Frontal/Medial Temporal Lobe Contributions to Memory

描述(由申请人提供)：神经成像研究表明 记忆过程中额叶和内侧颞区的参与 队形。对内侧颞叶功能的评估是必要的 以颞叶切除术治疗癫痫，避免术后遗忘症。注射用 进入颈内动脉的麻醉剂阿米托已被用于 预测对侧手术能否维持记忆。由此产生的 记忆力减退对术后记忆力下降的预测效果不佳。前额 记忆中的脑叶激活可以解释这些结果，因为 杏仁核注射对内侧颞叶结构的灌流。此外， 记忆的材料类型的类似的偏侧效应已经被 描述了额叶激活和大脑杏仁核结果。 在拟议的研究中，记忆编码的功能磁共振(FMRI)将是 在接受大脑杏仁核测试的患者和随后的 颞叶切除术。这些功能磁共振研究的目的是：1)图像中间 候选患者的颞叶(MTL)功能活动 治疗癫痫的颞叶切除术。激活左侧和右侧MTL 将使用不同的编码范例进行优化。2)展现优势 记忆功能磁共振成像对术后记忆功能的预测价值 与大脑杏仁核测试的预测价值进行比较。术前功能磁共振成像 研究将试图证明MTL的完整性与 手术侧以及手术侧的任何剩余功能。3) 与MTL相比，与额叶激活的相关性更好 大脑杏仁核的激活结果与已知的一致 颈动脉内注射的分布。4)遵循额叶的可塑性 颞叶切除术后的肺叶激活。手术后的功能磁共振成像 接受颞叶切除术的患者将接受手术，以确定是否 记忆编码期间的额叶激活仍然存在，如果它保持其 术前对不同材料进行编码的定侧。这一最终目标 有助于建立同侧额叶和内侧之间的关系 激活了颞叶。

DESCRIPTION (provided by applicant): Neuroimaging studies have suggested involvement of both frontal and medial temporal regions during memory formation. The evaluation of medial temporal lobe function is necessary prior to temporal lobectomy for epilepsy to avoid postoperative amnesia. Injection of the anesthetic, amytal, into the internal carotid artery has been used to predict whether the side opposite surgery can sustain memory. The resulting memory impairment is poorly predictive of postoperative memory decline. Frontal lobe activation in memory could explain these results given the limited perfusion of medial temporal lobe structures with amytal injections. Further, similar lateralizing effects of the type of material memorized have been described for both frontal lobe activation and cerebral amytal results. In the proposed studies, functional MRI (fMRI) of memory encoding would be performed in patients undergoing cerebral amytal testing and subsequent temporal lobectomy. These fMRI studies are proposed to: 1) Image medial temporal lobe (MTL) functional activity in patients who are candidates for temporal lobectomy to treat seizures. Activation of both left and right MTL will be optimized using different encoding paradigms. 2) Demonstrate superior predictive value of postoperative memory performance with fMRI of memory compared to the predictive value of the cerebral amytal test. Preoperative fMRI studies will attempt to demonstrate both the integrity of the MTL opposite the side of operation as well as any remaining function on the side of surgery. 3) Demonstrate better correlation with frontal lobe activations than MTL activations with results of the cerebral amytaL consistent with the known distribution of intracarotid injections. 4) Follow the plasticity of frontal lobe activations following temporal lobectomy. Functional MRI of postoperative patients, who undergo temporal lobectomy, will be performed to determine if frontal lobe activation during memory encoding remains, and if it retains its preoperative lateralization with encoding different material. This final aim will help establish the relationship between ipsilateral frontal and medial temporal lobe activation.