Right hemisphere restitution of language and memory functions in right hemisphere language-dominant patients with left temporal lobe epilepsy

Helmstaedter, C.; Kurthen, Martin; Linke, D. B.; Elger, Christian E.

doi:10.1093/brain/117.4.729

Cited by 72 publications

(51 citation statements)

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“…However, in contrast to previous studies on the crowding phenomenon (Saykin et al, 1989;Strauss et al, 1990;Carlsson et al, 1994;Helmstaedter et al, 1994;Mariotti et al, 1998;Staudt et al, 2002), no negative behavioral consequences could be ascertained in our subjects. Most importantly, we did not find major discrepancies between verbal and nonverbal performance.…”

Section: Neuropsychologic Implicationscontrasting

confidence: 99%

Atypical Hemispheric Dominance for Attention: Functional MRI Topography

Flöel

Jansen

Deppe

et al. 2005

J Cereb Blood Flow Metab

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The right hemisphere is predominantly involved in tasks associated with spatial attention. However, left hemispheric dominance for spatial attention can be found in healthy individuals, and both spatial attention and language can be lateralized to the same hemisphere. Little is known about the underlying regional distribution of neural activation in these 'atypical' individuals. Previously a large number of healthy subjects were screened for hemispheric dominance of visuospatial attention and language, using functional Doppler ultrasonography. From this group, subjects were chosen who were 'atypical' for hemispheric dominance of visuospatial attention and language, and their pattern of brain activation was studied with functional magnetic resonance imaging during a task probing spatial attention. Right-handed subjects with the 'typical' pattern of brain organization served as control subjects. It was found that subjects with an inverted lateralization of language and spatial attention (language right, attention left) recruited left-hemispheric areas in the attention task, homotopic to those recruited by control subjects in the right hemisphere. Subjects with lateralization of both language and attention to the right hemisphere activated an attentional network in the right hemisphere that was comparable to control subjects. The present findings suggest that not the hemispheric side, but the intrahemispheric pattern of activation is the distinct feature for the neural processes underlying language and attention.

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Section: Neuropsychologic Implicationscontrasting

confidence: 99%

Atypical Hemispheric Dominance for Attention: Functional MRI Topography

Flöel

Jansen

Deppe

et al. 2005

J Cereb Blood Flow Metab

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“…42,44,48 However, left and right mesial structures appear to provide highly redundant and compensatory functions in verbal memory processing. 17 Accordingly, it can be observed that nonverbal memory may be sacrificed in favor of verbal memory 20 and that material-specific impairments in TLE are less likely in the presence of generally reduced mental capacities. 19 In the surgery group, verbal memory was found to deteriorate significantly in 6 of 8 patients with left temporal resection and in 2 of 3 with right temporal resection.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Vogt¹,

Malter²,

Schoene-Bake³

et al. 2014

JNS

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Object. The purpose of this study was to retrospectively assess the objective and subjective neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis (AHS).Methods. Memory and executive functions were evaluated at baseline and at follow-up in 11 surgically treated patients and compared with 8 pharmacologically treated patients with temporal lobe epilepsy and bilateral AHS. The median follow-up duration was 16 months in the surgically treated patients and 80.5 months in the pharmacologically treated group. Subjective outcome was evaluated by questionnaires and included mood, quality of life, subjective memory, and activities of daily living.Results. At the follow-up assessment, 82% of the surgically treated patients as opposed to 0% of the nonsurgery patients were seizure free. In the surgical group, nonverbal memory performance did not change significantly in any patient after surgery, but there was a floor effect in 55% of the surgical patients. Regarding verbal memory, 9% of the surgical patients improved while 73% declined, despite severe impairments already evident at baseline. In the nonsurgery control group, 13% of the patients declined in nonverbal memory (floor effect in 63%) and 25% declined in verbal memory (floor effect in 25%) at follow-up. None of the controls improved at follow-up. Executive functions remained unchanged on an impaired level in both groups. At follow-up, the patient groups did not differ significantly with respect to mood, quality of life, subjective memory, or activities of daily living. However, in most aspects, surgically treated patients reported a slightly better subjective outcome than pharmacologically treated patients and a significantly improved quality of life.Conclusions. These results suggest that beyond benefits concerning seizure control, surgically treated patients with bilateral AHS, despite already poor baseline performance, are still at risk for severe postoperative decline in memory. In the light of predominantly minor benefits on a subjective level, the findings put the overall outcome of epilepsy surgery in bilateral AHS patients into perspective. (http://thejns.org/doi/abs/10.3171/2014.7.JNS132037) key WordS • neuropsychological outcome • temporal lobe epilepsy surgery • memory • bilateral Ammon's horn sclerosis Abbreviations used in this paper: AHS = Ammon's horn sclerosis; BDI = Beck Depression Inventory; QOLIE = Quality of Life in Epilepsy Inventory; RCI = reliable change index; TLE = temporal lobe epilepsy; VLMT = Verbaler Lern-und Merkfähigkeitstest.

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“…Because so little is understood about the mechanisms responsible for inter-versus intrahemispheric language transfer after LH focal lesions [de Bode, 1998;Duchowny et al, 1996;Helmstaedter et al, 1994], studies of focal damage in children may not be adequate for determining the potential of the RH to serve as the substrate for the acquisition of grammar. It is often unknown whether impaired performance in these cases reflects the best efforts of the damaged LH, the linguistic performance of the RH or some combination of both.…”

Section: Literature Reviewmentioning

confidence: 99%

Age and Etiology as Predictors of Language Outcome following Hemispherectomy

Curtiss¹,

Bode²

1999

Dev Neurosci

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We report on the effects of etiology and age on the linguistic outcomes in a large pediatric hemispherectomy population. Four populations were considered separately: cortical dysplasia (multilobar involvement), Rasmussen’s encephalitis, infarction as a primary etiology and, fourth, children who failed to develop language, regardless of etiology. We argue against the ‘the-earlier-the-better’ hypothesis and propose our own hypothesis that weds maturational factors to etiological factors to predict language outcomes following pervasive brain insult. The implications of our ‘critical impact point’ hypothesis are discussed.

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Right hemisphere restitution of language and memory functions in right hemisphere language-dominant patients with left temporal lobe epilepsy

Cited by 72 publications

References 0 publications

Atypical Hemispheric Dominance for Attention: Functional MRI Topography

Atypical Hemispheric Dominance for Attention: Functional MRI Topography

Neuropsychological outcome after epilepsy surgery in patients with bilateral Ammon's horn sclerosis

Age and Etiology as Predictors of Language Outcome following Hemispherectomy

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