Aims and objectives
Background
FMRI for language has replaced the WADA test in the majority of epilepsy centres,
and while WADA has been used as a test to predict memory outcome,
the reliability and validity remains questioned.1
fMRI is a non-invasive technique that has substantial potential to lateralize memory functions and predict post-operative memory outcome in epilepsy patients undergoing temporal lobe epilepsy surgery.1,2
Aim
Aim of the study is to testify the cognitive functional outcome of temporal lobe epilepsy surgery based on memory fMRI using the Home Town...
Methods and materials
Method
From July 2014 to April 2017,
26 memory fMRI was done on epileptic patients who are deemed suitable for temporal lobe resection surgery.
No WADA test was performed.
FMRI was performed on 3T Siemens Vario MRI scanner.
Sequence Parameters were: EPI sequence with TR 3000ms,
TE 30ms,
in-plane resolution 3.9mm (64x64 matrix,
FOV 250 mm),
slice thickness 3mm (gap 25%).
Home-town walk memory paradigm consisted of 10 sets of Active-Baseline blocks.
The fMRI is performed on two consecutive days with a block design using...
Results
Results
9/26 refractory epilepsy patients were operated by anterior temporal lobectomy (RATL =7 and LATL =2).
7/26 patients underwent insertion of Vagal nerve stimulator
None of the operated patient were found to have any memory deficit on clinical follow up.
Six out of nine patients had detailed neuropsychiatric assessment at one year follow up,
while three are waiting to be done soon.
In these six patients,
whom post-surgical psychometric test were performed; comparison with pre-surgical baseline assessment showed no decline in any domain of cognition...
Conclusion
Memory fMRI using the Home Town Walking Paradigm produced consistent and reproducible results for lateralization of memory.
Preliminary results are promising in predicting post- operative memory functions after temporal lobe surgery.
References
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Memory fMRI predicts verbal memory decline after anterior temporal lobe resection.
Neurology.
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Towgood K,
Barker GJ,
Caceres A,
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Bringing memory fMRI to the clinic: comparison of seven memory fMRI protocols in temporal lobe epilepsy.
Hum Brain Mapp.
2015;36(4):1595-608.
Avila C,
Barrós-loscertales A,
Forn C,
et al.
Memory lateralization with 2 functional MR imaging tasks in patients with lesions in the temporal lobe.
AJNR Am J Neuroradiol.
2006;27(3):498-503.
Binder JR,
Sabsevitz DS,
Swanson SJ et...