Dissecting the Cognitive Roles of Hippocampus, Other Temporal Lobe Structures

剖析海马和其他颞叶结构的认知作用

基本信息

  • 批准号:
    9062533
  • 负责人:
  • 金额:
    $ 59.13万
  • 依托单位:
  • 依托单位国家:
    美国
  • 项目类别:
  • 财政年份:
    2014
  • 资助国家:
    美国
  • 起止时间:
    2014-07-01 至 2019-04-30
  • 项目状态:
    已结题

项目摘要

DESCRIPTION (provided by applicant): Epilepsy surgery involving the anteromedial temporal lobe (ATL) often results in verbal memory and naming decline following language dominant resection and in visual memory decline after nondominant resection. We have shown open ATL resections also frequently result in recognition or naming declines for several object types (e.g., famous persons) and related functions (e.g., proper noun fluency). These deficits, not previously recognized as clinical risks, compromise functional status and compound the burden of memory decline. We propose these deficits reflect collateral damage incurred when surgically accessing the mesial TL. Our ongoing NINDS K02 award uses DTI probabilistic tractography to determine if decline results from damage to specific white matter (WM) paths. This K02 is laying the groundwork for developing surgical options to improve cognitive outcome by sparing key paths underlying these functions. Preliminary data show several WM paths are related to baseline performance on these measures, and resection of specific tracts leads to predicted decline. Our R01 proposal uses a novel, minimally invasive, MRI-guided laser ablation technique, selective laser amygdalohippocampotomy (SLAH), to directly test our collateral damage hypothesis. SLAH ablates at least 50% of hippocampus and amygdala, but does not directly damage WM due to its minimally invasive nature. We hypothesize damage restricted to these structures will not lead to naming and recognition deficits, consistent with our preliminary data. This allows us to assess the popular view that mesial TL structures are essential to these processes, which has arisen from indirect paradigms (fMRI/stimulation mapping). Our clinical data also indicate most SLAH patients do not experience episodic memory decline, again contrary to prevailing views of hippocampal function. We propose better memory outcomes after SLAH results from: (a) sparing surrounding mesial TL structures; and (b) less direct and secondary degenerative damage to WM paths away from the resection zone. We predict patients undergoing SLAH will not experience naming and recognition deficits, and will exhibit a significantly better outcome than open resection patients. We predict WM tracts included in open resections will contribute to performance declines on these tasks, but not hippocampal and amygdalar resection volumes. Secondly, we evaluate the contribution of the hippocampus and amygdala to episodic memory functions, predicting greater memory deficits following open resection compared to SLAH. Lastly, we will explore secondary changes in non-resected WM tracts using MRI diffusion parameters, predicting greater improvement in these parameters after SLAH versus open resection. We hypothesize diffusivity improvements in these non-resected tracts and contralateral hippocampus will correlate with improved memory scores (greatest for the SLAH cohort). In sum, this research allows us to: (a) dissociate the contribution of amygdala and hippocampus from that of the overlying cortex and TL WM paths to key cognitive functions, and (b) determine if SLAH preserves cognitive functions frequently affected by open resections.
描述(由申请人提供):涉及前内侧颞叶(ATL)的癫痫手术通常导致语言优势切除术后言语记忆和命名下降,以及非优势切除术后视觉记忆下降。我们已经表明,开放ATL切除也经常导致几种对象类型的识别或命名下降(例如, 名人)和相关功能(例如,专有名词流畅性)。这些缺陷,以前没有被认为是临床风险,损害功能状态和复合记忆衰退的负担。我们认为这些缺陷反映了手术进入近中TL时所产生的附带损伤。我们正在进行的NINDS K 02奖使用DTI概率纤维束成像来确定是否衰退是由于特定白色物质(WM)路径的损伤。该K 02为开发手术方案奠定了基础,通过保留这些功能的关键路径来改善认知结果。初步数据显示,几个WM路径与这些措施的基线性能有关,切除特定的道会导致预测的下降。我们的R 01提案使用了一种新型的微创MRI引导激光消融技术,选择性激光杏仁核切除术(SLAH),以直接测试我们的附带损伤假设。SLAH消融至少50%的海马和杏仁核,但由于其微创性,不会直接损伤WM。我们假设仅限于这些结构的损伤不会导致命名和识别缺陷,这与我们的初步数据一致。这使我们能够评估流行的观点,近中TL结构是必不可少的这些过程中,这已经出现了间接的范例(功能磁共振成像/刺激映射)。我们的临床数据还表明,大多数SLAH患者没有经历情景记忆衰退,再次与海马功能的流行观点相反。我们认为,SLAH后记忆效果更好的原因在于:(a)保留周围近中TL结构;(B)远离切除区的WM路径的直接和继发退行性损伤更少。我们预测接受SLAH的患者不会出现命名和识别缺陷,并且将表现出比开放切除患者更好的结局。我们预测开放性切除的WM束会导致这些任务的性能下降,但海马和杏仁核切除量不会。其次,我们评估了海马和杏仁核对情景记忆功能的贡献,预测开放切除术后与SLAH相比记忆缺陷更大。最后,我们将使用MRI扩散参数探讨未切除WM束的继发性变化,预测SLAH与开放切除术后这些参数的改善更大。我们假设这些未切除的神经束和对侧海马的扩散性改善与记忆评分的改善相关(SLAH组最大)。总之,这项研究使我们能够:(a)分离杏仁核和海马的贡献,从上覆皮层和TL WM路径的关键认知功能,和(B)确定是否SLAH保留经常受到开放切除术影响的认知功能。

项目成果

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DANIEL L DRANE其他文献

DANIEL L DRANE的其他文献

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{{ truncateString('DANIEL L DRANE', 18)}}的其他基金

Disecting the cognitive Role of Hippocampus Administrative Supplement
剖析海马行政补充剂的认知作用
  • 批准号:
    10406765
  • 财政年份:
    2021
  • 资助金额:
    $ 59.13万
  • 项目类别:
Disecting the cognitive Role of Hippocampus Diversity Supplement
剖析海马多样性补充剂的认知作用
  • 批准号:
    10410211
  • 财政年份:
    2021
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10052937
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10613065
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10604348
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus, Other Temporal Lobe Structures
剖析海马和其他颞叶结构的认知作用
  • 批准号:
    8767846
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10206274
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus, Other Temporal Lobe Structures
剖析海马和其他颞叶结构的认知作用
  • 批准号:
    8878370
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10831920
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:
Dissecting the Cognitive Roles of Hippocampus and Other Temporal Lobe Structures in Patients Undergoing Epilepsy Surgery
剖析海马和其他颞叶结构在癫痫手术患者中的认知作用
  • 批准号:
    10388256
  • 财政年份:
    2014
  • 资助金额:
    $ 59.13万
  • 项目类别:

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