Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
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Functional Reorganization Associated with Semantic Language Processing in Temporal Lobe Epilepsy Patients after Anterior Temporal Lobectomy: A Longitudinal Functional Magnetic Resonance Image Study

  • Kim, Jae-Hun (Department of Biomedical Engineering, Hanyang University) ;
  • Lee, Jong-Min (Department of Biomedical Engineering, Hanyang University) ;
  • Kang, Eun-Joo (Department of Psychology, Kangwon National University) ;
  • Kim, June-Sic (MEG Center, Departments of Neurosurgery, Seoul National University College of Medicine) ;
  • Song, In-Chan (MEG Center, Radiology, Seoul National University College of Medicine) ;
  • Chung, Chun-Kee (MEG Center, Departments of Neurosurgery, Seoul National University College of Medicine)
  • Published : 2010.01.28
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Abstract

Objective: The focus of this study is brain plasticity associated with semantic aspects of language function in patients with medial temporal lobe epilepsy (mTLE) Methods: Using longitudinal functional magnetic resonance imaging (fMRI), patterns of brain activation were observed in twelve left and seven right unilateral mTLE patients during a word-generation task relative to a pseudo-word reading task before and after anterior temporal section surgery. Results: No differences were observed in precentral activations in patients relative to normal controls (n = 12), and surgery did not alter the phonological-associated activations. The two mTLE patient groups showed left inferior prefrontal activations associated with semantic processing (word-generation>pseudo-word reading), as did control subjects. The amount of semantic-associated activation in the left inferior prefrontal region was negatively correlated with epilepsy duration in both patient groups. Following temporal resection, semantic-specific activations in inferior prefrontal region became more bilateral in left mTLE patients, but more left-lateralized in right mTLE patients. The longer the duration of epilepsy in the patients, the larger the increase in the left inferior prefrontal semantic-associated activation after surgery in both patient groups. Semantic activation of the intact hippocampus, which had been negatively correlated with seizure frequency, normalized after the epileptic side was removed. Conclusion: These results indicate alternation of semantic language network related to recruitment of left inferior prefrontal cortex and functional recovery of the hippocampus contralateral to the epileptogenic side, suggesting an intra- and inter-hemispheric reorganization following surgery.

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References

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