Cognitive effects of resecting basal temporal language areas
Cognitive effects of resecting basal temporal language areas
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DOI：
10.1111/j.1528-1157.1996.tb00594.x
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发表时间：
1996-05-01
期刊：
影响因子：
5.6
通讯作者：
Lesser, RP
中科院分区：
文献类型：
--
作者：
Krauss, GL;Fisher, R;Lesser, RP
在癫痫患者行部分颞叶切除术之前，对优势半球的基底颞区进行电刺激有时会导致语言功能暂时中断，但切除该区域的意义尚不清楚。我们评估了基底颞叶语言区（BTLA）切除与某些类型的术后语言障碍之间的相关性。在25例患者中，我们用皮层电刺激绘制了下外侧颞叶，用三维计算机断层扫描（CT）验证了刺激电极的位置。80%的患者在刺激下出现短暂的语言障碍，特别是在对抗命名和理解测试中。BTLA主要位于梭状回，距颞尖1 ~ 9 cm。在术后6-12个月的测试中，BTLA切除术的患者在对抗命名测试中的表现（平均下降9%）比没有BTLA切除术的患者（平均改善4%）差（p = 0.03）。切除的大小占较少的方差减少对抗命名比切除的BTLA。性能测试T.Q. (PIQ)语言智商(VIQ)两组之间在单词和言语学习的再认记忆方面没有显著差异。大多数患者在基底颞叶距尖端5-6 cm处切除后，即使切除BTLA，也不会出现语言能力下降。然而，有些患者的命名能力持续下降。
Electrical stimulation of the basal temporal region of the dominant hemisphere before partial temporal lobectomy for epilepsy sometimes produces temporary interruption of language function, but the significance of removal of this area is unknown. We evaluated the correlation between resection of the basal temporal language areas (BTLA) and certain types of postoperative language deficits. In a population of 25 patients, we mapped the inferolateral temporal lobe with cortical electrical stimulation, verifying the positions of the stimulating electrodes with three-dimensional computed tomography (CT). Eighty percent of the patients developed transient language deficits with stimulation, particularly with tests of confrontation naming and comprehension. BTLA was primarily located in the fusiform gyrus, from 1 to 9 cm from the temporal tip. At testing 6-12 months after operation, patients with BTLA resection performed worse (mean 9% decrease) than those with no BTLA resection (mean 4% improvement) on tests of confrontation naming (p = 0.03). Resection size accounted for less of the variance in decrease in confrontation naming than did resection of the BTLA. Tests of performance T.Q. (PIQ), verbal I.Q. (VIQ), or recognition memory for word and verbal learning showed no significant difference between these groups. Most patients do not have language decrease with removal of basal temporal lobe 5-6 cm from the tip, even with removal of BTLA. Some patients, however, have persistent decrease in naming.