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.

项目概要/摘要 说话时说出正确词语的能力对于正常的社交、学术和职业至关重要 发挥作用。不幸的是，对于许多癫痫无法控制的儿童来说，需要手术治疗来控制癫痫发作 可能会使这些重要的语言技能面临风险。对成人难治性癫痫患者的广泛研究表明 根据临床可在手术前预测对单词产生或“命名”能力的重大风险 因素，并且在某些情况下阻止使用术前语言映射。与此形成鲜明对比的是，我们 目前无法预测儿童表达语言的风险，以及目前的绘图技术 所使用的方法未能可靠地识别和保护儿童的语言皮层。这代表着严重的差距 临床护理，因为语言的预测和保护在发育过程中至关重要。一个关键问题是 儿童命名方法，包括行为评估和术前语言映射。 命名神经科学的重大进展表明，仅依赖于命名的传统方法 视觉对象命名不考虑命名的反应速度和其他认知特征，可能会错过真正的命名 评估中的命名缺陷，并且未能识别皮质语言映射中的基本命名区域。在 对于成人，在术前评估中添加听觉描述命名有助于侧化 与致癫痫皮层相关的功能障碍，并通过识别关键语言提高了绘图效率 否则未被发现的皮质。我们最近开发了儿科听觉命名和 互补的视觉命名措施对偏侧性癫痫相关的表现出显着的敏感性 难治性癫痫儿童术前功能障碍。这些措施现在可以实现准确和 对儿童命名的详细评估。该项目将使用这些最近开发的测试、预测试和 术后，并在皮质语言映射中：1）确定预测短期和长期的因素 术后短期衰退，2) 确定衰退是全面的还是仅限于一种模式，以及 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层。结果 承诺基于经验的知识，了解难治性癫痫儿童术后言语技能的风险， 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数量不断增加，我们预计 需要准确预测、保护和测量儿科语言结果。

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

Shared space, separate processes: Neural activation patterns for auditory description and visual object naming in healthy adults.

• DOI: 10.1002/hbm.22345
• 发表时间: 2014-06
• 期刊: HUMAN BRAIN MAPPING
• 影响因子: 4.8
• 作者: Hamberger, Marla J.;Habeck, Christian G.;Pantazatos, Spiro P.;Williams, Alicia C.;Hirsch, Joy
• 通讯作者: Hirsch, Joy

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