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Abnormalities of language networks in temporal lobe epilepsy
Powell H.W. Robert, Parker GJM, Alexander Daniel C, Symms Mark R, Boulby Philip A, Wheeler-Kingshott Claudia A.M, Barker Gareth J, Koepp Matthias J, Duncan John S
Neuroimage. 2007;36:209-221.
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Abstract
Functional magnetic resonance imaging (fMRI) in patients withtemporal lobe epilepsy (TLE) has demonstrated reorganisation oflanguage functions with greater involvement of the non-dominanthemisphere. The structural brain connections supporting this atypicallanguage dominance have not previously been identified. Weperformed fMRI of language functions and imaging of white matterconnections using MR tractography in 14 patients with unilateral TLEand hippocampal sclerosis and 10 controls. Verb generation andreading comprehension paradigms were used to define functionalregions which were used to generate starting regions for tractography.Controls and right TLE patients had a left-lateralised pattern of bothlanguage-related activations and the associated structural connections.Left TLE patients showed more symmetrical language activations,along with reduced left hemisphere and increased right hemispherestructural connections. Subjects with more lateralised functionalactivation had also more highly lateralised connecting pathways. Weprovide evidence for structural reorganisation of white matter tractsthat reflects the altered functional language lateralisation in left TLEpatients. The combination of fMRI and tractography offers apromising tool for studying the reorganisation of language functionsin many neurological conditions and may prove useful in predictinglanguage deficits following temporal lobe surgery.© 2007 Elsevier Inc. All rights reserved.