Characterization of atypical language activation patterns in focal epilepsy.
Characterization of atypical language activation patterns in focal epilepsy.
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DOI：
10.1002/ana.24015
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发表时间：
2014-01
影响因子：
11.2
通讯作者：
Gaillard, William D.
中科院分区：
文献类型：
--
作者：
Berl, Madison M.;Zimmaro, Lauren A.;Khan, Omar I.;Dustin, Irene;Ritzl, Eva;Duke, Elizabeth S.;Sepeta, Leigh N.;Sato, Susumu;Theodore, William H.;Gaillard, William D.
功能磁共振成像对语言网络模式的变化很敏感。需要大量的人群来严格评估非典型模式，即使在神经系统人群中，也是少数。我们研究了220名局灶性癫痫患者和118名健康志愿者，他们进行了听觉描述决策任务。我们将数据驱动的层次聚类方法与常用的先验偏侧指数（LI）阈值（LI < 0.20为非典型）进行了比较，以分类额叶和颞叶感兴趣区域内的语言模式。我们探讨了（n = 128）是否智商不同的语言激活模式。非典型语言在健康志愿者（2.5%）和患者（24.5%）中的比率与以前的研究一致，但是，我们发现了6种非典型语言模式：对称双侧，2单侧交叉，3右优势模式。分类方法之间有很高的一致性，但聚类分析揭示了新的相关性与临床特征。除了左撇子、早期癫痫发作和血管病理与非典型语言的既定关联外，聚类分析还发现了惯用手与额叶偏侧化、早期癫痫发作与颞叶偏侧化、左半球病灶与单侧右侧模式的关联。各模式间智商差异不显著。语言优势是一个连续体，然而，我们的研究结果表明，在分类偏侧有意义的阈值。非典型语言模式比典型语言模式频率低，但变化更大，对准确的术前规划提出了挑战。语言优势应在区域而不是半球的基础上进行评估，临床特征应告知非典型语言优势的评估。语言的重组并不总是对语言功能有害。
Functional magnetic resonance imaging is sensitive to the variation in language network patterns. Large populations are needed to rigorously assess atypical patterns, which, even in neurological populations, are a minority. We studied 220 patients with focal epilepsy and 118 healthy volunteers who performed an auditory description decision task. We compared a data-driven hierarchical clustering approach to the commonly used a priori laterality index (LI) threshold (LI < 0.20 as atypical) to classify language patterns within frontal and temporal regions of interest. We explored (n = 128) whether IQ varied with different language activation patterns. The rate of atypical language among healthy volunteers (2.5%) and patients (24.5%) agreed with previous studies; however, we found 6 patterns of atypical language: a symmetrically bilateral, 2 unilaterally crossed, and 3 right dominant patterns. There was high agreement between classification methods, yet the cluster analysis revealed novel correlations with clinical features. Beyond the established association of left-handedness, early seizure onset, and vascular pathology with atypical language, cluster analysis identified an association of handedness with frontal lateralization, early seizure onset with temporal lateralization, and left hemisphere focus with a unilateral right pattern. Intelligence quotient was not significantly different among patterns. Language dominance is a continuum; however, our results demonstrate meaningful thresholds in classifying laterality. Atypical language patterns are less frequent but more variable than typical language patterns, posing challenges for accurate presurgical planning. Language dominance should be assessed on a regional rather than hemispheric basis, and clinical characteristics should inform evaluation of atypical language dominance. Reorganization of language is not uniformly detrimental to language functioning.
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DOI：
10.1073/pnas.0402680101
发表时间：
2004-05-25
影响因子：
11.1
作者：
Gogtay, N;Giedd, JN;Thompson, PM
通讯作者：
Thompson, PM
影响因子：
9.9
作者：
Gaillard, WD;Balsamo, L;Theodore, WH
通讯作者：
Theodore, WH
影响因子：
5.7
作者：
Holland, SK;Plante, E;Ball, WS
通讯作者：
Ball, WS
影响因子：
56.9
作者：
Just, MA;Carpenter, PA;Thulborn, KR
通讯作者：
Thulborn, KR
影响因子：
5.6
作者：
Bonelli SB;Thompson PJ;Yogarajah M;Vollmar C;Powell RH;Symms MR;McEvoy AW;Micallef C;Koepp MJ;Duncan JS
通讯作者：
Duncan JS