Epilepsy Society MRI Unit, Epilepsy Society, Chalfont St Peter, SL9 0LR, UK.
Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, Queen Square, London, WC1N 3BG, UK.
Brain. 2018 Aug 1;141(8):2406-2418. doi: 10.1093/brain/awy164.
Impairment of naming function is a critical problem for temporal lobe epilepsy patients, yet the neural correlates of the disruption of temporal lobe language networks are poorly understood. Using functional MRI, we investigated the activation and task-related functional connectivity of left temporal lobe language networks and their relation to clinical naming performance and disease characteristics. We studied 59 adult patients with temporal lobe epilepsy (35 left temporal lobe epilepsy) and 32 healthy controls with auditory and visual naming functional MRI tasks. Time series of activation maxima in the left posterior inferior temporal lobe were extracted to create a psychophysiological interaction regressor for subsequent seed-based whole-brain task-related functional connectivity analyses. Correlational analyses were performed to assess the association of functional MRI activation and functional connectivity with clinical naming scores, age of onset of epilepsy, and duration of epilepsy. Auditory naming elicited activation in the left posterior inferior temporal gyrus and visual naming in the left fusiform gyrus across all groups. Activations in the left inferior temporal gyrus, left thalamus and left supplementary motor region during auditory naming as well as left fusiform activations during picture naming correlated with better clinical naming performance. Functional connectivity analyses indicated coupling of left posterior inferior temporal regions to bilateral anterior and posterior temporal lobe regions and the bilateral inferior precentral gyrus as well as contralateral occipital cortex. Stronger functional connectivity was associated with better clinical naming performance in all groups. In patients with left temporal lobe epilepsy only, functional connectivity increased with later age of onset of epilepsy and shorter disease duration. This suggests that onset of seizures early in life and prolonged disease duration lead to disrupted recruitment of temporal lobe networks ipsilateral to the seizure focus, which might account for naming deficits in temporal lobe epilepsy.
命名功能障碍是颞叶癫痫患者的一个关键问题，但颞叶语言网络中断的神经相关性仍知之甚少。我们使用功能磁共振成像技术研究了左颞叶语言网络的激活和与任务相关的功能连接及其与临床命名表现和疾病特征的关系。我们研究了 59 名成年颞叶癫痫患者（35 名左侧颞叶癫痫）和 32 名健康对照者，进行了听觉和视觉命名功能磁共振成像任务。从左后颞叶的激活最大值时间序列中提取时间序列，以创建心理生理相互作用回归器，用于随后的基于种子的全脑任务相关功能连接分析。相关性分析用于评估功能磁共振成像激活和功能连接与临床命名评分、癫痫发病年龄和癫痫持续时间的相关性。听觉命名在所有组中都能激活左后颞叶下部，视觉命名在左梭状回。听觉命名时左颞叶下部、左丘脑和左辅助运动区的激活以及图片命名时左梭状回的激活与临床命名表现较好相关。功能连接分析表明，左后颞叶区域与双侧前颞叶和后颞叶区域以及双侧下中央前回和对侧枕叶皮层耦合。所有组中，功能连接越强，临床命名表现越好。仅在左颞叶癫痫患者中，功能连接随癫痫发病年龄的延迟和疾病持续时间的缩短而增加。这表明癫痫发作早期和疾病持续时间延长会导致对侧颞叶网络的招募中断，这可能是颞叶癫痫命名缺陷的原因。
