CORTICAL LOCALIZATION IN TEMPORAL LOBE EPILEPSY

描述(申请人摘要)：成功的手术治疗 顽固性癫痫需要准确的术前皮质定位 癫痫灶。在手术前，认知评估有助于 皮质功能障碍的定侧化和定位化 癫痫组织和辅助预测术后能力。在……里面 在某些情况下，需要认知功能的皮质映射来 防止术后衰退。 视觉对象命名是手术前评估的一个重要组成部分 语言技能，并在皮质标测中广泛使用，以防止 近远期癫痫发作患者术后语言功能障碍 语言皮层。然而，许多颞叶癫痫(TLE)患者 抱怨找词困难，在谈话节目中表现欠缺 在对象命名任务上没有赤字。此外，术后找字 尽管使用了视觉功能，但缺陷可能会出现或变得更严重 语言映射期间的命名任务。这些观察结果挑战了 使用视觉命名1)检测找词困难的效度 从而推断癫痫灶的定位和2)帮助预防 术后语言功能下降。初步调查结果显示， 听觉命名对词提取缺陷的敏感度显著提高 在左侧TLE(即语言优势，LTLE)患者中，视觉命名比视觉命名更重要。 这种差异可能反映了认知操作的不同 在物体命名和语音过程中的潜在单词提取。在……里面 此外，在使用视觉和视觉进行皮质标测期间的初步观察 听觉命名任务表明，这些功能是不同的 在给定的皮质部位受到刺激而受损，表明它们反映了 语言处理的不同方面。

DESCRIPTION (Applicant's Abstract): Successful surgical treatment of intractable epilepsy requires accurate presurgical localization of cortical seizure foci. Presurgically, cognitive assessment contributes to lateralization and localization of cortical dysfunction associated with epileptogenic tissue and assists prediction of postoperative abilities. In certain cases, cortical mapping of cognitive functions is required to prevent postoperative decline. Visual object naming is a major component in presurgical assessment of verbal skills and is widely utilized during cortical mapping to prevent postoperative language dysfunction in patients with seizures arising near language cortex. However, many temporal lobe epilepsy (TLE) patients who complain of word finding difficulties and show deficits in conversation show no deficits on object naming tasks. Furthermore, postoperative word finding deficits can arise or become more severe despite utilization of visual naming tasks during language mapping. These observations challenge the validity of using visual naming 1) to detect word finding difficulties and thereby infer localization of seizure foci and 2) to help prevent postoperative language decline. Preliminary findings suggested that auditory naming was significantly more sensitive to word retrieval deficits in left TLE (i.e., language dominant, LTLE) patients than was visual naming. This discrepancy may reflect differences in the cognitive operations underlying word retrieval during object naming and during speech. In addition, preliminary observations during cortical mapping using visual and auditory naming tasks indicated that these functions were differentially impaired by stimulation at a given cortical site, suggesting they reflect different aspects of language processing.