Use of preoperative functional MRI to predict verbal memory decline after temporal lobe epilepsy surgery
Use of preoperative functional MRI to predict verbal memory decline after temporal lobe epilepsy surgery
复制标题
DOI：
10.1111/j.1528-1167.2008.01625.x
复制
发表时间：
2008-08-01
期刊：
影响因子：
5.6
通讯作者：
Mueller, Wade M.
中科院分区：
文献类型：
--
作者：
Binder, Jeffrey R.;Sabsevitz, David S.;Mueller, Wade M.
目的：语言记忆减退是左前颞叶切除术（L-ATL）的常见并发症。本研究的目的是确定是否术前语言映射功能磁共振成像（fMRI）是有用的预测哪些患者可能会遇到语言记忆力下降后L-ATL.Methods：60例L-ATL患者进行术前语言映射功能磁共振成像，术前颈动脉内异戊巴比妥（Wada）测试语言和记忆偏侧化，和术前和术后神经心理学测试。检查了人口统计学、历史、神经心理学和成像变量预测术前至术后记忆变化的能力。结果：超过30%的患者出现言语记忆下降。良好的术前表现，癫痫发作时的年龄晚，功能磁共振成像的左侧优势，和Wada测试的左侧优势都是记忆力下降的预测因素。术前表现和发病时的年龄共同解释了大约50%的记忆结果差异（p < 0.001），而功能磁共振成像解释了另外10%的差异（p < 0.001）。
Purpose: Verbal memory decline is a frequent complication of left anterior temporal lobectomy (L-ATL). The goal of this study was to determine whether preoperative language mapping using functional magnetic resonance imaging (fMRI) is useful for predicting which patients are likely to experience verbal memory decline after L-ATL.Methods: Sixty L-ATL patients underwent preoperative language mapping with fMRI, preoperative intracarotid amobarbital (Wada) testing for language and memory lateralization, and pre- and postoperative neuropsychological testing. Demographic, historical, neuropsychological, and imaging variables were examined for their ability to predict pre- to postoperative memory change.Results: Verbal memory decline occurred in over 30% of patients. Good preoperative performance, late age at onset of epilepsy, left dominance on fMRI, and left dominance on the Wada test were each predictive of memory decline. Preoperative performance and age at onset together accounted for roughly 50% of the variance in memory outcome (p < 0.001), and fMRI explained an additional 10% of this variance (p