Patients with drug-resistant temporal lobe epilepsy should consider surgery as a therapy option (TLE) Although this treatment has a high possibility of seizure independence, it also has a high risk of postoperative linguistic damage. Extent of resection, fibre integrity, or present task-basis cannot fully explain the widely varied neurocognitive profiles in surgical epilepsy patients.fMRI data was used to examine functional connectivity, activation maps, and laterality indices for language dominance. The fractional anisotropy values of seven main tracts were calculated after surgery. Before and after surgery, naming, semantic, and phonematic verbal fluency scores were linked with imaging data. Preoperative atypical linguistic dominance indicated better outcomes in the left TLE.
Preoperative atypical linguistic dominance predicted higher postoperative verbal fluency and naming function in the left TLE. Left frontal language dominance before and after surgery was associated with strong semantic verbal fluency, and left fronto-temporal language laterality predicted good naming outcome in right TLE. Activation analysis did not capture extensive, bihemispheric variations in language architecture identified by network analysis. These network modifications were discovered before to surgery and progressed with distinct patterns in the left and right TLEs. Regardless of seizure side, ongoing seizures after surgery (Engel classes ID–IV) were linked to naming degradation. Functional connectivity study provides unique insight into bihemispheric language network remodelling processes following epilepsy surgery, with distinct findings in left and right TLE.
Reference Link – https://thejns.org/view/journals/j-neurosurg/134/6/article-p1694.xml?body=abstract
