Pre- and postsurgical memory performance in patients with temporal and frontal lobe epilepsy

癫痫手术是颞叶癫痫（TLE）和额叶癫痫（FLE）患者的有效治疗选择，这些患者通常难以医学治疗。癫痫手术的主要副作用之一是术后记忆功能的恶化。迄今为止，还不可能从单个患者的术前数据可靠地预测手术后记忆功能的变化。我们的项目旨在提高对手术前记忆功能及其潜在神经关联的理解。这将有助于更好地理解癫痫手术对TLE和FLE患者术后记忆的改变。首先，将比较TLE和FLE患者的术前记忆表现和术后改变程度。在这种情况下，损伤定位对记忆性能的影响将是分析的主要焦点。我们将使用基于体素的症状-病变映射方法来检测与术前和术后记忆损伤特别相关的病变和切除部位。其次，在手术前使用多模态fMRI学习范式来识别与颞叶或额叶脑损伤特别相关的记忆相关神经。与记忆任务相关的术前fMRI激活将与术前和术后记忆的神经心理学测量相关联。我们的目的是提高对TLE和FLE患者术后记忆变化的预测。为此，我们将开发一个多因素预测模型。除了癫痫相关的临床因素和神经心理学测量外，该模型还将包含手术前评估的基于mri的参数，即来自我们学习范式的fMRI激活，来自语言流畅性fMRI任务，基于默认模式网络的功能连接数据，弥散张量成像和基于体素的形态测量数据。在测试了这些参数的预测值之后，我们将把最好的预测因子组合到一个加权的多因子模型中。总之，该项目将有助于了解手术治疗的TLE和FLE患者的遗忘功能和术后变化。通过研究脑外科手术前后的这些“人类损伤模型”，它将对颞叶和额叶脑区域对记忆过程的贡献提供普遍的见解。

Epilepsy surgery is an effective treatment option in patients with temporal lobe epilepsy (TLE) and in patients with frontal lobe epilepsy (FLE) who are often difficult to treat medically. One of the main side effects of epilepsy surgery are postsurgical deteriorations of memory functions. To date, it is not possible to reliably predict postsurgical changes of mnestic functions from presurgical data in individual patients.Our project aims at improving the understanding of presurgical mnestic functions and their underlying neural correlates. It will contribute to a better understanding of postsurgical memory changes caused by epilepsy surgery in patients with TLE and FLE. In a first step, presurgical memory performance and the extent of postsurgical changes will be compared between TLE and FLE patients. In this context, the effect of lesion localisation on memory performance will be the main focus of analysis. We will use the method of voxel-based symptom-lesion mapping to detect lesion and resection sites that are specifically associated with pre- and postsurgical memory impairments. Secondly, a multimodal fMRI learning paradigm will be used prior to surgery to identify memory-related neural correlates that are specifically associated with temporal or frontal brain lesions. Presurgical fMRI activation associated with memory tasks will be correlated with presurgical and postsurgical neuropsychological measures of memory. We aim at improving the prediction of postsurgical memory changes in TLE and FLE patients. For this purpose, we will develop a multifactorial prediction model. Besides epilepsy-related clinical factors and neuropsychological measures, this model will contain presurgically assessed MRI-based parameters, i.e., fMRI activations from our learning paradigm, from a verbal fluency fMRI task, data on functional connectivity based on the default mode network, diffusion tensor imaging and voxel-based morphometry data. After testing the predictive value of each of these parameters, we will combine the best predictors to a weighted multifactorial model. In summary, the project will contribute to the understanding of mnestic functions and postoperative changes in surgically treated TLE and FLE patients. It will give generalisable insights into the contribution of temporal and frontal brain areas to memory processes by investigating these "human lesion models" prior and after brain surgery.