Hippocampal activation correlates with visual confrontation naming: fMRI findings in controls and patients with temporal lobe epilepsy.
Hippocampal activation correlates with visual confrontation naming: fMRI findings in controls and patients with temporal lobe epilepsy.
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DOI：
10.1016/j.eplepsyres.2011.04.007
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发表时间：
2011-08
影响因子：
2.2
通讯作者：
Koepp, Matthias J.
中科院分区：
文献类型：
--
作者：
Bonelli, Silvia B.;Powell, Rob;Thompson, Pamela J.;Yogarajah, Mahinda;Focke, Niels K.;Stretton, Jason;Vollmar, Christian;Symms, Mark R.;Price, Cathy J.;Duncan, John S.;Koepp, Matthias J.
在海马硬化（HS）导致的左颞叶癫痫（TLE）患者中，命名能力下降是常见的，这表明左颞叶内侧在这项任务中起着关键作用。我们用功能磁共振成像（fMRI）研究了对照组和TLE患者语言网络的完整性。我们对22名对照组和66名单侧近中颞叶癫痫患者（37名左侧HS，29名右侧HS）进行了fMRI语言流畅性研究。语言流畅性和命名能力作为标准术前神经心理学评估的一部分进行了研究。使用视觉对抗命名测试评估可解释性。左侧TLE患者的命名评分显著低于对照组和右侧TLE患者。右侧TLE患者的表现不如对照组，但优于左侧TLE患者。左颞叶癫痫患者的语言流畅性评分显著低于对照组。在对照组和右侧TLE中，语言流畅性任务期间左侧海马的激活与命名显著相关，其特征在于海马fMRI激活程度越高的受试者得分越高。在左侧TLE中，在左侧海马中未观察到与命名分数的相关性，但在左侧额中回和额下回中存在显著相关性，而在对照组和右侧TLE中未观察到。在左侧和右侧TLE中，扫描仪外语言流畅性评分与左侧额中回和额下回的语言流畅性fMRI激活显著相关。良好的对抗命名能力取决于海马体和连接额颞叶网络的完整性。在健康对照组和右侧TLE患者中，语言流畅性过程中左侧海马的功能性MRI激活与命名功能相关。在左侧TLE中，当命名更熟练时，有证据表明左额叶参与，最有可能反映了由于持续的癫痫活动和/或潜在病理学引起的代偿反应。
In patients with left temporal lobe epilepsy (TLE) due to hippocampal sclerosis (HS) decreased naming ability is common, suggesting a critical role for the medial left temporal lobe in this task. We investigated the integrity of language networks with functional MRI (fMRI) in controls and TLE patients. We performed an fMRI verbal fluency paradigm in 22 controls and 66 patients with unilateral mesial TLE (37 left HS, 29 right HS). Verbal fluency and naming ability were investigated as part of the standard presurgical neuropsychological assessment. Naming ability was assessed using a visual confrontation naming test. Left TLE patients had significantly lower naming scores than controls and those with right TLE. Right TLE patients performed less well than controls, but better than those with left TLE. Left TLE had significantly lower scores for verbal fluency than controls. In controls and right TLE, left hippocampal activation during the verbal fluency task was significantly correlated with naming, characterised by higher scores in subjects with greater hippocampal fMRI activation. In left TLE no correlation with naming scores was seen in the left hippocampus, but there was a significant correlation in the left middle and inferior frontal gyri, not observed in controls and right TLE. In left and right TLE, out of scanner verbal fluency scores significantly correlated with fMRI activation for verbal fluency in the left middle and inferior frontal gyri. Good confrontation naming ability depends on the integrity of the hippocampus and the connecting fronto-temporal networks. Functional MRI activation in the left hippocampus during verbal fluency is associated with naming function in healthy controls and patients with right TLE. In left TLE, there was evidence of involvement of the left frontal lobe when naming was more proficient, most likely reflecting a compensatory response due to the ongoing epileptic activity and/or underlying pathology.
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