Memory fMRI predicts verbal memory decline after anterior temporal lobe resection

Neurology. 2015 Apr 14;84(15):1512-9. doi: 10.1212/WNL.0000000000001461. Epub 2015 Mar 13.


Objective: To develop a clinically applicable memory functional MRI (fMRI) method of predicting postsurgical memory outcome in individual patients.

Methods: In this prospective cohort study, 50 patients with temporal lobe epilepsy (23 left) and 26 controls underwent an fMRI memory encoding paradigm of words with a subsequent out-of-scanner recognition assessment. Neuropsychological assessment was performed preoperatively and 4 months after anterior temporal lobe resection, and at equal time intervals in controls. An event-related analysis was used to explore brain activations for words remembered and change in verbal memory scores 4 months after surgery was correlated with preoperative activations. Individual lateralization indices were calculated within a medial temporal and frontal region and compared with other clinical parameters (hippocampal volume, preoperative verbal memory, age at onset of epilepsy, and language lateralization) as a predictor of verbal memory outcome.

Results: In left temporal lobe epilepsy patients, left frontal and anterior medial temporal activations correlated significantly with greater verbal memory decline, while bilateral posterior hippocampal activation correlated with less verbal memory decline postoperatively. In a multivariate regression model, left lateralized memory lateralization index (≥0.5) within a medial temporal and frontal mask was the best predictor of verbal memory outcome after surgery in the dominant hemisphere in individual patients. Neither clinical nor functional MRI parameters predicted verbal memory decline after nondominant temporal lobe resection.

Conclusion: We propose a clinically applicable memory fMRI paradigm to predict postoperative verbal memory decline after surgery in the language-dominant hemisphere in individual patients.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anterior Temporal Lobectomy / adverse effects*
  • Brain Mapping
  • Cerebral Cortex / physiopathology*
  • Cerebral Cortex / surgery*
  • Epilepsy, Temporal Lobe / surgery*
  • Frontal Lobe / physiopathology
  • Functional Laterality / physiology*
  • Hippocampus / physiopathology
  • Hippocampus / surgery
  • Humans
  • Magnetic Resonance Imaging
  • Memory Disorders / etiology
  • Memory Disorders / physiopathology*
  • Postoperative Complications / physiopathology*
  • Predictive Value of Tests
  • Prospective Studies
  • Sensitivity and Specificity
  • Temporal Lobe / physiopathology
  • Temporal Lobe / surgery