Abstract Details

Title Increased Right Hemisphere Activation in a Visual Confrontation Naming Paradigm in Left Mesial Temporal Sclerosis

Topic Epilepsy

Presentation(s) P06 - (-)

Poster/Presentation
Number 163

Objective

Background BACKGROUND: fMRI has become an important tool in presurgical language mapping. fMRI and WADA studies have shown that left MTS patients have higher rates of atypical language lateralization compared with right MTS patients.

Design/Methods DESIGN/METHODS: We studied 23 left(L) and 16 right(R) MTS patients and 22 healthy controls(C). Subjects were right-handed, aged between 18-55years, and had at least eight years of education. Patients underwent WADA testing that documented left hemisphere language dominance. Subjects underwent language battery and fMRI study with visual confrontation naming paradigm specifically developed for this study. Patients and controls did not differ in terms of age, years of education, gender, presence of initial precipitating insult, age at initial insult, silent period duration, age at epilepsy onset, and epilepsy duration. Data were acquired using 3T MRI scanner with compressed GRE EPI BOLD images, and normalization to MNI152 space. A between groups ANOVA comparison was performed with a significance level of p<0.05.

Results RESULTS: Clinical language assessment showed that LMTS and RMTS patients performed worse than C in semantic fluency and in proper noun naming tasks. RMTS performed worse than LMTS and C in action naming task. fMRI activation pattern analysis showed that LMTS patients had increased right hemisphere activation compared to controls in the inferior frontal, posterior parietal and basal frontal areas. RMTS activation patterns did not differ from controls.

Conclusions CONCLUSIONS: Language network reorganization in visual confrontation naming involves increased activation of right hemisphere frontal and parietal areas. These areas are homologous to left hemisphere areas activated by the visual confrontation paradigm, indicating a right hemisphere shift of the activation map for visual confrontation naming in left MTS patients.

Authors/Disclosures
PRESENTER	No disclosure on file
Tanya Simuni, MD, FAAN (Northwestern University Feinberg School of Medicien)	Dr. Simuni has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for cadia, AcureX, Adamas, AskBio, Amneal, Blue Rock Therapeutics, Caraway Therapeutics, Critical Path for Parkinson's Consortium (CPP), Denali, Michael J Fox Foundation, Neuroderm, Sanofi, Sinopia, Roche, Takeda and Vanqua Bio. Dr. Simuni has received personal compensation in the range of $5,000-$9,999 for serving on a Scientific Advisory or Data Safety Monitoring board for of Koneksa, Neuroderm, Sanofi, UCB, AcureX, Adamas, AskBio, Biohaven, Denali, GAIN, Neuron23 and Roche. Dr. Simuni has received research support from Amneal, Biogen, Neuroderm, Prevail, Roche, and UCB and an investigator for NINDS, MJFF, Parkinson's Foundation.
	No disclosure on file
	No disclosure on file
Rosa M. Valerio, PhD	No disclosure on file
	No disclosure on file
	No disclosure on file
Luiz H. Castro, MD (University of Sao Paulo)	Dr. Castro has nothing to disclose.

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