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Neuroradiol J. 2014 Apr;27(2):158-62. doi: 10.15274/NRJ-2014-10031. Epub 2014 Apr 18.

Functional connectivity MRI and post-operative language performance in temporal lobe epilepsy: initial experience.

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Neuroradiology Department, Neurocenter of Italian Switzerland; Lugano, Switzerland - Department of Neuroradiology, Catholic University of Rome; Rome, Italy -
Department of Neuroscience and Imaging and ITAB - Institute Advanced Biomedical Technologies, "G. d'Annunzio" University; Chieti-Pescara, Italy.
Department of Neurosurgery, Catholic University of Rome; Rome, Italy.
Department of Neuroradiology, Catholic University of Rome; Rome, Italy.


Anterior temporal lobectomy is an effective treatment for drug-resistant epilepsy of temporal origin, although new language impairment may develop after surgery. Since correlations between functional connectivity (FC) MRI of the language network and verbal-IQ performance before surgery have recently been reported, we investigated the existence of correlations between the preoperative FC of the language network and post-operative verbal-IQ decline. FC between nodes of the language network of the two hemispheres (Interhemispheric-FC) and within nodes of the left hemisphere (LH-FC) and language lateralization indexes were estimated in five right-handed patients with non-tumoral left temporal lobe epilepsy undergoing anterior temporal lobectomy. Correlations between preoperative FC measures and lateralization indexes, and the post-operative (12 months) neuropsychological verbal-IQ decline were investigated. Verbal-IQ decline was inversely correlated with the degree of left lateralization and directly correlated with the strength of Interhemispheric-FC. No significant correlation was found between LH-FC and post-operative verbal-IQ change. The results from this limited number of patients suggest that a stronger preoperative connectivity between homologue regions, associated with the absence of a definite hemispheric lateralization, appears to be an unfavorable prognostic biomarker.


epilepsy; functional neuroimaging; language; magnetic resonance imaging; temporal lobe

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