Cortical Dynamics of Episodic Memory Processing in Tempora Lobe Epilepsy

描述（由申请人提供）：拟议的研究将通过结合全头脑磁图（MEG）和脑电图（EEG）与高分辨率结构MRI来探索颞叶癫痫（TLE）患者情景记忆处理的皮质动力学。本研究的目的是阐明1）哪些脑区参与TLE的记忆加工，2）何时参与，以及3）MEG/EEG激活模式是否可用于预测TLE的记忆功能障碍。这些目标将通过以下方法实现。首先，在言语和非言语记忆的MEG/EEG任务期间，将比较TLE患者和健康对照组的神经激活的时间过程和空间范围。其次，将使用高分辨率MRI量化TLE患者的结构病理学。第三，神经生理学（MEG/EEG）和结构（MRI）数据将用于预测TLE的神经心理学表现。这项研究具有很大的临床实用性，因为识别参与记忆的脑区的时间和分布可以帮助TLE的术前规划，并可能降低与切除功能皮层相关的发病率。该提案的目标也与NIH/NINDS癫痫研究基准保持一致，该基准鼓励使用改进的技术来获取和分析癫痫患者的详细大脑图像。该研究项目将是对颞叶和颞外癫痫患者进行MEG/EEG研究的长期计划的一部分，该研究最终将结合其他尖端的多模态成像工具（即，MEG/fMRI）了解癫痫的认知功能障碍。本提案中描述的研究计划将使申请人能够1）发展MEG/EEG和结构MRI数据收集和分析方面的专业知识，2）将这些新学到的技能应用于重要临床人群的认知功能障碍研究。癫痫是一种常见的神经系统疾病，每年花费医疗保健系统约125亿美元，并可能对个人的生活质量，就业和健康状况产生负面影响。目前的项目对公共卫生有很大的影响，因为它致力于通过使用新的、改进的技术来识别癫痫患者脑功能障碍的区域，从而改善癫痫患者的术前评估。这些信息可能有助于制定手术计划，并降低术后认知能力下降的可能性。

DESCRIPTION (provided by applicant): The proposed research study will explore the cortical dynamics of episodic memory processing in patients with temporal lobe epilepsy (TLE) by combining whole-head magnetoencephalography (MEG) and electroencephalography (EEG) with high-resolution structural MRI. The goals of this research are to elucidate 1) what brain regions are involved in memory processing in TLE, 2) when they are involved, and 3) whether or not MEG/EEG activation patterns can be used to predict memory dysfunction in TLE. These goals will be accomplished using the following methods. First, the time course and spatial extent of neural activations will be compared in patients with TLE and healthy controls during MEG/EEG tasks of verbal and nonverbal memory. Second, structural pathology will be quantified in patients with TLE using high-resolution MRI. Third, neurophysiological (MEG/EEG) and structural (MRI) data will be used to predict neuropsychological performances in TLE. This study has great clinical utility in that identifying the timing and distribution of brain regions involved in memory can assist with preoperative planning in TLE and possibly reduce morbidity associated with removal of eloquent cortex. The goals of this proposal are also aligned with the NIH/NINDS Benchmarks for Epilepsy Research, which encourage the use of improved technology for obtaining and analyzing detailed brain images of patients with epilepsy. This research project will be part of a programmatic, long-term line of MEG/EEG research in patients with temporal and extratemporal epilepsy that will eventually incorporate other cutting-edge multimodal imaging tools (i.e., MEG/fMRI) to understand cognitive dysfunction in epilepsy. The research plan described in this proposal will enable the applicant to 1) develop expertise in MEG/EEG and structural MRI data collection and analysis and 2) apply these newly learned skills to the study of cognitive dysfunction in an important clinical population. Epilepsy is a common neurological disease that costs the healthcare system approximately $12.5 billion annually and can negatively impact an individual's quality of life, employment, and health status. The current project has strong implications for public health because it strives to improve the presurgical evaluation of patients with epilepsy by using new, improved technology to identify regions of brain dysfunction in epilepsy. This information may facilitate surgical planning and reduce the potential for postoperative cognitive decline.