Name Calling in the Temporal Lobe

Evidence for Cortical Reorganization of Language in Patients with Hippocampal Sclerosis. Hamberger MJ, Seidel WT, Goodman RR, Williams A, Perrine K, Devinsky O, McKhann GM 2nd. Brain 2007;130(Pt 11):2942–2950. Naming is mediated by perisylvian cortex in the left (language-dominant) hemisphere, and thus, left anterior temporal lobe resection for pharmacologically intractable temporal lobe epilepsy (TLE) carries risk for post-operative naming decline. Interestingly, this risk is lower in patients with hippocampal sclerosis (HS) relative to those without HS (non-HS). Although the hippocampus has traditionally been considered a critical structure for memory, without contribution to naming, this pattern might implicate direct hippocampal naming involvement. On the other hand, critical naming sites have been found in anterior, lateral temporal (i.e. extra-hippocampal) neocortex, the region typically removed with ‘standard’ TLE resection. We, therefore, speculated that the relative preservation of naming in post-operative HS patients might reflect cortical reorganization of language to areas outside this region. Using pre-resection electrical stimulation mapping, we compared the topography of auditory and visual naming sites in 12 patients with HS and 12 patients without structural brain pathology. Consistent with previous work, non-HS patients exhibited post-operative naming decline, whereas HS patients did not. As hypothesized, HS patients had proportionally fewer overall naming sites in anterior temporal cortex, the region typically removed with standard anterior temporal resection, whereas non-HS patients exhibited a more even distribution of naming sites in anterior and posterior temporal regions ( P = 0.03). Although both groups exhibited the previously reported pattern of auditory naming sites anterior to visual naming sites, auditory naming sites had a significantly more posterior distribution in HS patients ( P = 0.02). Additionally, non-HS patients exhibited a greater proportion of visual naming sites above the superior temporal sulcus, whereas visual naming sites in HS patients were scattered across superior and inferior temporal cortex. Results suggest that preserved naming ability in HS patients following anterior temporal resection might be attributable, at least in part, to intrahemispheric reorganization of language in response to the likely, early development of sclerosis in the medial temporal region. Furthermore, their more posterior distribution of naming sites is consistent with the more anterior propagation of EEG discharges in TLE. These results hold theoretical implications regarding the role of the dominant hippocampus in determining the cortical representation of semantic and lexical information, and raise questions regarding the specific roles of medial and lateral temporal cortex in targeted word retrieval. The different patterns of naming areas identified in patients with and without HS may also carry clinical implications, potentially improving efficiency during the time-constrained process of stimulation mapping.

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Functional MRI evidence for a role of frontal and inferior temporal cortex in amodal components of priming

Brain ◽

10.1093/brain/123.3.620 ◽

2000 ◽

Vol 123 (3) ◽

pp. 620-640 ◽

Cited By ~ 213

Author(s):

R. L. Buckner

Keyword(s):

Functional Mri ◽

Temporal Cortex ◽

Inferior Temporal Cortex

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Stereoelectroencephalographic language mapping of the basal temporal cortex predicts postoperative naming outcome

Journal of Neurosurgery ◽

10.3171/2020.8.jns202431 ◽

2021 ◽

pp. 1-11

Author(s):

Chifaou Abdallah ◽

Hélène Brissart ◽

Sophie Colnat-Coulbois ◽

Ludovic Pierson ◽

Olivier Aron ◽

...

Keyword(s):

Temporal Lobe ◽

Verbal Fluency ◽

Temporal Cortex ◽

Visual Object ◽

Drug Resistant ◽

Language Mapping ◽

Individual Level ◽

Language Outcome ◽

Temporal Lobe Resection ◽

The Individual

OBJECTIVEIn drug-resistant temporal lobe epilepsy (TLE) patients, the authors evaluated early and late outcomes for decline in visual object naming after dominant temporal lobe resection (TLR) according to the resection status of the basal temporal language area (BTLA) identified by cortical stimulation during stereoelectroencephalography (SEEG).METHODSTwenty patients who underwent SEEG for drug-resistant TLE met the inclusion criteria. During language mapping, a site was considered positive when stimulation of two contiguous contacts elicited at least one naming impairment during two remote sessions. After TLR ipsilateral to their BTLA, patients were classified as BTLA+ when at least one positive language site was resected and as BTLA− when all positive language sites were preserved. Outcomes in naming and verbal fluency tests were assessed using pre- and postoperative (means of 7 and 25 months after surgery) scores at the group level and reliable change indices (RCIs) for clinically meaningful changes at the individual level.RESULTSBTLA+ patients (n = 7) had significantly worse naming scores than BTLA− patients (n = 13) within 1 year after surgery but not at the long-term evaluation. No difference in verbal fluency tests was observed. When RCIs were used, 5 of 18 patients (28%) had naming decline within 1 year postoperatively (corresponding to 57% of BTLA+ and 9% of BTLA− patients). A significant correlation was found between BTLA resection and naming decline.CONCLUSIONSBTLA resection is associated with a specific and early naming decline. Even if this decline is transient, naming scores in BTLA+ patients tend to remain lower compared to their baseline. SEEG mapping helps to predict postoperative language outcome after dominant TLR.

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Word comprehension in temporal cortex and Wernicke area

Neurology ◽

10.1212/wnl.0000000000006788 ◽

2018 ◽

Vol 92 (3) ◽

pp. e224-e233 ◽

Cited By ~ 6

Author(s):

M.-Marsel Mesulam ◽

Benjamin M. Rader ◽

Jaiashre Sridhar ◽

Matthew J. Nelson ◽

Jungmoon Hyun ◽

...

Keyword(s):

Temporal Lobe ◽

Sentence Comprehension ◽

Single Case ◽

Temporal Cortex ◽

Primary Progressive Aphasia ◽

Single Word ◽

Word Comprehension ◽

Cerebrovascular Lesions ◽

Core Components

ObjectiveTo explore atrophy–deficit correlations of word comprehension and repetition in temporoparietal cortices encompassing the Wernicke area, based on patients with primary progressive aphasia (PPA).MethodsCortical thickness in regions within and outside the classical Wernicke area, measured by FreeSurfer, was correlated with repetition and single word comprehension scores in 73 right-handed patients at mild to moderate stages of PPA.ResultsAtrophy in the Wernicke area was correlated with repetition (r = 0.42, p = 0.001) but not single word comprehension (r = −0.072, p = 0.553). Correlations with word comprehension were confined to more anterior parts of the temporal lobe, especially its anterior third (r = 0.60, p < 0.001). A single case with postmortem autopsy illustrated preservation of word comprehension but not repetition 6 months prior to death despite nearly 50% loss of cortical volume and severe neurofibrillary degeneration in core components of the Wernicke area.ConclusionsTemporoparietal cortices containing the Wernicke area are critical for language repetition. Contrary to the formulations of classic aphasiology, their role in word and sentence comprehension is ancillary rather than critical. Thus, the Wernicke area is not sufficient to sustain word comprehension if the anterior temporal lobe is damaged. Traditional models of the role of the Wernicke area in comprehension are based almost entirely on patients with cerebrovascular lesions. Such lesions also cause deep white matter destruction and acute network diaschisis, whereas progressive neurodegenerative diseases associated with PPA do not. Conceptualizations of the Wernicke area that appear to conflict, therefore, can be reconciled by considering the hodologic and physiologic differences of the underlying lesions.

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Partial cortico-hippocampectomy in cats, as therapy for refractory temporal epilepsy: A descriptive cadaveric study

PLoS ONE ◽

10.1371/journal.pone.0244892 ◽

2021 ◽

Vol 16 (1) ◽

pp. e0244892

Author(s):

Jessica Zilli ◽

Monika Kressin ◽

Anne Schänzer ◽

Marian Kampschulte ◽

Martin J. Schmidt

Keyword(s):

Temporal Lobe ◽

Tissue Injury ◽

Histopathological Examination ◽

Hippocampal Sclerosis ◽

Intraoperative Complications ◽

Temporal Cortex ◽

Cadaveric Study ◽

Vascular Lesions ◽

Temporal Epilepsy ◽

The Brain

Cats, similar to humans, are known to be affected by hippocampal sclerosis (HS), potentially causing antiepileptic drug (AED) resistance. HS can occur as a consequence of chronic seizure activity, trauma, inflammation, or even as a primary disease. In humans, temporal lobe resection is the standardized therapy in patients with refractory temporal lobe epilepsy (TLE). The majority of TLE patients are seizure free after surgery. Therefore, the purpose of this prospective cadaveric study is to establish a surgical technique for hippocampal resection in cats as a treatment for AED resistant seizures. Ten cats of different head morphology were examined. Pre-surgical magnetic resonance imaging (MRI) and computed tomography (CT) studies of the animals’ head were carried out to complete 3D reconstruction of the head, brain, and hippocampus. The resected hippocampal specimens and the brains were histologically examined for tissue injury adjacent to the hippocampus. The feasibility of the procedure, as well as the usability of the removed specimen for histopathological examination, was assessed. Moreover, a micro-CT (mCT) examination of the brain of two additional cats was performed in order to assess temporal vasculature as a reason for possible intraoperative complications. In all cats but one, the resection of the temporal cortex and the hippocampus were successful without any evidence of traumatic or vascular lesions in the surrounding neurovascular structures. In one cat, the presence of mechanical damage (a fissure) of the thalamic surface was evident in the histopathologic examination of the brain post-resection. All hippocampal fields and the dentate gyrus were identified in the majority of the cats via histological examination. The study describes a new surgical approach (partial temporal cortico-hippocampectomy) offering a potential treatment for cats with clinical and diagnostic evidence of temporal epilepsy which do not respond adequately to the medical therapy.

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Subliminal Convergence of Kanji and Kana Words: Further Evidence for Functional Parcellation of the Posterior Temporal Cortex in Visual Word Perception

Journal of Cognitive Neuroscience ◽

10.1162/0898929054021166 ◽

2005 ◽

Vol 17 (6) ◽

pp. 954-968 ◽

Cited By ~ 108

Author(s):

Kimihiro Nakamura ◽

Stanislas Dehaene ◽

Antoinette Jobert ◽

Denis Le Bihan ◽

Sid Kouider

Keyword(s):

Temporal Cortex ◽

Visual Word ◽

Inferior Temporal Cortex ◽

Temporal Region ◽

Writing Systems ◽

Semantic Level ◽

Visual Words ◽

Processing Level ◽

Word Repetition ◽

Repetition Suppression

Recent evidence has suggested that the human occipito-temporal region comprises several subregions, each sensitive to a distinct processing level of visual words. To further explore the functional architecture of visual word recognition, we employed a subliminal priming method with functional magnetic resonance imaging (fMRI) during semantic judgments of words presented in two different Japanese scripts, Kanji and Kana. Each target word was preceded by a subliminal presentation of either the same or a different word, and in the same or a different script. Behaviorally, word repetition produced significant priming regardless of whether the words were presented in the same or different script. At the neural level, this cross-script priming was associated with repetition suppression in the left inferior temporal cortex anterior and dorsal to the visual word form area hypothesized for alphabetical writing systems, suggesting that cross-script convergence occurred at a semantic level. fMRI also evidenced a shared visual occipito-temporal activation for words in the two scripts, with slightly more mesial and right-predominant activation for Kanji and with greater occipital activation for Kana. These results thus allow us to separate script-specific and script-independent regions in the posterior temporal lobe, while demonstrating that both can be activated subliminally.

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Verbal learning and memory outcome in selective amygdalohippocampectomy versus temporal lobe resection in patients with hippocampal sclerosis

Epilepsy & Behavior ◽

10.1016/j.yebeh.2017.12.007 ◽

2018 ◽

Vol 79 ◽

pp. 180-187 ◽

Cited By ~ 4

Author(s):

Mette Thrane Foged ◽

Kirsten Vinter ◽

Louise Stauning ◽

Troels W. Kjær ◽

Brice Ozenne ◽

...

Keyword(s):

Learning And Memory ◽

Temporal Lobe ◽

Hippocampal Sclerosis ◽

Verbal Learning ◽

Selective Amygdalohippocampectomy ◽

Temporal Lobe Resection

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Simultaneous Electroencephalographic and Electocorticographic Recordings of Lateralized Periodic Discharges in Temporal Lobe Epilepsy

Clinical EEG and Neuroscience ◽

10.1177/1550059420972266 ◽

2020 ◽

pp. 155005942097226

Author(s):

Ayumi Sakata ◽

Nobutaka Mukae ◽

Takato Morioka ◽

Shunya Tanaka ◽

Takafumi Shimogawa ◽

...

Keyword(s):

Temporal Lobe Epilepsy ◽

Temporal Lobe ◽

Chronic Conditions ◽

Medial Temporal Lobe ◽

Temporal Cortex ◽

Temporal Region ◽

Pathophysiological Mechanism ◽

Periodic Discharges ◽

Pathological Conditions ◽

Eeg Pattern

Objective Lateralized periodic discharges (LPDs), which constitute an abnormal electroencephalographic (EEG) pattern, are most often observed in critically ill patients with acute pathological conditions, and are less frequently observed in chronic conditions such as focal epilepsies, including temporal lobe epilepsy (TLE). Here we aim to explore the pathophysiological mechanism of LPD in TLE. Methods We retrospectively selected 3 patients with drug-resistant TLE who simultaneously underwent EEG and electrocorticography (ECoG) and demonstrated LPDs. We analyzed the correlation between the EEG and ECoG findings. Results In patients 1 and 2, LPDs were recorded in the temporal region of the scalp during the interictal periods, when repeated spikes followed by slow waves (spike-and-wave complexes; SWs) and periodic discharges (PDs) with amplitudes of >600 to 800 µV appeared in the lateral temporal lobe over a cortical area of >10 cm2. In patient 3, when the ictal discharges persisted and were confined to the medial temporal lobe, repeated SWs were provoked on the lateral temporal lobe. When repeated SWs with amplitudes of >800 µV appeared in an area of the lateral temporal lobe of >10 cm2, the corresponding EEG discharges appeared on the temporal scalp. Conclusions LPDs in patients with TLE originate from repeated SWs and PDs of the lateral temporal lobe, which might represent a highly irritable state of the lateral temporal cortex during both interictal and ictal periods.

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Left Transsylvian Transcisternal and Transinferior Insular Sulcus Approach for Resection of Uncohippocampal Tumor: 3-Dimensional Operative Video

Operative Neurosurgery ◽

10.1093/ons/opy106 ◽

2018 ◽

Vol 15 (6) ◽

pp. E79-E80 ◽

Cited By ~ 1

Author(s):

Juan C Fernandez-Miranda

Keyword(s):

Temporal Lobe ◽

Medial Temporal Lobe ◽

Anterior Segment ◽

Temporal Cortex ◽

Surgical Anatomy ◽

Temporal Lobectomy ◽

Temporal Region ◽

3 Dimensional ◽

Selective Amygdalohippocampectomy ◽

Selective Approach

Abstract The medial temporal lobe can be divided in anterior, middle, and posterior segments. The anterior segment is formed by the uncus and hippocampal head, and it has extra and intraventricular structures. There are 2 main approaches to the uncohippocampal region, the anteromedial temporal lobectomy (Spencer's technique) and the transsylvian selective amygdalohippocampectomy (Yasargil's technique). In this video, we present the case of a 29-yr-old man with new onset of generalized seizures and a contrast-enhancing lesion in the left anterior segment of the medial temporal lobe compatible with high-grade glioma. He had a medical history of cervical astrocytoma at age 8 requiring craniospinal radiation therapy and ventriculoperitoneal shunt placement. The tumor was approached using a combined transsylvian transcisternal and transinferior insular sulcus approach to the extra and intraventricular aspects of the uncohippocampal region. It was resected completely, and the patient was neurologically intact after resection with no further seizures at 6-mo follow-up. The diagnosis was glioblastoma IDH-wild type, for which he underwent adjuvant therapy. Surgical anatomy and technical nuances of this approach are illustrated using a 3-dimensional video and anatomic dissections. The selective approach, when compared to an anteromedial temporal lobectomy, has the advantage of preserving the anterolateral temporal cortex, which is particularly relevant in dominant-hemisphere lesions, and the related fiber tracts, including the inferior fronto-occipital and inferior longitudinal fascicles, and most of the optic radiation fibers. The transsylvian approach, however, is technically and anatomically more challenging and potentially carries a higher risk of vascular injury and vasospasm. Page 1 and figures from Fernández-Miranda JC et al, Microvascular Anatomy of the Medial Temporal Region: Part 1: Its Application to Arteriovenous Malformation Surgery, Operative Neurosurgery, 2010, Volume 67, issue 3, ons237-ons276, by permission of the Congress of Neurological Surgeons (1:26-1:37 in video). Page 1 from Fernández-Miranda JC et al, Three-Dimensio-nal Microsurgical and Tractographic Anatomy of the White Matter of the Human Brain, Neurosurgery, 2008, Volume 62, issue suppl_3, SHC989-SHC1028, by permission of the Congress of Neurological Surgeons (1:54-1:56 in video).

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