Multimodal Imaging of Language in the Preoperative Evaluation of Epilepsy

语言多模态成像在癫痫术前评估中的应用

• 批准号: 8654266
• 负责人: CARRIE R MCDONALD
• 金额: $ 42.28万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN DIEGO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-09-14
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8654266
• 关键词: Activities of Daily Living; Address; Anterior; Anterior Temporal Lobectomy; Attenuated; Auditory; Behavioral; Benchmarking; Biological Markers; Brain; Brain region; Categories; Clinical; Cognitive; Communication; Comorbidity; Comprehension; Contralateral; Cost of Illness; Data; Diffusion Magnetic Resonance Imaging; Employment; Epilepsy; Evaluation; Event; Excision; Fiber; Functional Imaging; Functional Magnetic Resonance Imaging; Functional disorder; Goals; Handedness; Health Status; Healthcare Systems; Hippocampus (Brain); Human; Image; Individual; Intracarotid; Investigation; Ipsilateral; Language; Language Disorders; Left; Light; Magnetic Resonance Imaging; Magnetoencephalography; Maps; Measures; Methods; Modality; Modeling; Morbidity - disease rate; Multimodal Imaging; Names; National Institute of Neurological Disorders and Stroke; Operative Surgical Procedures; Outcome; Parietal; Parietal Lobe; Pathology; Patients; Pattern; Performance; Positioning Attribute; Postoperative Period; Procedures; Public Health; Quality of life; Reading; Relative (related person); Relative Risks; Research; Resolution; Risk; Risk Factors; Seizures; Sensitivity and Specificity; Signal Transduction; Source; Stimulus; Techniques; Technology; Temporal Lobe; Temporal Lobe Epilepsy; Testing; Thick; Time; Tissues; Visual; auditory comprehension; base; frontal lobe; hippocampal atrophy; imaging modality; improved; indexing; innovation; interest; language processing; lexical; neocortical; nervous system disorder; neuroimaging; neuropsychological; non-invasive imaging; public health relevance; reading comprehension; reconstruction; relating to nervous system; response; semantic processing; skills; success; white matter

DESCRIPTION (provided by applicant): The proposed research will investigate the use of non-invasive multimodal imaging to evaluate preoperative language processing and predict postsurgical language outcome in patients with temporal lobe epilepsy (TLE). This research will be accomplished by combining magnetoencephalography (MEG), functional magnetic resonance imaging (fMRI), and diffusion tensor imaging (DTI) with high-resolution structural MRI. The research goals are to elucidate (1) what brain regions are involved in language processing, and (2) whether or not structural measures (i.e., cortical thickness and white matter tractography) can be combined with MEG and fMRI activation patterns to optimize the prediction of postoperative language outcome in TLE, an issue with important and immediate clinical implications. 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 tasks of lexical-semantic processing using MEG and fMRI informed by cortical reconstruction from structural MRI. Second, the integrity of key white matter fiber tracts will be quantified using DTI. Third, cortical thickness and hippocampal volumes will be quantified from structural MRI. Fourth, functional (MEG/ fMRI) and structural (MRI/DTI) data will be combined to predict the risk for postoperative language decline in TLE. This study has great clinical utility in that identifying the structural and functional correlates of language processing in TLE can assist with preoperative planning and possibly reduce morbidity associated with removal of eloquent cortex. The goals of this proposal are aligned with the NINDS Benchmarks for Epilepsy Research (Part IIIB, Identify predictors and underlying mechanisms that contribute to co-morbidities), which encourage the combined use of innovative structural and functional neuroimaging methods for identifying the predictors and underlying mechanisms that contribute to cognitive and behavioral co-morbidities in epilepsy. 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 advanced, noninvasive technology to identify regions of brain dysfunction in epilepsy.

描述（由申请人提供）：拟议的研究将调查使用非侵入性多模态成像来评估颞叶癫痫（TLE）患者的术前语言处理并预测术后语言结果。这项研究将通过将脑磁图 (MEG)、功能磁共振成像 (fMRI) 和扩散张量成像 (DTI) 与高分辨率结构 MRI 相结合来完成。研究目标是阐明 (1) 哪些大脑区域参与语言处理，以及 (2) 结构测量（即皮质厚度和白质纤维束成像）是否可以与 MEG 和 fMRI 激活模式相结合，以优化 TLE 术后语言结果的预测，这是一个具有重要和直接临床意义的问题。这些目标将通过以下方法来实现。首先，将使用 MEG 和功能磁共振成像（通过结构 MRI 的皮层重建提供信息）来比较 TLE 患者和健康对照组在词汇语义处理任务中神经激活的时间过程和空间范围。其次，将使用 DTI 量化关键白质纤维束的完整性。第三，皮质厚度和海马体积将从结构 MRI 中量化。第四，功能性（MEG/fMRI）和结构性（MRI/DTI）数据将结合起来预测 TLE 术后语言能力下降的风险。这项研究具有很大的临床实用性，因为确定 TLE 中语言处理的结构和功能相关性可以帮助术前计划，并可能减少与去除口才皮层相关的发病率。该提案的目标与 NINDS 癫痫研究基准（第 IIIB 部分，识别导致共病的预测因子和潜在机制）一致，鼓励结合使用创新的结构和功能神经影像方法来识别导致癫痫认知和行为共病的预测因子和潜在机制。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，并对个人的生活质量、就业和健康状况产生负面影响。当前的项目对公共卫生具有重大影响，因为它致力于通过使用先进的非侵入性技术来识别癫痫脑功能障碍区域，从而改善癫痫患者的术前评估。