Abstract:
PURPOSE:To retrospectively determine whether blood oxygen level-dependent functional magnetic resonance (MR) imaging can aid prediction of postoperative memory changes in epileptic patients after temporal lobe surgery. MATERIALS AND METHODS:This study was approved by the local ethics committee, and informed consent was obtained from all patients. Data were analyzed from 25 patients (12 women, 13 men; age range, 19-52 years) with refractory epilepsy in whom temporal lobe surgery was performed after they underwent preoperative functional MR imaging, the Wada test, and neuropsychological testing. The functional MR imaging protocol included three different memory tasks (24-hour delayed recognition, encoding, and immediate recognition). Individual activations were measured in medial temporal lobe (MTL) regions of both hemispheres. The prognostic accuracy of functional MR imaging for prediction of postoperative memory changes was compared with the accuracy of the Wada test and preoperative neuropsychological testing by using a backward multiple regression analysis. RESULTS:An equation that was based on left functional MR imaging MTL activation during delayed recognition, side of the epileptic focus, and preoperative global verbal memory score was used to correctly predict worsening of verbal memory in 90% of patients. The right functional MR imaging MTL activation did not substantially correlate with the nonverbal memory outcome, which was only predicted by using the preoperative nonverbal global score. Wada test data were not good predictors of changes in either verbal or nonverbal memory. CONCLUSION:Findings suggest that functional MR imaging activation during a delayed-recognition task is a better predictor of individual postoperative verbal memory outcome than is the Wada test.
journal_name
Radiologyjournal_title
Radiologyauthors
Dupont S,Duron E,Samson S,Denos M,Volle E,Delmaire C,Navarro V,Chiras J,Lehéricy S,Samson Y,Baulac Mdoi
10.1148/radiol.09091079subject
Has Abstractpub_date
2010-04-01 00:00:00pages
128-34issue
1eissn
0033-8419issn
1527-1315pii
255/1/128journal_volume
255pub_type
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