Frontal/Medial Temporal Lobe Contributions to Memory

描述（由申请人提供）：神经影像学研究表明 额叶和内侧颞区参与记忆 阵颞叶内侧功能的评估是必要的 颞叶切除术治疗癫痫，避免术后失忆。注射 麻醉剂amytal，进入颈内动脉， 预测手术对侧是否能维持记忆。所得 记忆障碍对术后记忆衰退的预测性较差。正面 记忆叶的激活可以解释这些结果， 用阿米妥注射液灌注内侧颞叶结构。此外，本发明还 记忆材料类型的类似侧化效应已经被 描述了额叶激活和大脑杏仁核结果。 在拟议的研究中，记忆编码的功能磁共振成像（fMRI）将是 在接受脑淀粉酶测试的患者中进行， 颞叶切除术这些功能磁共振成像研究建议：1）图像内侧 颞叶（MTL）功能活动的患者谁是候选人， 颞叶切除术来治疗癫痫激活左侧和右侧MTL 将使用不同的编码范例进行优化。2)显示上级 记忆功能磁共振成像对术后记忆功能的预测价值 与大脑杏仁核测试的预测值相比。术前fMRI 研究将试图证明MTL的完整性， 手术侧以及手术侧的任何剩余功能。第三章 证明与额叶激活的相关性优于MTL 激活，大脑amytaL的结果与已知的 颈动脉内注射的分布。4)遵循额叶的可塑性 颞叶切除术后的叶激活。术后功能磁共振成像 接受颞叶切除术的患者将进行手术，以确定是否 额叶在记忆编码过程中的激活仍然存在，如果它保持其 术前侧化，编码不同的材料。这个最终目标 将有助于建立同侧额叶和内侧 颞叶激活

DESCRIPTION (provided by applicant): Neuroimaging studies have suggested involvement of both frontal and medial temporal regions during memory formation. The evaluation of medial temporal lobe function is necessary prior to temporal lobectomy for epilepsy to avoid postoperative amnesia. Injection of the anesthetic, amytal, into the internal carotid artery has been used to predict whether the side opposite surgery can sustain memory. The resulting memory impairment is poorly predictive of postoperative memory decline. Frontal lobe activation in memory could explain these results given the limited perfusion of medial temporal lobe structures with amytal injections. Further, similar lateralizing effects of the type of material memorized have been described for both frontal lobe activation and cerebral amytal results. In the proposed studies, functional MRI (fMRI) of memory encoding would be performed in patients undergoing cerebral amytal testing and subsequent temporal lobectomy. These fMRI studies are proposed to: 1) Image medial temporal lobe (MTL) functional activity in patients who are candidates for temporal lobectomy to treat seizures. Activation of both left and right MTL will be optimized using different encoding paradigms. 2) Demonstrate superior predictive value of postoperative memory performance with fMRI of memory compared to the predictive value of the cerebral amytal test. Preoperative fMRI studies will attempt to demonstrate both the integrity of the MTL opposite the side of operation as well as any remaining function on the side of surgery. 3) Demonstrate better correlation with frontal lobe activations than MTL activations with results of the cerebral amytaL consistent with the known distribution of intracarotid injections. 4) Follow the plasticity of frontal lobe activations following temporal lobectomy. Functional MRI of postoperative patients, who undergo temporal lobectomy, will be performed to determine if frontal lobe activation during memory encoding remains, and if it retains its preoperative lateralization with encoding different material. This final aim will help establish the relationship between ipsilateral frontal and medial temporal lobe activation.