugs (AEDs) were documented. Patients were included in this study if they were seizure-free for a minimum of 24months with or without an AED. Twenty-seven patients were identified. There were 19 (70%) females, mean age at first seizure was 32.2 (range: 15-80years). In all patients, seizures were mild, and seizure freedom was readily achieved with the initiation of AED therapy. Sixteen patients (59%) had mesial temporal sclerosis (MTS). In three patients, we attempted to discontinue AED therapy after a prolonged period of remission (5-8years), but all had seizure recurrence within 2 to 4weeks. Not all temporal lobe epilepsy is refractory to medication, despite the presence of MTS. Until clinical trials indicate otherwise, surgery is not indicated but life-long medical treatment is advocated. Copyright © 2016 Elsevier Inc. All rights reserved.

  3. Brain Regions Underlying Word Finding Difficulties in Temporal Lobe Epilepsy

    Science.gov (United States)

    Trebuchon-Da Fonseca, Agnes; Guedj, Eric; Alario, F-Xavier; Laguitton, Virginie; Mundler, Olivier; Chauvel, Patrick; Liegeois-Chauvel, Catherine

    2009-01-01

    Word finding difficulties are often reported by epileptic patients with seizures originating from the language dominant cerebral hemisphere, for example, in temporal lobe epilepsy. Evidence regarding the brain regions underlying this deficit comes from studies of peri-operative electro-cortical stimulation, as well as post-surgical performance.…

  4. Surgical techniques in radiation induced temporal lobe necrosis in nasopharyngeal carcinoma patients.

    Science.gov (United States)

    Alfotih, Gobran Taha Ahmed; Zheng, Mei Guang; Cai, Wang Qing; Xu, Xin Ke; Hu, Zhen; Li, Fang Cheng

    2016-01-01

    Radiation induced brain injury ranges from acute reversible edema to late, irreversible radiation necrosis. Radiation induced temporal lobe necrosis is associated with permanent neurological deficits and occasionally progresses to death. We present our experience with surgery on radiation induced temporal lobe necrosis (RTLN) in nasopharyngeal carcinoma (NPC) patients with special consideration of clinical presentation, surgical technique, and outcomes. This retrospective study includes 12 patients with RTLN treated by the senior author between January 2010 and December 2014. Patients initially sought medical treatment due to headache; other symptoms were hearing loss, visual deterioration, seizure, hemiparesis, vertigo, memory loss and agnosia. A temporal approach through a linear incision was performed for all cases. RTLN was found in one side in 7 patients, and bilaterally in 5. 4 patients underwent resection of necrotic tissue bilaterally and 8 patients on one side. No death occurred in this series of cases. There were no post-operative complications, except 1 patient who developed aseptic meningitis. All 12 patients were free from headache. No seizure occurred in patients with preoperative epilepsy. Other symptoms such as hemiparesis and vertigo improved in all patients. Memory loss, agnosia and hearing loss did not change post-operatively in all cases. The follow-up MR images demonstrated no recurrence of necrotic lesions in all 12 patients. Neurosurgical intervention through a temporal approach with linear incision is warranted in patients with radiation induced temporal lobe necrosis with significant symptoms and signs of increased intracranial pressure, minimum space occupying effect on imaging, or neurological deterioration despite conservative management. Copyright © 2016 Polish Neurological Society. Published by Elsevier Urban & Partner Sp. z o.o. All rights reserved.

  5. Hyperphosphorylated tau in patients with refractory epilepsy correlates with cognitive decline: a study of temporal lobe resections.

    Science.gov (United States)

    Tai, Xin You; Koepp, Matthias; Duncan, John S; Fox, Nick; Thompson, Pamela; Baxendale, Sallie; Liu, Joan Y W; Reeves, Cheryl; Michalak, Zuzanna; Thom, Maria

    2016-09-01

    SEE BERNASCONI DOI101093/AWW202 FOR A SCIENTIFIC COMMENTARY ON THIS ARTICLE: Temporal lobe epilepsy, the most prevalent form of chronic focal epilepsy, is associated with a high prevalence of cognitive impairment but the responsible underlying pathological mechanisms are unknown. Tau, the microtubule-associated protein, is a hallmark of several neurodegenerative diseases including Alzheimer's disease and chronic traumatic encephalopathy. We hypothesized that hyperphosphorylated tau pathology is associated with cognitive decline in temporal lobe epilepsy and explored this through clinico-pathological study. We first performed pathological examination on tissue from 33 patients who had undergone temporal lobe resection between ages 50 and 65 years to treat drug-refractory temporal lobe epilepsy. We identified hyperphosphorylated tau protein using AT8 immunohistochemistry and compared this distribution to Braak patterns of Alzheimer's disease and patterns of chronic traumatic encephalopathy. We quantified tau pathology using a modified tau score created specifically for analysis of temporal lobectomy tissue and the Braak staging, which was limited without extra-temporal brain areas available. Next, we correlated tau pathology with pre- and postoperative cognitive test scores and clinical risk factors including age at time of surgery, duration of epilepsy, history of secondary generalized seizures, history of head injury, handedness and side of surgery. Thirty-one of 33 cases (94%) showed hyperphosphorylated tau pathology in the form of neuropil threads and neurofibrillary tangles and pre-tangles. Braak stage analysis showed 12% of our epilepsy cohort had a Braak staging III-IV compared to an age-matched non-epilepsy control group from the literature (8%). We identified a mixture of tau pathology patterns characteristic of Alzheimer's disease and chronic traumatic encephalopathy. We also found unusual patterns of subpial tau deposition, sparing of the hippocampus and

  6. Outcome of intracranial electroencephalography monitoring and surgery in magnetic resonance imaging-negative temporal lobe epilepsy.

    Science.gov (United States)

    Lee, Ricky W; Hoogs, Marietta M; Burkholder, David B; Trenerry, Max R; Drazkowski, Joseph F; Shih, Jerry J; Doll, Karey E; Tatum, William O; Cascino, Gregory D; Marsh, W Richard; Wirrell, Elaine C; Worrell, Gregory A; So, Elson L

    2014-07-01

    We evaluated the outcomes of intracranial electroencephalography (iEEG) recording and subsequent resective surgery in patients with magnetic resonance imaging (MRI)-negative temporal lobe epilepsy (TLE). Thirty-two patients were identified from the Mayo Clinic Epilepsy Surgery Database (Arizona, Florida, and Minnesota). Eight (25.0%) had chronic iEEG monitoring that recorded neocortical temporal seizure onsets; 12 (37.5%) had mesial temporal seizure onsets; 5 (15.6%) had independent neocortical and mesial temporal seizure onsets; and 7 (21.9%) had simultaneous neocortical and mesial seizure onsets. Neocortical temporal lobe seizure semiology was the only factor significantly associated with neocortical temporal seizure onsets on iEEG. Only 33.3% of patients who underwent lateral temporal neocorticectomy had an Engel class 1 outcome, whereas 76.5% of patients with iEEG-guided anterior temporal lobectomy that included the amygdala and the hippocampus had an Engel class 1 outcome. Limitations in cohort size precluded statistical analysis of neuropsychological test data. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. The relationship between frontal and temporal lobe lesions in traumatic brain injury and procedural memory

    International Nuclear Information System (INIS)

    Kato, Noriaki; Okazaki, Tetsuya; Hachisuka, Kenji

    2008-01-01

    We examined the correlation between the location of chronic phase brain damage identified by a head MRI and the procedural memory test results in patients who have sustained a traumatic brain injury (TBI). Subjects were 27 patients with TBI, who completed all of three procedural memory tasks (mirror-reading, mirror-drawing, and Tower of Toronto). Using a head MRI, the presence or absence of lesions in the frontal lobe and the temporal lobe were determined. To evaluate declarative memory, we implemented the Wechsler Memory Scale-Rivesed (WMS-R), Rivermead Behavioral Memory Test (RBMT), and Rey-Osterrieth Complex Figure Test (3-minute delayed recall). All three of procedural memory tasks were repeated 3 times a day for 3 consecutive days. The rate of improvement (%) of the procedural memory task was determined as {average of the results on the first day- average of the results on the third day)/average of the results on the first day} x 100. We obtained the rate of improvement for each of the three tasks. The patients were divided according to the existence of frontal and temporal lobe lesions in brain MRI, and then rates of improvement were compared by the existence of frontal or temporal lesion using the Mann-Whitney test. In result, the average value of the declarative memory test results was within the range of disorders for all items. On the procedural memory tasks, the rate of improvement did not significantly decrease by the presence of frontal or temporal lobe lesion. It is believed that the basal ganglia and the cerebellum are significantly involved in procedural memory. Also in TBI patients, the procedural memory tends to be retained. Our results suggest that frontal and temporal lobe lesions, which are frequently found in traumatic brain injury, are not likely to be related to procedural memory. (author)

  8. Altered medial temporal activation related to local glutamate levels in subjects with prodromal signs of psychosis.

    OpenAIRE

    Valli, I; Stone, J; Mechelli, A; Bhattacharyya, S; Raffin, M; Allen, P; Fusar-Poli, P; Lythgoe, D; O'Gorman, R; Seal, M; McGuire, P

    2011-01-01

    In individuals at high risk of psychosis, medial temporal dysfunction seemed related to a loss of the normal relationship with local glutamate levels. This study provides the first evidence that links medial temporal dysfunction with the central glutamate system in humans and is consistent with evidence that drugs that modulate glutamatergic transmission might be useful in the treatment of psychosis.

  9. [A surgical case of mesial temporal lobe epilepsy associated with hippocampal sclerosis and traumatic neocortical lesion].

    Science.gov (United States)

    Kitazawa, Yu; Jin, Kazutaka; Iwasaki, Masaki; Suzuki, Hiroyoshi; Tanaka, Fumiaki; Nakasato, Nobukazu

    2017-11-25

    A 26-year-old right-handed woman, with a history of left temporal lobe contusion caused by a fall at the age of 9 months, started to have complex partial seizures with oral automatism at the age of 7 years. The seizures occurred once or twice a month despite combination therapy with several antiepileptic agents. Her history and imaging studies suggested the diagnosis of epilepsy arising from traumatic neocortical temporal lesion. Comprehensive assessment including long-term video EEG monitoring, MRI, FDG-PET, MEG, and neuropsychological evaluation was performed at the age of 26 years. The diagnosis was left mesial temporal lobe epilepsy associated with hippocampal atrophy and traumatic temporal cortical lesion. The patient was readmitted for surgical treatment at the age of 27 years. Intracranial EEG monitoring showed that ictal discharges started in the left hippocampus and spread to the traumatic lesion in the left posterior superior temporal gyrus 10 seconds after the onset. This case could not be classified as dual pathology exactly, because the traumatic left temporal cortical lesion did not show independent epileptogenicity. However, the traumatic lesion was highly likely to be the source of the epileptogenicity, and she had right hemispheric dominance for language and functional deterioration in the whole temporal cortex. Therefore, left amygdalo-hippocampectomy and left temporal lobectomy including the traumatic lesion were performed according to the diagnosis of dual pathology. Subsequently, she remained seizure-free for 3 years. Comprehensive assessment of seizure semiology, neurophysiology, neuroradiology, and neuropsychology is important to determine the optimum therapeutic strategies for drug-resistant epilepsy.

  10. Representation of thermal information in the antennal lobe of leaf-cutting ants

    Directory of Open Access Journals (Sweden)

    Markus eRuchty

    2010-11-01

    Full Text Available Insects are equipped with various types of antennal sensilla, which house thermosensitive neurons adapted to receive different parameters of the thermal environment for a variety of temperature-guided behaviors. In the leaf-cutting ant Atta vollenweideri, the physiology and the morphology of the thermosensitive sensillum coeloconicum (Sc has been thoroughly investigated. However, the central projections of its receptor neurons are unknown. Here we selectively stained the three neurons found in single Sc and tracked their axons into the brain of Atta vollenweideri workers. Each of the three axons terminates in a single glomerulus of the antennal lobe (Sc-glomeruli. Two of the innervated glomeruli are adjacent to each other and are located laterally, while the third one is clearly separated and located medially in the antennal lobe. Using two-photon Ca2+ imaging of antennal lobe projection neurons, we studied where in the antennal lobe thermal information is represented. In the 11 investigated antennal lobes, we found up to 10 different glomeruli in a single specimen responding to temperature stimulation. Both, warm- and cold-sensitive glomeruli could be identified. The thermosensitive glomeruli were mainly located in the medial part of the antennal lobe. Based on the general representation of thermal information in the antennal lobe and functional data on the Sc-glomeruli we conclude that temperature stimuli received by Sc are processed in the medial of the three target glomeruli. The present study reveals an important role of the antennal lobe in temperature processing and links a specific thermosensitive neuron to its central target glomerulus.

  11. Accelerated cognitive decline in a rodent model for temporal lobe epilepsy

    NARCIS (Netherlands)

    Schipper, Sandra; Aalbers, Marlien W.; Rijkers, Kim; Lagiere, Melanie; Bogaarts, Jan G.; Blokland, Arjan; Klinkenberg, Sylvia; Hoogland, Govert; Vles, Johan S. H.

    2016-01-01

    Objective: Cognitive impairment is frequently observed in patients with temporal lobe epilepsy. It is hypothesized that cumulative seizure exposure causes accelerated cognitive decline in patients with epilepsy. We investigated the influence of seizure frequency on cognitive decline in a rodent

  12. Thalamotemporal impairment in temporal lobe epilepsy: a combined MRI analysis of structure, integrity, and connectivity.

    Science.gov (United States)

    Keller, Simon S; O'Muircheartaigh, Jonathan; Traynor, Catherine; Towgood, Karren; Barker, Gareth J; Richardson, Mark P

    2014-02-01

    Thalamic abnormality in temporal lobe epilepsy (TLE) is well known from imaging studies, but evidence is lacking regarding connectivity profiles of the thalamus and their involvement in the disease process. We used a novel multisequence magnetic resonance imaging (MRI) protocol to elucidate the relationship between mesial temporal and thalamic pathology in TLE. For 23 patients with TLE and 23 healthy controls, we performed T1 -weighted (for analysis of tissue structure), diffusion tensor imaging (tissue connectivity), and T1 and T2 relaxation (tissue integrity) MRI across the whole brain. We used connectivity-based segmentation to determine connectivity patterns of thalamus to ipsilateral cortical regions (occipital, parietal, prefrontal, postcentral, precentral, and temporal). We subsequently determined volumes, mean tractography streamlines, and mean T1 and T2 relaxometry values for each thalamic segment preferentially connecting to a given cortical region, and of the hippocampus and entorhinal cortex. As expected, patients had significant volume reduction and increased T2 relaxation time in ipsilateral hippocampus and entorhinal cortex. There was bilateral volume loss, mean streamline reduction, and T2 increase of the thalamic segment preferentially connected to temporal lobe, corresponding to anterior, dorsomedial, and pulvinar thalamic regions, with no evidence of significant change in any other thalamic segments. Left and right thalamotemporal segment volume and T2 were significantly correlated with volume and T2 of ipsilateral (epileptogenic), but not contralateral (nonepileptogenic), mesial temporal structures. These convergent and robust data indicate that thalamic abnormality in TLE is restricted to the area of the thalamus that is preferentially connected to the epileptogenic temporal lobe. The degree of thalamic pathology is related to the extent of mesial temporal lobe damage in TLE. © 2014 The Authors. Epilepsia published by Wiley Periodicals, Inc

  13. Improvement in the performance of CAD for the Alzheimer-type dementia based on automatic extraction of temporal lobe from coronal MR images

    International Nuclear Information System (INIS)

    Kaeriyama, Tomoharu; Kodama, Naoki; Kaneko, Tomoyuki; Shimada, Tetsuo; Tanaka, Hiroyuki; Takeda, Ai; Fukumoto, Ichiro

    2004-01-01

    In this study, we extracted whole brain and temporal lobe images from MR images (26 healthy elderly controls and 34 Alzheimer-type dementia patients) by means of binarize, mask processing, template matching, Hough transformation, and boundary tracing etc. We assessed the extraction accuracy by comparing the extracted images to images extracts by a radiological technologist. The results of assessment by consistent rate; brain images 91.3±4.3%, right temporal lobe 83.3±6.9%, left temporal lobe 83.7±7.6%. Furthermore discriminant analysis using 6 textural features demonstrated sensitivity and specificity of 100% when the healthy elderly controls were compared to the Alzheimer-type dementia patients. Our research showed the possibility of automatic objective diagnosis of temporal lobe abnormalities by automatic extracted images of the temporal lobes. (author)

  14. Decreased occipital lobe metabolism by FDG-PET/CT

    Science.gov (United States)

    Solnes, Lilja; Nalluri, Abhinav; Cohen, Jesse; Jones, Krystyna M.; Zan, Elcin; Javadi, Mehrbod S.; Venkatesan, Arun

    2017-01-01

    Objective: To compare brain metabolism patterns on fluorodeoxyglucose (FDG)-PET/CT in anti–NMDA receptor and other definite autoimmune encephalitis (AE) and to assess how these patterns differ between anti–NMDA receptor neurologic disability groups. Methods: Retrospective review of clinical data and initial dedicated brain FDG-PET/CT studies for neurology inpatients with definite AE, per published consensus criteria, treated at a single academic medical center over a 10-year period. Z-score maps of FDG-PET/CT were made using 3-dimensional stereotactic surface projections in comparison to age group–matched controls. Brain region mean Z scores with magnitudes ≥2.00 were interpreted as significant. Comparisons were made between anti–NMDA receptor and other definite AE patients as well as among patients with anti–NMDA receptor based on modified Rankin Scale (mRS) scores at the time of FDG-PET/CT. Results: The medial occipital lobes were markedly hypometabolic in 6 of 8 patients with anti–NMDA receptor encephalitis and as a group (Z = −4.02, interquartile range [IQR] 2.14) relative to those with definite AE (Z = −2.32, 1.46; p = 0.004). Among patients with anti–NMDA receptor encephalitis, the lateral and medial occipital lobes were markedly hypometabolic for patients with mRS 4–5 (lateral occipital lobe Z = −3.69, IQR 1; medial occipital lobe Z = −4.08, 1) compared with those with mRS 0–3 (lateral occipital lobe Z = −0.83, 2; p occipital lobe Z = −1.07, 2; p = 0.001). Conclusions: Marked medial occipital lobe hypometabolism by dedicated brain FDG-PET/CT may serve as an early biomarker for discriminating anti–NMDA receptor encephalitis from other AE. Resolution of lateral and medial occipital hypometabolism may correlate with improved neurologic status in anti–NMDA receptor encephalitis. PMID:29159205

  15. Transcortical selective amygdalohippocampectomy technique through the middle temporal gyrus revisited: An anatomical study laboratory investigation.

    Science.gov (United States)

    Bozkurt, Baran; da Silva Centeno, Ricardo; Chaddad-Neto, Feres; da Costa, Marcos Devanir Silva; Goiri, Marcelo Augusto Acosta; Karadag, Ali; Tugcu, Bekir; Ovalioglu, Talat Cem; Tanriover, Necmettin; Kaya, Serdar; Yagmurlu, Kaan; Grande, Andrew

    2016-12-01

    The anterior temporal lobectomy (ATL) and selective amygdalohippocampectomy (SelAH) have been used for surgical treatment of mesial temporal lobe epilepsy. We examined the comprehensive white matter tract anatomy of the temporal lobe to gain an insight into the trans-middle temporal gyrus, a lateral approach which has been commonly used. The transmiddle temporal gyrus approach was performed in a stepwise manner on cadaveric human heads to examine the traversing white matter pathways through it and the structures located in the temporal horn. We reviewed the literature to compare the trans-middle temporal gyrus approach with other SelAH techniques based on surgical outcomes. There does not appear to be a significant difference in seizure outcome between SelAH and ATL. However, the SelAH provides a better neuropsychological outcomes than the ATL in selected patients. Each SelAH approach has individual advantages and disadvantages. Based on our anatomical study, in the transcortical amygdalohippocampectomy technique through the middle temporal gyrus the white matter pathways to be encountered. In the temporal horn, the collateral eminence, hippocampus, lateral ventricular sulcus, choroidal fissure, inferior choroidal point, choroid plexus, fimbria of the fornix, and amygdala are exposed. The subpial dissection is performed along the lateral ventricular sulcus from the collateral eminence on lateral side and from the choroidal fissure on medial side by microdissector for en bloc resection of the hippocampus proper. The trans-middle temporal gyrus approach is commonly used in treatment of mesial temporal lobe epilepsy patients. A better anatomical and functional understanding of the structures of the temporal lobe is crucial for safer and more accurate surgery. Copyright © 2016 Elsevier Ltd. All rights reserved.

  16. A single subconvulsant dose of domoic acid at mid-gestation does not cause temporal lobe epilepsy in mice.

    Science.gov (United States)

    Demars, Fanny; Clark, Kristen; Wyeth, Megan S; Abrams, Emily; Buckmaster, Paul S

    2018-05-01

    Harmful blooms of domoic acid (DA)-producing algae are a problem in oceans worldwide. DA is a potent glutamate receptor agonist that can cause status epilepticus and in survivors, temporal lobe epilepsy. In mice, one-time low-dose in utero exposure to DA was reported to cause hippocampal damage and epileptiform activity, leading to the hypothesis that unrecognized exposure to DA from contaminated seafood in pregnant women can damage the fetal hippocampus and initiate temporal lobe epileptogenesis. However, development of epilepsy (i.e., spontaneous recurrent seizures) has not been tested. In the present study, long-term seizure monitoring and histology was used to test for temporal lobe epilepsy following prenatal exposure to DA. In Experiment One, the previous study's in utero DA treatment protocol was replicated, including use of the CD-1 mouse strain. Afterward, mice were video-monitored for convulsive seizures from 2 to 6 months old. None of the CD-1 mice treated in utero with vehicle or DA was observed to experience spontaneous convulsive seizures. After seizure monitoring, mice were evaluated for pathological evidence of temporal lobe epilepsy. None of the mice treated in utero with DA displayed the hilar neuron loss that occurs in patients with temporal lobe epilepsy and in the mouse pilocarpine model of temporal lobe epilepsy. In Experiment Two, a higher dose of DA was administered to pregnant FVB mice. FVB mice were tested as a potentially more sensitive strain, because they have a lower seizure threshold, and some females spontaneously develop epilepsy. Female offspring were monitored with continuous video and telemetric bilateral hippocampal local field potential recording at 1-11 months old. A similar proportion of vehicle- and DA-treated female FVB mice spontaneously developed epilepsy, beginning in the fourth month of life. Average seizure frequency and duration were similar in both groups. Seizure frequency was lower than that of positive

  17. High-field magnetic resonance imaging of the human temporal lobe

    Directory of Open Access Journals (Sweden)

    Luis M. Colon-Perez

    2015-01-01

    Conclusions: Fresh ex vivo MR imaging, along with tractography, revealed complex intra-temporal structural variation corresponding to neuronal cell body layers, dendritic fields, and axonal projection systems evident histologically. This is the first study to describe in detail the human temporal lobe structural organization using high-field MR imaging and tractography. By preserving the 3-dimensional structures of the hippocampus and surrounding structures, specific changes in anatomy may inform us about the changes that occur in TLE in relation to the disease process and structural underpinnings in epilepsy-related memory dysfunction.

  18. Accelerated cognitive decline in a rodent model for temporal lobe epilepsy.

    Science.gov (United States)

    Schipper, Sandra; Aalbers, Marlien W; Rijkers, Kim; Lagiere, Melanie; Bogaarts, Jan G; Blokland, Arjan; Klinkenberg, Sylvia; Hoogland, Govert; Vles, Johan S H

    2016-12-01

    Cognitive impairment is frequently observed in patients with temporal lobe epilepsy. It is hypothesized that cumulative seizure exposure causes accelerated cognitive decline in patients with epilepsy. We investigated the influence of seizure frequency on cognitive decline in a rodent model for temporal lobe epilepsy. Neurobehavioral assessment was performed before and after surgery, after the induction of self-sustaining limbic status epilepticus (SSLSE), and in the chronic phase in which rats experienced recurrent seizures. Furthermore, we assessed potential confounders of memory performance. Rats showed a deficit in spatial working memory after the induction of the SSLSE, which endured in the chronic phase. A progressive decline in recognition memory developed in SSLSE rats. Confounding factors were absent. Seizure frequency and also the severity of the status epilepticus were not correlated with the severity of cognitive deficits. The effect of the seizure frequency on cognitive comorbidity in epilepsy has long been debated, possibly because of confounders such as antiepileptic medication and the heterogeneity of epileptic etiologies. In an animal model of temporal lobe epilepsy, we showed that a decrease in spatial working memory does not relate to the seizure frequency. This suggests for other mechanisms are responsible for memory decline and potentially a common pathophysiology of cognitive deterioration and the occurrence and development of epileptic seizures. Identifying this common denominator will allow development of more targeted interventions treating cognitive decline in patients with epilepsy. The treatment of interictal symptoms will increase the quality of life of many patients with epilepsy. Copyright © 2016 Elsevier Inc. All rights reserved.

  19. Proton MR spectroscopy in patients with acute temporal lobe seizures.

    Science.gov (United States)

    Castillo, M; Smith, J K; Kwock, L

    2001-01-01

    Decreases in N-acetyl aspartate (NAA) as seen by proton MR spectroscopy are found in hippocampal sclerosis, and elevated levels of lipids/lactate have been observed after electroconvulsive therapy. Our purpose was to determine whether increased levels of lipids/lactate are found in patients with acute seizures of hippocampal origin. Seventeen patients with known temporal lobe epilepsy underwent proton MR spectroscopy of the mesial temporal lobes within 24 hours of their last seizure. Four of them were restudied when they were seizure-free. Five healthy individuals were used as control subjects. All MR spectroscopy studies were obtained using a single-voxel technique with TEs of 135 and 270. The relationship between the presence of lipids/lactate and seizures was tested using Fisher's exact test. Mean and standard deviations for NAA/creatine (Cr) were obtained in the hippocampi in patients with seizures on initial and follow-up studies and these values were compared with those in the control subjects. Seizure lateralization was obtained in 15 patients. Of the 17 seizure locations that involved hippocampi, 16 showed lipids/lactate by proton MR spectroscopy. Of the 13 hippocampi not directly affected by seizures, 10 showed no lipids/lactate and three showed lipids/lactate. The relationship between lipids/lactate and seizure location was confirmed. A comparison of NAA/Cr ratios for the involved hippocampi with those in control subjects showed significant differences on initial MR spectroscopy; however, no significant difference was found between acute and follow-up NAA/Cr ratios in hippocampi affected by seizures. Lipids/lactate were present in the hippocampi of patients with acute seizures and decreased when the patients were seizure-free. Thus, lipids/lactate may be a sensitive marker for acute temporal lobe seizures.

  20. Progressively Disrupted Intrinsic Functional Connectivity of Basolateral Amygdala in Very Early Alzheimer’s Disease

    Directory of Open Access Journals (Sweden)

    Marion Ortner

    2016-09-01

    Full Text Available Abstract:Very early Alzheimer’s disease (AD - i.e., AD at stages of mild cognitive impairment (MCI and mild dementia - is characterized by progressive structural and neuropathologic changes such as atrophy or tangle deposition in medial temporal lobes, including hippocampus and entorhinal cortex but also adjacent amygdala. While progressively disrupted intrinsic connectivity of hippocampus with other brain areas has been demonstrated by many studies, amygdala connectivity was rarely investigated in AD, notwithstanding its known relevance for emotion processing and mood disturbances, which are both important in early AD. Intrinsic functional connectivity (iFC patterns of hippocampus and amygdala overlap in healthy persons. Thus, we hypothesized that increased alteration of iFC patterns along AD is not limited to the hippocampus but also concerns the amygdala, independent from atrophy. To address this hypothesis, we applied structural and functional resting-state MRI in healthy controls (CON, n=33 and patients with AD in the stages of MCI (AD-MCI, n=38 and mild dementia (AD-D, n=36. Outcome measures were voxel-based morphometry (VBM values and region of interest-based intrinsic functional connectivity maps (iFC of basolateral amygdala, which has extended cortical connectivity. Amygdala VBM values were progressively reduced in patients (CON > AD-MCI and AD-D. Amygdala iFC was progressively reduced along impairment severity (CON > AD-MCI > AD-D, particularly for hippocampus, temporal lobes, and fronto-parietal areas. Notably, decreased iFC was independent of amygdala atrophy. Results demonstrate progressively impaired amygdala intrinsic connectivity in temporal and fronto-parietal lobes independent from increasing amygdala atrophy in very early AD. Data suggest that early AD disrupts intrinsic connectivity of medial temporal lobe key regions including that of amygdala.

  1. White matter abnormalities in the anterior temporal lobe suggest the side of the seizure foci in temporal lobe epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Adachi, Y.; Yagishita, A. [Tokyo Metropolitan Neurological Hospital, Department of Neuroradiology, Fuchu, Tokyo (Japan); Arai, N. [Tokyo Metropolitan Neurological Institute, Department of Clinical Neuropathology, Fuchu, Tokyo (Japan)

    2006-07-15

    White matter abnormalities in the anterior temporal lobe (WAATL) are sometimes observed on magnetic resonance (MR) images of patients with temporal lobe epilepsy (TLE). Our purpose was to determine whether WAATL could indicate if the seizure foci are ipsilateral on electroencephalograms (EEG) in TLE patients. We reviewed 112 consecutive patients with medically intractable TLE.