From the Departments of Neurology (E.C.-B., M. Carreño, M. Centeno, I.M., A.D.)
Institut d'Investigacions Biomèdiques August Pi i Sunyer (E.C.-B., M. Carreño, M. Centeno, A.D., T.B., L.P., J.R., P.R., X.S., N.B.), Barcelona, Spain.
AJNR Am J Neuroradiol. 2022 Oct;43(10):1445-1452. doi: 10.3174/ajnr.A7622. Epub 2022 Sep 22.
fMRI is a noninvasive tool for predicting postsurgical deficits in candidates with pharmacoresistant temporal lobe epilepsy. We aimed to test an adapted paradigm of the Rey Auditory Verbal Learning Test to evaluate differences in memory laterality indexes between patients and healthy controls and its association with neuropsychological scores.
We performed a prospective study of 50 patients with temporal lobe epilepsy and 22 healthy controls. Participants underwent a block design language and memory fMRI. Laterality indexes and the hippocampal anterior-posterior index were calculated. Language and memory lateralization was organized into typical and atypical on the basis of laterality indexes. A neuropsychological assessment was performed with a median time from fMRI of 8 months and was compared with fMRI performance.
We studied 40 patients with left temporal lobe epilepsy and 10 with right temporal lobe epilepsy. Typical language occurred in 65.3% of patients and 90.9% of healthy controls ( = .04). The memory fMRI laterality index was obtained in all healthy controls and 92% of patients. The verbal memory laterality index was bilateral (24.3%) more frequently than the language laterality index (7.69%) in patients with left temporal lobe epilepsy. Atypical verbal memory was greater in patients with left temporal lobe epilepsy (56.8%) than in healthy controls (36.4%), and the proportion of bilateral laterality indexes (53.3%) was larger than right laterality indexes (46.7%). Atypical verbal memory might be associated with higher cognitive scores in patients. No relevant differences were seen in the hippocampal anterior-posterior index according to memory impairment.
The adapted Rey Auditory Verbal Learning Test paradigm fMRI might support verbal memory lateralization. Temporal lobe epilepsy laterality influences hippocampal memory laterality indexes. Left temporal lobe epilepsy has shown a higher proportion of atypical verbal memory compared with language, potentially to memory functional reorganization.
功能磁共振成像（fMRI）是一种非侵入性工具，可用于预测药物难治性颞叶癫痫患者术后缺陷。我们旨在测试 Rey 听觉言语学习测试的改编范式，以评估患者和健康对照组之间记忆侧化指数的差异及其与神经心理学评分的关联。
我们对 50 例颞叶癫痫患者和 22 例健康对照者进行了前瞻性研究。参与者接受了语言 fMRI 块设计。计算侧化指数和海马前后指数。根据侧化指数将语言和记忆侧化组织为典型和非典型。神经心理学评估在 fMRI 后中位数 8 个月进行，并与 fMRI 表现进行比较。
我们研究了 40 例左侧颞叶癫痫患者和 10 例右侧颞叶癫痫患者。典型语言在患者中为 65.3%，在健康对照组中为 90.9%（ =.04）。所有健康对照组和 92%的患者均获得了记忆 fMRI 侧化指数。与语言侧化指数（7.69%）相比，左侧颞叶癫痫患者的言语记忆侧化指数更常为双侧（24.3%）。左侧颞叶癫痫患者的非典型言语记忆大于健康对照组（56.8%比 36.4%），双侧侧化指数（53.3%）的比例大于右侧侧化指数（46.7%）。非典型言语记忆可能与患者的更高认知评分相关。根据记忆障碍，海马前后指数无明显差异。
改编的 Rey 听觉言语学习测试 fMRI 范式可能支持言语记忆侧化。颞叶癫痫侧化影响海马记忆侧化指数。与语言相比，左侧颞叶癫痫显示出更高比例的非典型言语记忆，可能与记忆功能重组有关。
