Cortical localization in epilepsy

癫痫的皮质定位

• 批准号: 10438583
• 负责人: MARLA J HAMBERGER
• 金额: $ 40.18万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-12-01 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10438583
• 关键词: Accounting; Address; Adult; Age; Anterior; Area; Auditory; Behavior assessment; Characteristics; Child; Childhood; Clinical; Cognitive; Cues; Development; Epilepsy; Excision; Failure; Functional disorder; Goals; Grant; Impairment; Individual; Intractable Epilepsy; Investigation; Knowledge; Language; Language Development; Left; Location; Measurement; Measures; Methods; Modality; Names; Neurosciences; Occupational; Operative Surgical Procedures; Performance; Pharmaceutical Preparations; Postoperative Period; Predictive Factor; Production; Psychometrics; Reaction Time; Recovery; Research; Risk; Seizures; Site; Speed; Standardization; Stimulus; Techniques; Testing; Time; Visual; Vocabulary; Work; base; boys; childhood epilepsy; clinical care; cognitive neuroscience; cortex mapping; cost; follow-up; girls; high risk; improved; language outcome; prevent; relating to nervous system; response; sex; skills; social; surgical risk

Project Summary/Abstract The ability to produce the correct words while speaking is critical for normal social, academic and occupational functioning. Unfortunately, for many children with uncontrolled epilepsy, surgical treatment for seizure control can place these vital language skills at risk. Extensive research in adults with refractory epilepsy has shown significant risk to word production or “naming” ability that can be predicted before surgery based on clinical factors and, in some cases, prevented using preoperative language mapping. In marked contrast, we are currently unable to predict risk to expressive language in children, and the mapping techniques currently utilized have failed to reliably identify and protect language cortex in children. This represents a serious gap in clinical care, as prediction and protection of language are critical during development. A key problem has been the approach to naming in children, both in behavioral assessment and in preoperative language mapping. Significant advances in the neuroscience of naming have shown that traditional methods, which rely solely on visual object naming without regard to speed of response and other cognitive features of naming, can miss true naming deficits in assessment, and fail to identify essential naming areas in cortical language mapping. In adults, the addition of auditory description naming to preoperative assessment has assisted in lateralization of dysfunction related to epileptogenic cortex, and has improved mapping efficacy by identifying critical language cortex that otherwise remained undetected. We recently developed pediatric auditory naming and complementary visual naming measures that showed significant sensitivity to lateralized epilepsy-related dysfunction in preoperative children with refractory epilepsy. These measures now enable accurate and detailed assessment of naming in children. This project will use these recently developed tests, pre and postoperatively, and in cortical language mapping to: 1) identify the factors that predict both short- and long- term postoperative decline, 2) determine when decline is global or limited to one modality, and 3) determine whether modality-based naming can more effectively identify and protect language cortex in children. Results promise empirically based knowledge of risk to postoperative verbal skills in children with refractory epilepsy, improved language mapping in children, and advances in the cognitive neuroscience of language development and recovery. With increasing numbers of children undergoing epilepsy surgery, we can expect a growing need for accurate prediction, protection and measurement of pediatric language outcome.

项目摘要/摘要 在讲话时产生正确单词的能力对于正常的社会，学术和职业至关重要 功能。不幸的是，对于许多患有不受控制的癫痫病的儿童，手术治疗癫痫 可以使这些重要的语言技能处于危险之中。耐火癫痫的成年人的广泛研究已显示 基于临床的手术前可以预测的单词生产或“命名”能力的重大风险 因素，在某些情况下，可以防止使用术前映射。与之形成鲜明对比，我们是 目前无法预测儿童表达语言的风险，目前的映射技术 利用未能可靠地识别和保护儿童的语言皮质。这代表了一个严重的差距 临床护理，因为对语言的预测和保护在发展过程中至关重要。一个关键问题是 在行为评估和术前语言映射中，儿童命名的方法。 命名神经科学的重大进展表明，传统方法仅依赖于 视觉对象命名不考虑响应速度和命名的其他认知特征，可能会错过True 命名在评估中定义，并且无法确定皮质语言映射中的基本命名区域。 成人，添加听觉描述将术前评估命名为横向化 与癫痫病皮质有关的功能障碍，并通过识别关键语言提高了映射效率 否则仍未发现的皮质。我们最近开发了儿科听觉命名和 完全可视的命名措施，对侧向癫痫相关的敏感性显着 术前儿童难治性癫痫的功能障碍。这些措施现在实现了准确的 详细评估儿童命名。该项目将使用这些最近开发的测试，PRE和 分配给：1）确定预测短期和长期的因素 术语术后下降，2）确定降低何时全球或仅限于一种方式，3）确定 基于模态的命名是否可以更有效地识别和保护儿童的语言皮质。结果 迫切希望基于难治性癫痫儿童的术后口头技能的风险知识， 改善儿童的语言映射，以及语言发展的认知神经科学的进步 和恢复。随着接受癫痫手术的儿童人数越来越多，我们可以预期 需要对小儿语言结果进行准确的预测，保护和测量。

项目成果

Game-changing, or business as usual? New findings on naming skills after temporal lobe surgery.

改变游戏规则，还是一切如常？

• DOI: 10.1212/wnl.0b013e3181f46a0a
• 发表时间: 2010
• 期刊: Neurology
• 影响因子: 9.9
• 作者: Hamberger,MarlaJ;Seidel,WilliamT;McKhann2nd,GuyM;Goodman,RobertR
• 通讯作者: Goodman,RobertR

Test-retest reliability of cortical language mapping in a patient with refractory focal epilepsy: 11 years later.

难治性局灶性癫痫患者皮质语言图谱的重测可靠性：11 年后。

• DOI: 10.3171/2016.12.jns161727
• 发表时间: 2018
• 期刊: Journal of neurosurgery
• 影响因子: 4.1
• 作者: Bortnik,KirstyE;McKhann,GuyM;Hamberger,MarlaJ
• 通讯作者: Hamberger,MarlaJ

Auditory and visual naming tests for children.

• DOI: 10.1080/09297049.2017.1414172
• 发表时间: 2018-10
• 期刊: Child neuropsychology : a journal on normal and abnormal development in childhood and adolescence
• 作者: Hamberger MJ;Seidel WT;MacAllister WS;Smith ML
• 通讯作者: Smith ML

Anxiety is common and independently associated with clinical features of epilepsy.

• DOI: 10.1016/j.yebeh.2018.05.024
• 发表时间: 2018-08
• 期刊: Epilepsy & behavior : E&B
• 作者: Munger Clary HM;Snively BM;Hamberger MJ
• 通讯作者: Hamberger MJ

Noninvasive identification of seizure lateralization in children: Name that thing.

儿童癫痫偏侧化的无创识别：说出那个东西。

• DOI: 10.1212/wnl.0000000000006691
• 发表时间: 2019
• 期刊: Neurology
• 影响因子: 9.9
• 作者: Hamberger,MarlaJ;MacAllister,WilliamS;Seidel,WilliamT;Busch,RobynM;Salinas,ChristineM;Klaas,Patricia;Smith,MaryLou
• 通讯作者: Smith,MaryLou