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e-Article

MRI evidence for material-specific encoding deficits and mesial-temporal alterations in presurgical frontal lobe epilepsy patients.
Document Type
Academic Journal
Author
Doll A; Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.; Department of Psychology, Bielefeld University, Bielefeld, Germany.; Wegrzyn M; Department of Psychology, Bielefeld University, Bielefeld, Germany.; Woermann FG; Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.; Labudda K; Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.; Department of Psychology, Bielefeld University, Bielefeld, Germany.; Bien CG; Department of Epileptology (Krankenhaus Mara), Medical School, Bielefeld University, Bielefeld, Germany.; Kissler J; Department of Psychology, Bielefeld University, Bielefeld, Germany.; Center for Cognitive Interaction Technology (CITEC), Bielefeld University, Bielefeld, Germany.
Source
Publisher: John Wiley & Sons, Inc Country of Publication: United States NLM ID: 101692036 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2470-9239 (Electronic) Linking ISSN: 24709239 NLM ISO Abbreviation: Epilepsia Open Subsets: MEDLINE
Subject
Language
English
Abstract
Objective: Neuroimaging studies reveal frontal lobe (FL) contributions to memory encoding. Accordingly, memory impairments are documented in frontal lobe epilepsy (FLE). Still, little is known about the structural or functional correlates of such impairments. Particularly, material specificity of functional changes in cerebral activity during memory encoding in FLE is unclear.
Methods: We compared 24 FLE patients (15 right-sided) undergoing presurgical evaluation with 30 healthy controls on a memory fMRI-paradigm of learning scenes, faces, and words followed by an out-of-scanner recognition task as well as regarding their mesial temporal lobe (mTL) volumes. We also addressed effects of FLE lateralization and performance level (normal vs. low).
Results: FLE patients had poorer memory performance and larger left hippocampal volumes than controls. Volume increase seemed, however, irrelevant or even dysfunctional for memory performance. Further, functional changes in FLE patients were right-sided for scenes and faces and bilateral for words. In detail, during face encoding, FLE patients had, regardless of their performance level, decreased mTL activation, while during scene and word encoding only low performing FLE patients had decreased mTL along with decreased FL activation. Intact verbal memory performance was associated with higher right frontal activation in FLE patients but not in controls.
Significance: Pharmacoresistant FLE has a distinct functional and structural impact on the mTL. Effects vary with the encoded material and patients' performance levels. Thus, in addition to the direct effect of the FL, memory impairment in FLE is presumably to a large part due to functional mTL changes triggered by disrupted FL networks.
Plain Language Summary: Frontal lobe epilepsy (FLE) patients may suffer from memory impairment. Therefore, we asked patients to perform a memory task while their brain was scanned by MRI in order to investigate possible changes in brain activation during learning. FLE patients showed changes in brain activation during learning and also structural changes in the mesial temporal lobe, which is a brain region especially relevant for learning but not the origin of the seizures in FLE. We conclude that FLE leads to widespread changes that contribute to FLE patients' memory impairment.
(© 2023 The Authors. Epilepsia Open published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.)