CORTICAL LOCALIZATION IN TEMPORAL LOBE EPILEPSY

描述（申请人摘要）： 难治性癫痫需要精确的术前皮质定位 癫痫灶 从心理学的角度来看，认知评估有助于 大脑皮层功能障碍的定侧和定位 癫痫组织和辅助预测术后能力。 在 在某些情况下，需要认知功能的皮层映射， 防止术后衰退。 视觉对象命名是术前评估的主要组成部分， 语言技能，并广泛用于皮层映射，以防止 癫痫发作患者术后语言功能障碍 语言皮层 然而，许多颞叶癫痫患者， 抱怨找词困难，在谈话中表现出缺陷 在物体命名任务上没有缺陷。 此外，术后单词查找 尽管使用了视觉， 在语言映射期间命名任务。 这些观察结果挑战了 使用视觉命名的有效性1）检测单词查找困难， 从而推断癫痫灶的定位，以及2）帮助预防 术后语言能力下降。 初步调查结果显示， 听觉命名对词汇提取缺陷的敏感性显著高于听觉命名 在左TLE（即，语言优势型（LTLE）患者的命名能力高于视觉命名。 这种差异可能反映了认知操作的差异 在物体命名和说话过程中的潜在单词检索。 在 此外，在使用视觉和 听觉命名任务表明，这些功能是不同的， 在特定的皮质部位受到刺激而受损，这表明它们反映了 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.