Estimating risk of word-finding problems in adults undergoing epilepsy surgery

Busch, Robyn M.; Floden, Darlene; Prayson, Brigid E.; Chapin, Jessica S.; Kim, Kevin H.; Ferguson, Lisa; Bingaman, William; Najm, Imad

doi:10.1212/wnl.0000000000003378

Cited by 56 publications

(69 citation statements)

References 18 publications

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“…Better preoperative BNT scores were only marginally associated with postoperative decline in naming ability, though this trend is consistent with existing literature (Busch et al, 2016;Sabsevitz et al, 2003). This relationship is also in agreement with findings from this study that individuals with greater degree within the to-be-resected region had better naming ability before surgery and worse ability afterward.…”

Section: Preoperative Language Ability LI and Postoperative Naminsupporting

confidence: 92%

Language network measures at rest indicate individual differences in naming decline after anterior temporal lobe resection

Audrain

Barnett

McAndrews

2018

Human Brain Mapping

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While anterior temporal lobe (ATL) resection is an effective treatment for temporal lobe epilepsy, surgery on the dominant hemisphere is associated with variable decline in confrontation naming. Accurate prediction of naming impairment is critical to inform clinical decision making, and while there has been some degree of success using task-based functional MRI (fMRI) paradigms, there remains a growing interest in the predictive utility of resting-state connectivity as it allows for relatively shorter scans with low task demands. Our objective was to assess the relationship between measures of preoperative resting-state connectivity and postoperative naming change in patients following left ATL resection. We compared the resting language network connectivity of each patient to a normative healthy control template using a novel measure called "matrix similarity," and found that patients with more abnormal global language-network connectivity-particularly of regions spared from surgery-showed greater postoperative naming decline than those with normative patterns of connectivity. When we interrogated the degree centrality of to-be-resected regions in a more targeted approach of the pathological temporal lobe, we found that greater functional integration of those regions with the rest of the language network at rest was related to greater decline in naming following surgery. Finally, we found that matrix similarity was a better predictor of postoperative outcome than degree within to-be-resected regions, network clustering, modularity, and language task fMRI laterality. We provide some of the first evidence that using this novel measure, a relatively short preoperative resting scan can be exploited to inform naming ability following ATL resection.

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Section: Preoperative Language Ability LI and Postoperative Naminsupporting

confidence: 92%

Language network measures at rest indicate individual differences in naming decline after anterior temporal lobe resection

Audrain

Barnett

McAndrews

2018

Human Brain Mapping

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“…This finding is consistent with the literature 38. Other language functions, namely language comprehension and phonemic fluency remained unchanged.…”

Section: Discussionsupporting

confidence: 93%

Neuropsychological outcome after subtemporal versus transsylvian approach for selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy: a randomised prospective clinical trial

Vogt

Delev

Grote

et al. 2017

J Neurol Neurosurg Psychiatry

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“…33 ECM was performed for both auditory and visual naming, but surgery was guided by preserving only visual and not auditory naming sites (which were anterior to visual naming). 3,27 We found a similar relationship after excluding one potential outlier. The ADDT fMRI task identifies areas anterior to ECM-localized visual naming sites, that, if resected, may lead to naming impairment.…”

Section: Discussionsupporting

confidence: 64%

“…This work highlights the importance of the specific language tasks used for preoperative planning, as well as the criteria used to determine language-positive sites. Older age at seizure onset and surgery also predicted decline in previous studies 27 ; object names learned late in childhood were most vulnerable. 24,36 In addition to the traditionally described Broca and Wernicke areas, language decline following temporal lobe surgery may also occur due to resection of the basal temporal language area.…”

Section: Discussionmentioning

confidence: 62%

fMRI prediction of naming change after adult temporal lobe epilepsy surgery: Activation matters

et al. 2019

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Summary Objective We aimed to predict language deficits after epilepsy surgery. In addition to evaluating surgical factors examined previously, we determined the impact of the extent of functional magnetic resonance imaging (fMRI) activation that was resected on naming ability. Method Thirty‐five adults (mean age 37.5 ± 10.9 years, 13 male) with temporal lobe epilepsy completed a preoperative fMRI auditory description decision task, which reliably activates frontal and temporal language networks. Patients underwent temporal lobe resections (20 left resection). The Boston Naming Test (BNT) was used to determine language functioning before and after surgery. Language dominance was determined for Broca and Wernicke area (WA) by calculating a laterality index following statistical parametric mapping processing. We used an innovative method to generate anatomic resection masks automatically from pre‐ and postoperative MRI tissue map comparison. This mask provided the following: (a) resection volume; (b) overlap between resection and preoperative activation; and (c) overlap between resection and WA. We examined postoperative language change predictors using stepwise linear regression. Predictors included parameters described above as well as age at seizure onset (ASO), preoperative BNT score, and resection side and its relationship to language dominance. Results Seven of 35 adults had significant naming decline (6 dominant‐side resections). The final regression model predicted 38% of the naming score change variance (adjusted r2 = 0.28, P = 0.012). The percentage of top 10% fMRI activation resected (P = 0.017) was the most significant contributor. Other factors in the model included WA LI, ASO, volume of WA resected, and WA LI absolute value (extent of laterality). Significance Resection of fMRI activation during a word‐definition decision task is an important factor for postoperative change in naming ability, along with other previously reported predictors. Currently, many centers establish language dominance using fMRI. Our results suggest that the amount of the top 10% of language fMRI activation in the intended resection area provides additional predictive power and should be considered when planning surgical resection.

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Estimating risk of word-finding problems in adults undergoing epilepsy surgery

Abstract: In addition to discussions regarding risk for memory decline following left TLR, patients should be counseled about potential decline in word-finding ability.

Cited by 56 publications

References 18 publications

Language network measures at rest indicate individual differences in naming decline after anterior temporal lobe resection

Language network measures at rest indicate individual differences in naming decline after anterior temporal lobe resection

Neuropsychological outcome after subtemporal versus transsylvian approach for selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy: a randomised prospective clinical trial

fMRI prediction of naming change after adult temporal lobe epilepsy surgery: Activation matters

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