Functional and structural changes in the memory network associated with left temporal lobe epilepsy

Authors

  • Natalie L. Voets,

    Corresponding author
    1. FMRIB Centre, Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
    2. GlaxoSmithKline Clinical Imaging Centre, Clinical Pharmacology and Discovery Medicine, Hammersmith Hospital, London, United Kingdom
    • FMRIB Centre, John Radcliffe Hospital, Headington, Oxford OX3 9DU, UK
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  • Jane E. Adcock,

    1. Department of Clinical Neurology, John Radcliffe Hospital, Oxford, United Kingdom
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  • Richard Stacey,

    1. Department of Neurosurgery, John Radcliffe Hospital, Oxford, United Kingdom
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  • Yvonne Hart,

    1. Department of Clinical Neurology, John Radcliffe Hospital, Oxford, United Kingdom
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  • Katherine Carpenter,

    1. Russell Cairns Unit, John Radcliffe Hospital, Oxford, United Kingdom
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  • Paul M. Matthews,

    1. GlaxoSmithKline Clinical Imaging Centre, Clinical Pharmacology and Discovery Medicine, Hammersmith Hospital, London, United Kingdom
    2. Department of Clinical Neurosciences, Imperial College, London, United Kingdom
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  • Christian F. Beckmann

    1. FMRIB Centre, Department of Clinical Neurology, University of Oxford, Oxford, United Kingdom
    2. Department of Clinical Neurosciences, Imperial College, London, United Kingdom
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Abstract

Understanding functional plasticity in memory networks associated with temporal lobe epilepsy (TLE) is central to predicting memory decline following surgery. However, the extent of functional reorganization within memory networks remains unclear. In this preliminary study, we used novel analysis methods assessing network-level changes across the brain during memory task performance in patients with TLE to test the hypothesis that hippocampal functions may not readily shift between hemispheres, but instead may show altered intra-hemispheric organization with unilateral damage. In addition, we wished to relate functional differences to structural changes along specific fibre pathways associated with memory function. Nine pre-operative patients with intractable left TLE and 10 healthy controls underwent functional MRI during complex scene encoding. Diffusion tensor imaging was additionally performed in the same patients. In our study, we found no evidence of inter-hemispheric shifts in memory-related activity in TLE using standard general linear model analysis. However, tensor independent component analysis revealed significant reductions in functional connectivity between bilateral MTL, occipital and left orbitofrontal regions among others in left TLE. This altered orbitofrontal activity was directly related to measures of fornix tract coherence in patients (P < 0.05). Our results suggest that specific fibre pathways, potentially affected by MTL neurodegeneration, may play a central role in functional plasticity in TLE and highlight the importance of network-based analysis approaches. Relative to standard model-based methods, novel objective functional connectivity analyses may offer improved sensitivity to subtle changes in the distribution of memory functions relevant for surgical planning in TLE. Hum Brain Mapp, 2009. © 2009 Wiley-Liss, Inc.

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