Cortical Dynamics of Episodic Memory Processing in Tempora Lobe Epilepsy

描述(申请人提供)：这项拟议的研究将结合全头脑磁图(MEG)和脑电图(EEG)与高分辨率结构磁共振成像，探索颞叶癫痫(TLE)患者情节记忆处理的皮质动力学。本研究的目的是阐明1)大脑中哪些区域参与了TLE的记忆处理，2)它们何时参与，以及3)脑磁图/EEG激活模式是否可以用来预测TLE的记忆功能障碍。这些目标将使用以下方法来实现。首先，将比较TLE患者和健康对照组在语言和非语言记忆的MEG/EEG任务中神经激活的时间进程和空间范围。其次，将使用高分辨率MRI对TLE患者的结构病理进行量化。第三，将使用神经生理学(MEG/EEG)和结构(MRI)数据来预测TLE的神经心理表现。这项研究具有很大的临床实用价值，因为识别涉及记忆的大脑区域的时间和分布可以帮助TLE的术前计划，并可能减少与去除口才皮质相关的发病率。这项建议的目标也与NIH/NINDS癫痫研究基准一致，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脑图像。这项研究项目将是对颞叶和颞外癫痫患者进行的脑磁图/脑电研究项目的一部分，该项目将最终纳入其他尖端多模式成像工具(即脑磁图/功能磁共振成像)，以了解癫痫患者的认知功能障碍。这项建议中描述的研究计划将使申请者能够1)发展脑磁图/脑电和结构磁共振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，每年给医疗保健系统造成约125亿美元的损失，并会对个人的生活质量、就业和健康状况产生负面影响。目前的项目对公众健康具有重大影响，因为它努力通过使用新的、改进的技术来识别癫痫患者的脑功能障碍区域，从而改善对癫痫患者的术前评估。这些信息可能有助于手术计划和减少术后认知功能下降的可能性。

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.