NEUROPSYCHOLOGICAL AND COGNITIVE STUDIES IN EPILEPSY

我们一直在进行语言组织的成像研究， 正常对照组和癫痫患者。 使用PET，激活 脑血流量（CBF）与单词和物体识别相关， 听觉理解，音素，单词和句子的产生是 定位在大脑中。 正在对传统的 条件反射和内隐及外显记忆表现。 数据从 硬膜下刺激、PET和MRI使用数字图像集成 加工技术 结合刺激和PET数据使我们能够 研究认知激活与认知中断之间的关系 活动，并形成更准确的组织概念， 大脑功能 这些研究将阐明区域的功能 如基底颞叶语言区，具有临床意义， 重要的是当手术不受控制的癫痫发作计划。 数字 信号处理技术用于确认 功能映射 使用表面拟合算法，PET、CT、MRI和 硬脑膜下电极位置被对准。 在PET实验中， 条件被平均并从活化条件中减去， 以揭示在执行任务期间血液流动增加的区域。 额下回（IFG）损伤后的广泛言语障碍 已被解释为IFG参与了任一或多个序列 规划，或语法和语义处理。 我们在6分钟内记录了CBF 正常志愿者使用PET。 每个人进行2个休息任务和4个语音 任务所有任务导致口面初级皮质CBF增加， 包括辅助语音区域。 但左IFG只在 当一段散文被读到时。 这表明IFG在以下方面发挥了作用： 语言处理，以及规划或排序。 我们发现 语言和表现智力的得分在 左右颞部病灶的患者。 发作间期放电 不会影响神经心理测试的分数 然而，波士顿航空公司 语言功能的得分显著低于 左颞叶癫痫发作的患者。 这些分数不是 左颞叶切除术后显著降低。

We have been performing imaging studies of language organization in normal controls and patients with epilepsy. Using PET, activation of cerebral blood flow (CBF) associated with word and object recognition, auditory comprehension, and phoneme, word, and sentence production are localized in the brain. Investigations are being conducted on classical conditioning and implicit and explicit memory performance. Data from subdural stimulation, PET, and MRI are integrated using digital image processing techniques. The combined stimulation and PET data allow us to study the relation between activation and disruption of cognitive activity, and to form more accurate concepts of the organization of cerebral function. These studies will elucidate the function of regions such as the basal temporal language area, which are of clinical importance when surgery for uncontrolled seizures is planned. Digital signal processing techniques are used to confirm anatomic localization of functional mapping. Using surface fitting algorithms, PET, CT, MRI, and subdural electrode positons are aligned. In PET experiments, rest conditions are averaged and subtracted from activated conditions, in order to reveal regions of increased blood flow during task performance. Extensive speech deficits following inferior frontal gyrus (IFG) lesions have been explained by IFG involvement in either oromotor sequence planning, or syntactical and semantic processing. We recorded CBF in 6 normal volunteers using PET. Each performed 2 resting tasks and 4 speech tasks All tasks led to increased CBF in orofacial primary cortex, including the supplementary speech area. But left IFG was active only when a prose passage was read. This suggests IFG plays a role in language processing, as well as planning oromotor sequences. We found that verbal and performance intelligence scores did not differ between patients with left and right temporal foci. Interictal discharges did not affect neuropsychological test scores. However, Boston Naming test scores, indicative of language function, were significantly lower in patients with left temporal seizure onset. These scores were not significantly lower after left temporal lobectomy.