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1.
Brain Commun ; 6(3): fcae176, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38883806

RESUMO

Whilst the concept of a general mental factor known as 'g' has been of longstanding interest, for unknown reasons, it has never been interrogated in epilepsy despite the 100+ year empirical history of the neuropsychology of epilepsy. This investigation seeks to identify g within a comprehensive neuropsychological data set and compare participants with temporal lobe epilepsy to controls, characterize the discriminatory power of g compared with domain-specific cognitive metrics, explore the association of g with clinical epilepsy and sociodemographic variables and identify the structural and network properties associated with g in epilepsy. Participants included 110 temporal lobe epilepsy patients and 79 healthy controls between the ages of 19 and 60. Participants underwent neuropsychological assessment, clinical interview and structural and functional imaging. Cognitive data were subjected to factor analysis to identify g and compare the group of patients with control participants. The relative power of g compared with domain-specific tests was interrogated, clinical and sociodemographic variables were examined for their relationship with g, and structural and functional images were assessed using traditional regional volumetrics, cortical surface features and network analytics. Findings indicate (i) significantly (P < 0.005) lower g in patients compared with controls; (ii) g is at least as powerful as individual cognitive domain-specific metrics and other analytic approaches to discriminating patients from control participants; (iii) lower g was associated with earlier age of onset and medication use, greater number of antiseizure medications and longer epilepsy duration (Ps < 0.04); and lower parental and personal education and greater neighbourhood deprivation (Ps < 0.012); and (iv) amongst patients, lower g was linked to decreased total intracranial volume (P = 0.019), age and intracranial volume adjusted total tissue volume (P = 0.019) and age and intracranial volume adjusted total corpus callosum volume (P = 0.012)-particularly posterior, mid-posterior and anterior (Ps < 0.022) regions. Cortical vertex analyses showed lower g to be associated specifically with decreased gyrification in bilateral medial orbitofrontal regions. Network analysis of resting-state data with focus on the participation coefficient showed g to be associated with the superior parietal network. Spearman's g is reduced in patients, has considerable discriminatory power compared with domain-specific metrics and is linked to a multiplex of factors related to brain (size, connectivity and frontoparietal networks), environment (familial and personal education and neighbourhood disadvantage) and disease (epilepsy onset, treatment and duration). Greater attention to contemporary models of human cognition is warranted in order to advance the neuropsychology of epilepsy.

2.
Neuropsychologia ; 201: 108939, 2024 Aug 13.
Artigo em Inglês | MEDLINE | ID: mdl-38897450

RESUMO

The organization of semantic memory, including memory for word meanings, has long been a central question in cognitive science. Although there is general agreement that word meaning representations must make contact with sensory-motor and affective experiences in a non-arbitrary fashion, the nature of this relationship remains controversial. One prominent view proposes that word meanings are represented directly in terms of their experiential content (i.e., sensory-motor and affective representations). Opponents of this view argue that the representation of word meanings reflects primarily taxonomic structure, that is, their relationships to natural categories. In addition, the recent success of language models based on word co-occurrence (i.e., distributional) information in emulating human linguistic behavior has led to proposals that this kind of information may play an important role in the representation of lexical concepts. We used a semantic priming paradigm designed for representational similarity analysis (RSA) to quantitatively assess how well each of these theories explains the representational similarity pattern for a large set of words. Crucially, we used partial correlation RSA to account for intercorrelations between model predictions, which allowed us to assess, for the first time, the unique effect of each model. Semantic priming was driven primarily by experiential similarity between prime and target, with no evidence of an independent effect of distributional or taxonomic similarity. Furthermore, only the experiential models accounted for unique variance in priming after partialling out explicit similarity ratings. These results support experiential accounts of semantic representation and indicate that, despite their good performance at some linguistic tasks, the distributional models evaluated here do not encode the same kind of information used by the human semantic system.


Assuntos
Semântica , Humanos , Feminino , Masculino , Adulto Jovem , Idioma , Adulto , Modelos Psicológicos , Tempo de Reação/fisiologia , Adolescente , Psicolinguística
3.
Cereb Cortex ; 34(6)2024 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-38863113

RESUMO

Neuropsychological and neuroimaging studies provide evidence for a degree of category-related organization of conceptual knowledge in the brain. Some of this evidence indicates that body part concepts are distinctly represented from other categories; yet, the neural correlates and mechanisms underlying these dissociations are unclear. We expand on the limited prior data by measuring functional magnetic resonance imaging responses induced by body part words and performing a series of analyses investigating the cortical representation of this semantic category. Across voxel-level contrasts, pattern classification, representational similarity analysis, and vertex-wise encoding analyses, we find converging evidence that the posterior middle temporal gyrus, the supramarginal gyrus, and the ventral premotor cortex in the left hemisphere play important roles in the preferential representation of this category compared to other concrete objects.


Assuntos
Mapeamento Encefálico , Imageamento por Ressonância Magnética , Humanos , Feminino , Masculino , Mapeamento Encefálico/métodos , Adulto , Adulto Jovem , Formação de Conceito/fisiologia , Encéfalo/fisiologia , Encéfalo/diagnóstico por imagem , Semântica
4.
Brain Commun ; 5(2): fcad095, 2023.
Artigo em Inglês | MEDLINE | ID: mdl-37038499

RESUMO

The relationship between temporal lobe epilepsy and psychopathology has had a long and contentious history with diverse views regarding the presence, nature and severity of emotional-behavioural problems in this patient population. To address these controversies, we take a new person-centred approach through the application of unsupervised machine learning techniques to identify underlying latent groups or behavioural phenotypes. Addressed are the distinct psychopathological profiles, their linked frequency, patterns and severity and the disruptions in morphological and network properties that underlie the identified latent groups. A total of 114 patients and 83 controls from the Epilepsy Connectome Project were administered the Achenbach System of Empirically Based Assessment inventory from which six Diagnostic and Statistical Manual of Mental Disorders-oriented scales were analysed by unsupervised machine learning analytics to identify latent patient groups. Identified clusters were contrasted to controls as well as to each other in order to characterize their association with sociodemographic, clinical epilepsy and morphological and functional imaging network features. The concurrent validity of the behavioural phenotypes was examined through other measures of behaviour and quality of life. Patients overall exhibited significantly higher (abnormal) scores compared with controls. However, cluster analysis identified three latent groups: (i) unaffected, with no scale elevations compared with controls (Cluster 1, 37%); (ii) mild symptomatology characterized by significant elevations across several Diagnostic and Statistical Manual of Mental Disorders-oriented scales compared with controls (Cluster 2, 42%); and (iii) severe symptomatology with significant elevations across all scales compared with controls and the other temporal lobe epilepsy behaviour phenotype groups (Cluster 3, 21%). Concurrent validity of the behavioural phenotype grouping was demonstrated through identical stepwise links to abnormalities on independent measures including the National Institutes of Health Toolbox Emotion Battery and quality of life metrics. There were significant associations between cluster membership and sociodemographic (handedness and education), cognition (processing speed), clinical epilepsy (presence and lifetime number of tonic-clonic seizures) and neuroimaging characteristics (cortical volume and thickness and global graph theory metrics of morphology and resting-state functional MRI). Increasingly dispersed volumetric abnormalities and widespread disruptions in underlying network properties were associated with the most abnormal behavioural phenotype. Psychopathology in these patients is characterized by a series of discrete latent groups that harbour accompanying sociodemographic, clinical and neuroimaging correlates. The underlying neurobiological patterns suggest that the degree of psychopathology is linked to increasingly dispersed abnormal brain networks. Similar to cognition, machine learning approaches support a novel developing taxonomy of the comorbidities of epilepsy.

5.
Cereb Cortex ; 33(12): 8056-8065, 2023 06 08.
Artigo em Inglês | MEDLINE | ID: mdl-37067514

RESUMO

Temporal lobe epilepsy (TLE) is the most common epilepsy syndrome that empirically represents a network disorder, which makes graph theory (GT) a practical approach to understand it. Multi-shell diffusion-weighted imaging (DWI) was obtained from 89 TLE and 50 controls. GT measures extracted from harmonized DWI matrices were used as factors in a support vector machine (SVM) analysis to discriminate between groups, and in a k-means algorithm to find intrinsic structural phenotypes within TLE. SVM was able to predict group membership (mean accuracy = 0.70, area under the curve (AUC) = 0.747, Brier score (BS) = 0.264) using 10-fold cross-validation. In addition, k-means clustering identified 2 TLE clusters: 1 similar to controls, and 1 dissimilar. Clusters were significantly different in their distribution of cognitive phenotypes, with the Dissimilar cluster containing the majority of TLE with cognitive impairment (χ2 = 6.641, P = 0.036). In addition, cluster membership showed significant correlations between GT measures and clinical variables. Given that SVM classification seemed driven by the Dissimilar cluster, SVM analysis was repeated to classify Dissimilar versus Similar + Controls with a mean accuracy of 0.91 (AUC = 0.957, BS = 0.189). Altogether, the pattern of results shows that GT measures based on connectome DWI could be significant factors in the search for clinical and neurobehavioral biomarkers in TLE.


Assuntos
Conectoma , Epilepsia do Lobo Temporal , Humanos , Epilepsia do Lobo Temporal/diagnóstico por imagem , Conectoma/métodos , Imagem de Difusão por Ressonância Magnética , Cognição , Imageamento por Ressonância Magnética/métodos
6.
bioRxiv ; 2023 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-36993310

RESUMO

The organization of semantic memory, including memory for word meanings, has long been a central question in cognitive science. Although there is general agreement that word meaning representations must make contact with sensory-motor and affective experiences in a non-arbitrary fashion, the nature of this relationship remains controversial. One prominent view proposes that word meanings are represented directly in terms of their experiential content (i.e., sensory-motor and affective representations). Opponents of this view argue that the representation of word meanings reflects primarily taxonomic structure, that is, their relationships to natural categories. In addition, the recent success of language models based on word co-occurrence (i.e., distributional) information in emulating human linguistic behavior has led to proposals that this kind of information may play an important role in the representation of lexical concepts. We used a semantic priming paradigm designed for representational similarity analysis (RSA) to quantitatively assess how well each of these theories explains the representational similarity pattern for a large set of words. Crucially, we used partial correlation RSA to account for intercorrelations between model predictions, which allowed us to assess, for the first time, the unique effect of each model. Semantic priming was driven primarily by experiential similarity between prime and target, with no evidence of an independent effect of distributional or taxonomic similarity. Furthermore, only the experiential models accounted for unique variance in priming after partialling out explicit similarity ratings. These results support experiential accounts of semantic representation and indicate that, despite their good performance at some linguistic tasks, the distributional models evaluated here do not encode the same kind of information used by the human semantic system.

7.
Sci Rep ; 12(1): 14407, 2022 08 24.
Artigo em Inglês | MEDLINE | ID: mdl-36002603

RESUMO

Machine learning analyses were performed on graph theory (GT) metrics extracted from brain functional and morphological data from temporal lobe epilepsy (TLE) patients in order to identify intrinsic network phenotypes and characterize their clinical significance. Participants were 97 TLE and 36 healthy controls from the Epilepsy Connectome Project. Each imaging modality (i.e., Resting-state functional Magnetic Resonance Imaging (RS-fMRI), and structural MRI) rendered 2 clusters: one comparable to controls and one deviating from controls. Participants were minimally overlapping across the identified clusters, suggesting that an abnormal functional GT phenotype did not necessarily mean an abnormal morphological GT phenotype for the same subject. Morphological clusters were associated with a significant difference in the estimated lifetime number of generalized tonic-clonic seizures and functional cluster membership was associated with age. Furthermore, controls exhibited significant correlations between functional GT metrics and cognition, while for TLE participants morphological GT metrics were linked to cognition, suggesting a dissociation between higher cognitive abilities and GT-derived network measures. Overall, these findings demonstrate the existence of clinically meaningful minimally overlapping phenotypes of morphological and functional GT networks. Functional network properties may underlie variance in cognition in healthy brains, but in the pathological state of epilepsy the cognitive limits might be primarily related to structural cerebral network properties.


Assuntos
Conectoma , Epilepsia do Lobo Temporal , Encéfalo/diagnóstico por imagem , Conectoma/métodos , Epilepsia do Lobo Temporal/diagnóstico por imagem , Humanos , Aprendizado de Máquina , Imageamento por Ressonância Magnética/métodos , Fenótipo
8.
J Neurosci ; 42(37): 7121-7130, 2022 09 14.
Artigo em Inglês | MEDLINE | ID: mdl-35940877

RESUMO

Neuroimaging, neuropsychological, and psychophysical evidence indicate that concept retrieval selectively engages specific sensory and motor brain systems involved in the acquisition of the retrieved concept. However, it remains unclear which supramodal cortical regions contribute to this process and what kind of information they represent. Here, we used representational similarity analysis of two large fMRI datasets with a searchlight approach to generate a detailed map of human brain regions where the semantic similarity structure across individual lexical concepts can be reliably detected. We hypothesized that heteromodal cortical areas typically associated with the default mode network encode multimodal experiential information about concepts, consistent with their proposed role as cortical integration hubs. In two studies involving different sets of concepts and different participants (both sexes), we found a distributed, bihemispheric network engaged in concept representation, composed of high-level association areas in the anterior, lateral, and ventral temporal lobe; inferior parietal lobule; posterior cingulate gyrus and precuneus; and medial, dorsal, ventrolateral, and orbital prefrontal cortex. In both studies, a multimodal model combining sensory, motor, affective, and other types of experiential information explained significant variance in the neural similarity structure observed in these regions that was not explained by unimodal experiential models or by distributional semantics (i.e., word2vec similarity). These results indicate that during concept retrieval, lexical concepts are represented across a vast expanse of high-level cortical regions, especially in the areas that make up the default mode network, and that these regions encode multimodal experiential information.SIGNIFICANCE STATEMENT Conceptual knowledge includes information acquired through various modalities of experience, such as visual, auditory, tactile, and emotional information. We investigated which brain regions encode mental representations that combine information from multiple modalities when participants think about the meaning of a word. We found that such representations are encoded across a widely distributed network of cortical areas in both hemispheres, including temporal, parietal, limbic, and prefrontal association areas. Several areas not traditionally associated with semantic cognition were also implicated. Our results indicate that the retrieval of conceptual knowledge during word comprehension relies on a much larger portion of the cerebral cortex than previously thought and that multimodal experiential information is represented throughout the entire network.


Assuntos
Mapeamento Encefálico , Semântica , Compreensão , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Parietal
9.
Neurology ; 98(23): e2337-e2346, 2022 06 07.
Artigo em Inglês | MEDLINE | ID: mdl-35410903

RESUMO

BACKGROUND AND OBJECTIVES: Naming decline after left temporal lobe epilepsy (TLE) surgery is common and difficult to predict. Preoperative language fMRI may predict naming decline, but this application is still lacking evidence. We performed a large multicenter cohort study of the effectiveness of fMRI in predicting naming deficits after left TLE surgery. METHODS: At 10 US epilepsy centers, 81 patients with left TLE were prospectively recruited and given the Boston Naming Test (BNT) before and ≈7 months after anterior temporal lobectomy. An fMRI language laterality index (LI) was measured with an auditory semantic decision-tone decision task contrast. Correlations and a multiple regression model were built with a priori chosen predictors. RESULTS: Naming decline occurred in 56% of patients and correlated with fMRI LI (r = -0.41, p < 0.001), age at epilepsy onset (r = -0.30, p = 0.006), age at surgery (r = -0.23, p = 0.039), and years of education (r = 0.24, p = 0.032). Preoperative BNT score and duration of epilepsy were not correlated with naming decline. The regression model explained 31% of the variance, with fMRI contributing 14%, with a 96% sensitivity and 44% specificity for predicting meaningful naming decline. Cross-validation resulted in an average prediction error of 6 points. DISCUSSION: An fMRI-based regression model predicted naming outcome after left TLE surgery in a large, prospective multicenter sample, with fMRI as the strongest predictor. These results provide evidence supporting the use of preoperative language fMRI to predict language outcome in patients undergoing left TLE surgery. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that fMRI language lateralization can help in predicting naming decline after left TLE surgery.


Assuntos
Epilepsia do Lobo Temporal , Idioma , Mapeamento Encefálico/métodos , Estudos de Coortes , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/cirurgia , Lateralidade Funcional , Humanos , Imageamento por Ressonância Magnética/métodos , Estudos Prospectivos
10.
Proc Natl Acad Sci U S A ; 119(6)2022 02 08.
Artigo em Inglês | MEDLINE | ID: mdl-35115397

RESUMO

The nature of the representational code underlying conceptual knowledge remains a major unsolved problem in cognitive neuroscience. We assessed the extent to which different representational systems contribute to the instantiation of lexical concepts in high-level, heteromodal cortical areas previously associated with semantic cognition. We found that lexical semantic information can be reliably decoded from a wide range of heteromodal cortical areas in the frontal, parietal, and temporal cortex. In most of these areas, we found a striking advantage for experience-based representational structures (i.e., encoding information about sensory-motor, affective, and other features of phenomenal experience), with little evidence for independent taxonomic or distributional organization. These results were found independently for object and event concepts. Our findings indicate that concept representations in the heteromodal cortex are based, at least in part, on experiential information. They also reveal that, in most heteromodal areas, event concepts have more heterogeneous representations (i.e., they are more easily decodable) than object concepts and that other areas beyond the traditional "semantic hubs" contribute to semantic cognition, particularly the posterior cingulate gyrus and the precuneus.


Assuntos
Formação de Conceito/fisiologia , Lobo Temporal/fisiologia , Adulto , Mapeamento Encefálico/métodos , Cognição/fisiologia , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Masculino , Lobo Parietal/fisiologia , Semântica , Adulto Jovem
11.
Cortex ; 141: 55-65, 2021 08.
Artigo em Inglês | MEDLINE | ID: mdl-34029858

RESUMO

PURPOSE: The neuropsychological complications of temporal lobe epilepsy are characterized by a spectrum of reproducible cognitive phenotypes that vary in the presence, type and degree of impairment. The nature of the disruptions to the neuropsychological networks that underlie these phenotypes remain to be characterized and represent the subject of this investigation. METHODS: Participants included 30 healthy controls and 104 patients with temporal lobe epilepsy who fell into three cognitive phenotypes (intact, focal impairment, generalized impairment). Eighteen neuropsychological measures representing multiple cognitive domains (language, memory, executive function, visuoperception, motor speed) were examined by graph theory techniques within the control and each epilepsy cognitive phenotype group to characterize their global and local network properties. RESULTS: Across the control and epilepsy cognitive phenotype groups (intact to focal to generalized impairment), there was: 1) an orderly breakdown in the positive manifold reflected by a stepwise reduction of positive associations among the neuropsychological tests, 2) stepwise abnormal increases in global measures including the normalized clustering coefficient and modularity index, 3) stepwise abnormal decreases in normalized global efficiency, 4) a community structure demonstrating well organized modules within the control group while each epilepsy group showed deviations from controls, and 5) lower strength, compared to controls, across 8 nodes in the focal and generalized impairment groups compared to only 3 nodes in the no-impairment epilepsy group, pointing to the superior integration of local connections in controls. DISCUSSION: The cognitive phenotypes of temporal lobe epilepsy are characterized by orderly abnormalities in their underlying neuropsychological networks. These findings inform the network perturbations that underlie the taxonomy of cognitive abnormality in temporal lobe epilepsy and provide a model for examination of similar issues in other focal and generalized epilepsies.


Assuntos
Epilepsia do Lobo Temporal , Cognição , Função Executiva , Humanos , Testes Neuropsicológicos , Fenótipo
12.
J Neurosci ; 41(18): 4100-4119, 2021 05 05.
Artigo em Inglês | MEDLINE | ID: mdl-33753548

RESUMO

Understanding how and where in the brain sentence-level meaning is constructed from words presents a major scientific challenge. Recent advances have begun to explain brain activation elicited by sentences using vector models of word meaning derived from patterns of word co-occurrence in text corpora. These studies have helped map out semantic representation across a distributed brain network spanning temporal, parietal, and frontal cortex. However, it remains unclear whether activation patterns within regions reflect unified representations of sentence-level meaning, as opposed to superpositions of context-independent component words. This is because models have typically represented sentences as "bags-of-words" that neglect sentence-level structure. To address this issue, we interrogated fMRI activation elicited as 240 sentences were read by 14 participants (9 female, 5 male), using sentences encoded by a recurrent deep artificial neural-network trained on a sentence inference task (InferSent). Recurrent connections and nonlinear filters enable InferSent to transform sequences of word vectors into unified "propositional" sentence representations suitable for evaluating intersentence entailment relations. Using voxelwise encoding modeling, we demonstrate that InferSent predicts elements of fMRI activation that cannot be predicted by bag-of-words models and sentence models using grammatical rules to assemble word vectors. This effect occurs throughout a distributed network, which suggests that propositional sentence-level meaning is represented within and across multiple cortical regions rather than at any single site. In follow-up analyses, we place results in the context of other deep network approaches (ELMo and BERT) and estimate the degree of unpredicted neural signal using an "experiential" semantic model and cross-participant encoding.SIGNIFICANCE STATEMENT A modern-day scientific challenge is to understand how the human brain transforms word sequences into representations of sentence meaning. A recent approach, emerging from advances in functional neuroimaging, big data, and machine learning, is to computationally model meaning, and use models to predict brain activity. Such models have helped map a cortical semantic information-processing network. However, how unified sentence-level information, as opposed to word-level units, is represented throughout this network remains unclear. This is because models have typically represented sentences as unordered "bags-of-words." Using a deep artificial neural network that recurrently and nonlinearly combines word representations into unified propositional sentence representations, we provide evidence that sentence-level information is encoded throughout a cortical network, rather than in a single region.


Assuntos
Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/fisiologia , Compreensão/fisiologia , Idioma , Redes Neurais de Computação , Semântica , Adulto , Simulação por Computador , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Leitura , Adulto Jovem
13.
Epilepsy Behav ; 117: 107841, 2021 04.
Artigo em Inglês | MEDLINE | ID: mdl-33611101

RESUMO

Temporal lobe epilepsy (TLE) has been conceptualized as focal disease with a discrete neurobiological focus and can respond well to targeted resection or ablation. In contrast, the neuro-cognitive deficits resulting from TLE can be widespread involving regions beyond the primary epileptic network. We hypothesize that this seemingly paradoxical findings can be explained by differences in connectivity between the primary epileptic region which is hyper-connected and its secondary influence on global connectome organization. This hypothesis is tested using regional and global graph theory metrics where we anticipate that regional mesial-temporal hyperconnectivity will be found and correlate with seizure frequency while global networks will be disorganized and be more closely associated with neuro-cognitive deficits. Resting-state fMRI was used to examine temporal lobe regional connectivity and global functional connectivity from 102 patients with TLE and 55 controls. Connectivity matrices were calculated for subcortical volumes and cortical parcellations. Graph theory metrics (global clustering coefficient (GCC), degree, closeness) were compared between groups and in relation to neuropsychological profiles and disease covariates using permutation testing and causal analysis. In TLE there was a decrease in GCC (p = 0.0345) associated with a worse neuropsychological profile (p = 0.0134). There was increased connectivity in the left hippocampus/amygdala (degree p = 0.0103, closeness p = 0.0104) and a decrease in connectivity in the right lateral temporal lobe (degree p = 0.0186, closeness p = 0.0122). A ratio between the hippocampus/amygdala and lateral temporal lobe-temporal lobe connectivity ratio (TLCR) revealed differences between TLE and controls for closeness (left p = 0.00149, right p = 0.0494) and for degree on left p = 0.00169; with trend on right p = 0.0567. Causal analysis suggested that "Epilepsy Activity" (seizure frequency, anti-seizure medications) was associated with increase in TLCR but not in GCC, while cognitive decline was associated with decreased GCC. These findings support the hypothesis that in TLE there is hyperconnectivity in the hippocampus/amygdala and hypoconnectivity in the lateral temporal lobe associated with "Epilepsy Activity." While, global connectome disorganization was associated with worse neuropsychological phenotype.


Assuntos
Conectoma , Epilepsia do Lobo Temporal , Epilepsia do Lobo Temporal/diagnóstico por imagem , Lateralidade Funcional , Hipocampo , Humanos , Imageamento por Ressonância Magnética , Rede Nervosa/diagnóstico por imagem , Lobo Temporal
14.
Epilepsia ; 61(9): 1939-1948, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32780878

RESUMO

OBJECTIVE: To define left temporal lobe regions where surgical resection produces a persistent postoperative decline in naming visual objects. METHODS: Pre- and postoperative brain magnetic resonance imaging data and picture naming (Boston Naming Test) scores were obtained prospectively from 59 people with drug-resistant left temporal lobe epilepsy. All patients had left hemisphere language dominance at baseline and underwent surgical resection or ablation in the left temporal lobe. Postoperative naming assessment occurred approximately 7 months after surgery. Surgical lesions were mapped to a standard template, and the relationship between presence or absence of a lesion and the degree of naming decline was tested at each template voxel while controlling for effects of overall lesion size. RESULTS: Patients declined by an average of 15% in their naming score, with wide variation across individuals. Decline was significantly related to damage in a cluster of voxels in the ventral temporal lobe, located mainly in the fusiform gyrus approximately 4-6 cm posterior to the temporal tip. Extent of damage to this region explained roughly 50% of the variance in outcome. Picture naming decline was not related to hippocampal or temporal pole damage. SIGNIFICANCE: The results provide the first statistical map relating lesion location in left temporal lobe epilepsy surgery to picture naming decline, and they support previous observations of transient naming deficits from electrical stimulation in the basal temporal cortex. The critical lesion is relatively posterior and could be avoided in many patients undergoing left temporal lobe surgery for intractable epilepsy.


Assuntos
Anomia/fisiopatologia , Lobectomia Temporal Anterior/métodos , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia do Lobo Temporal/cirurgia , Hipocampo/cirurgia , Complicações Pós-Operatórias/fisiopatologia , Lobo Temporal/cirurgia , Adulto , Anomia/etiologia , Lobectomia Temporal Anterior/efeitos adversos , Mapeamento Encefálico , Feminino , Neuroimagem Funcional , Hipocampo/diagnóstico por imagem , Hipocampo/fisiologia , Humanos , Testes de Linguagem , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Complicações Pós-Operatórias/etiologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/fisiologia , Adulto Jovem
15.
Neuroimage Clin ; 27: 102341, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32707534

RESUMO

This study explored the taxonomy of cognitive impairment within temporal lobe epilepsy and characterized the sociodemographic, clinical and neurobiological correlates of identified cognitive phenotypes. 111 temporal lobe epilepsy patients and 83 controls (mean ages 33 and 39, 57% and 61% female, respectively) from the Epilepsy Connectome Project underwent neuropsychological assessment, clinical interview, and high resolution 3T structural and resting-state functional MRI. A comprehensive neuropsychological test battery was reduced to core cognitive domains (language, memory, executive, visuospatial, motor speed) which were then subjected to cluster analysis. The resulting cognitive subgroups were compared in regard to sociodemographic and clinical epilepsy characteristics as well as variations in brain structure and functional connectivity. Three cognitive subgroups were identified (intact, language/memory/executive function impairment, generalized impairment) which differed significantly, in a systematic fashion, across multiple features. The generalized impairment group was characterized by an earlier age at medication initiation (P < 0.05), fewer patient (P < 0.001) and parental years of education (P < 0.05), greater racial diversity (P < 0.05), and greater number of lifetime generalized seizures (P < 0.001). The three groups also differed in an orderly manner across total intracranial (P < 0.001) and bilateral cerebellar cortex volumes (P < 0.01), and rate of bilateral hippocampal atrophy (P < 0.014), but minimally in regional measures of cortical volume or thickness. In contrast, large-scale patterns of cortical-subcortical covariance networks revealed significant differences across groups in global and local measures of community structure and distribution of hubs. Resting-state fMRI revealed stepwise anomalies as a function of cluster membership, with the most abnormal patterns of connectivity evident in the generalized impairment group and no significant differences from controls in the cognitively intact group. Overall, the distinct underlying cognitive phenotypes of temporal lobe epilepsy harbor systematic relationships with clinical, sociodemographic and neuroimaging correlates. Cognitive phenotype variations in patient and familial education and ethnicity, with linked variations in total intracranial volume, raise the question of an early and persisting socioeconomic-status related neurodevelopmental impact, with additional contributions of clinical epilepsy factors (e.g., lifetime generalized seizures). The neuroimaging features of cognitive phenotype membership are most notable for disrupted large scale cortical-subcortical networks and patterns of functional connectivity with bilateral hippocampal and cerebellar atrophy. The cognitive taxonomy of temporal lobe epilepsy appears influenced by features that reflect the combined influence of socioeconomic, neurodevelopmental and neurobiological risk factors.


Assuntos
Conectoma , Epilepsia do Lobo Temporal , Adulto , Cognição , Epilepsia do Lobo Temporal/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Testes Neuropsicológicos , Fenótipo
16.
Neuroimage ; 220: 117090, 2020 10 15.
Artigo em Inglês | MEDLINE | ID: mdl-32593799

RESUMO

Evaluation of language dominance is an essential step prior to epilepsy surgery. There is no consensus on an optimal methodology for determining language dominance using magnetoencephalography (MEG). Oscillatory dynamics are increasingly recognized as being of fundamental importance for brain function and dysfunction. Using task-related beta power modulations in MEG, we developed an analysis framework for localizing and lateralizing areas relevant to language processing in patients with focal epilepsy. We examined MEG responses from 29 patients (age 42 â€‹± â€‹13 years, 15M/14F) during auditory description naming (ADN) and visual picture naming (PN). MEG data were preprocessed using a combination of spatiotemporal filtering, signal thresholding, and ICA decomposition. Beta-band 17-25Hz power decrements were examined at both sensor and source levels. Volumetric grids of anatomical source space were constructed in MNI space at 8 â€‹mm isotropic resolution, and beta-band power changes were estimated using the dynamic imaging of coherent sources beamformer technique. A 600 â€‹ms temporal-window that ends 100 â€‹ms before speech onset was selected for analysis, to focus on later stages of word production such as phonologic selection and motor speech preparation. Cluster-based permutation testing was employed for patient- and group-level statistical inferences. Automated anatomic labeling atlas-driven laterality indices (LIs) were computed for 13 left and right language- and motor speech-related cortical regions. Group localization of ADN and PN consistently revealed significant task-related decrements of beta-power within language-related areas in the frontal, temporal and parietal lobes as well as motor-related regions of precentral/premotor and postcentral/somatomotor gyri. A region-of-interest analysis of ADN and PN suggested a strong correlation of r â€‹= â€‹0.74 (p â€‹< â€‹0.05, FDR corrected) between the two tasks within the language-related brain regions, with the highest spatial overlap in the prefrontal areas. Laterality indices (LIs) consistently showed left dominance (LI â€‹> â€‹0.1) for most individuals (93% and 82% during ADN and PN, respectively), with average LIs of 0.40 â€‹± â€‹0.25 and 0.34 â€‹± â€‹0.20 for ADN and PN, respectively. Source analysis of task-related beta power decrements appears to be a reliable method for lateralizing and localizing brain activations associated with language processing in patients with epilepsy.


Assuntos
Mapeamento Encefálico/métodos , Ondas Encefálicas/fisiologia , Encéfalo/fisiopatologia , Lateralidade Funcional/fisiologia , Idioma , Fala/fisiologia , Adulto , Epilepsias Parciais/fisiopatologia , Feminino , Humanos , Magnetoencefalografia , Masculino , Pessoa de Meia-Idade
17.
Epilepsy Behav ; 110: 107172, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32554180

RESUMO

Neuroticism, a core personality trait characterized by a tendency towards experiencing negative affect, has been reported to be higher in people with temporal lobe epilepsy (TLE) compared with healthy individuals. Neuroticism is a known predictor of depression and anxiety, which also occur more frequently in people with TLE. The purpose of this study was to identify abnormalities in whole-brain resting-state functional connectivity in relation to neuroticism in people with TLE and to determine the degree of unique versus shared patterns of abnormal connectivity in relation to elevated symptoms of depression and anxiety. Ninety-three individuals with TLE (55 females) and 40 healthy controls (18 females) from the Epilepsy Connectome Project (ECP) completed measures of neuroticism, depression, and anxiety, which were all significantly higher in people with TLE compared with controls. Resting-state functional connectivity was compared between controls and groups with TLE with high and low neuroticism using analysis of variance (ANOVA) and t-test. In secondary analyses, the same analytics were performed using measures of depression and anxiety and the unique variance in resting-state connectivity associated with neuroticism independent of symptoms of depression and anxiety identified. Increased neuroticism was significantly associated with hyposynchrony between the right hippocampus and Brodmann area (BA) 9 (region of prefrontal cortex (PFC)) (p < 0.005), representing a unique relationship independent of symptoms of depression and anxiety. Hyposynchrony of connection between the right hippocampus and BA47 (anterior frontal operculum) was associated with high neuroticism and with higher depression and anxiety scores (p < 0.05), making it a shared abnormal connection for the three measures. In conclusion, increased neuroticism exhibits both unique and shared patterns of abnormal functional connectivity with depression and anxiety symptoms between regions of the mesial temporal and frontal lobe.


Assuntos
Epilepsia do Lobo Temporal/diagnóstico por imagem , Lobo Frontal/diagnóstico por imagem , Sistema Límbico/diagnóstico por imagem , Rede Nervosa/diagnóstico por imagem , Neuroticismo/fisiologia , Lobo Temporal/diagnóstico por imagem , Adulto , Conectoma/métodos , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Lobo Frontal/fisiopatologia , Lateralidade Funcional/fisiologia , Humanos , Sistema Límbico/fisiopatologia , Imageamento por Ressonância Magnética/métodos , Masculino , Pessoa de Meia-Idade , Rede Nervosa/fisiopatologia , Descanso/fisiologia , Lobo Temporal/fisiopatologia
18.
Neuropsychologia ; 146: 107543, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32598966

RESUMO

Developmental dyslexia is a learning disorder characterized by difficulties reading words accurately and/or fluently. Several behavioral studies have suggested the presence of anomalies at an early stage of phoneme processing, when the complex spectrotemporal patterns in the speech signal are analyzed and assigned to phonemic categories. In this study, fMRI was used to compare brain responses associated with categorical discrimination of speech syllables (P) and acoustically matched nonphonemic stimuli (N) in children and adolescents with dyslexia and in typically developing (TD) controls, aged 8-17 years. The TD group showed significantly greater activation during the P condition relative to N in an area of the left ventral occipitotemporal cortex that corresponds well with the region referred to as the "visual word form area" (VWFA). Regression analyses using reading performance as a continuous variable across the full group of participants yielded similar results. Overall, the findings are consistent with those of previous neuroimaging studies using print stimuli in individuals with dyslexia that found reduced activation in left occipitotemporal regions; however, the current study shows that these activation differences seen during reading are apparent during auditory phoneme discrimination in youth with dyslexia, suggesting that the primary deficit in at least a subset of children may lie early in the speech processing stream and that categorical perception may be an important target of early intervention in children at risk for dyslexia.


Assuntos
Dislexia/fisiopatologia , Lobo Occipital/fisiopatologia , Fonética , Leitura , Percepção da Fala , Lobo Temporal/fisiopatologia , Adolescente , Criança , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Lobo Occipital/diagnóstico por imagem , Lobo Temporal/diagnóstico por imagem
19.
Epilepsy Behav ; 106: 106912, 2020 05.
Artigo em Inglês | MEDLINE | ID: mdl-32179500

RESUMO

Numerous studies have shown that surgical resection of the left anterior temporal lobe (ATL) is associated with a decline in object naming ability (Hermann et al., 1999). In contrast, few studies have examined the effects of left ATL surgery on auditory description naming (ADN) or category-specific naming. Compared with object naming, which loads heavily on visual recognition processes, ADN provides a more specific measure of concept retrieval. The present study examined ADN declines in a large group of patients who were tested before and after left ATL surgery, using a 2 × 2 × 2 factorial manipulation of uniqueness (common vs. proper nouns), taxonomic category (living vs. nonliving things), and time (pre- vs. postsurgery). Significant declines occurred across all categories but were substantially larger for proper living (PL) concepts, i.e., famous individuals. The disproportionate decline in PL noun naming relative to other conditions is consistent with the notion that the left ATL is specialized not only for retrieval of unique entity concepts, but also plays a role in processing social concepts and person-specific features.


Assuntos
Lobectomia Temporal Anterior/psicologia , Epilepsia Resistente a Medicamentos/psicologia , Epilepsia Resistente a Medicamentos/cirurgia , Idioma , Reconhecimento Psicológico , Vocabulário , Adulto , Lobectomia Temporal Anterior/tendências , Epilepsia Resistente a Medicamentos/diagnóstico por imagem , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Testes Neuropsicológicos , Estudos Prospectivos , Reconhecimento Psicológico/fisiologia , Lobo Temporal/diagnóstico por imagem , Lobo Temporal/cirurgia
20.
Neuroimage Clin ; 25: 102183, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32058319

RESUMO

The association of epilepsy with structural brain changes and cognitive abnormalities in midlife has raised concern regarding the possibility of future accelerated brain and cognitive aging and increased risk of later life neurocognitive disorders. To address this issue we examined age-related processes in both structural and functional neuroimaging among individuals with temporal lobe epilepsy (TLE, N = 104) who were participants in the Epilepsy Connectome Project (ECP). Support vector regression (SVR) models were trained from 151 healthy controls and used to predict TLE patients' brain ages. It was found that TLE patients on average have both older structural (+6.6 years) and functional (+8.3 years) brain ages compared to healthy controls. Accelerated functional brain age (functional - chronological age) was mildly correlated (corrected P = 0.07) with complex partial seizure frequency and the number of anti-epileptic drug intake. Functional brain age was a significant correlate of declining cognition (fluid abilities) and partially mediated chronological age-fluid cognition relationships. Chronological age was the only positive predictor of crystallized cognition. Accelerated aging is evident not only in the structural brains of patients with TLE, but also in their functional brains. Understanding the causes of accelerated brain aging in TLE will be clinically important in order to potentially prevent or mitigate their cognitive deficits.


Assuntos
Senilidade Prematura , Córtex Cerebral , Envelhecimento Cognitivo , Disfunção Cognitiva , Conectoma/métodos , Epilepsia do Lobo Temporal , Adulto , Fatores Etários , Senilidade Prematura/diagnóstico por imagem , Senilidade Prematura/etiologia , Senilidade Prematura/patologia , Senilidade Prematura/fisiopatologia , Córtex Cerebral/diagnóstico por imagem , Córtex Cerebral/patologia , Córtex Cerebral/fisiopatologia , Envelhecimento Cognitivo/fisiologia , Disfunção Cognitiva/diagnóstico por imagem , Disfunção Cognitiva/etiologia , Disfunção Cognitiva/patologia , Disfunção Cognitiva/fisiopatologia , Epilepsia do Lobo Temporal/complicações , Epilepsia do Lobo Temporal/diagnóstico por imagem , Epilepsia do Lobo Temporal/patologia , Epilepsia do Lobo Temporal/fisiopatologia , Feminino , Humanos , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Máquina de Vetores de Suporte , Adulto Jovem
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