Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy

Yu-Hsuan A Chang; Nobuko Kemmotsu; Kelly M Leyden; N Erkut Kucukboyaci; Vicente J Iragui; Evelyn S Tecoma; Leena Kansal; Marc A Norman; Rachelle Compton; Tobin J Ehrlich; Vedang S Uttarwar; Anny Reyes; Brianna M Paul; Carrie R McDonald

doi:10.1016/j.bandl.2017.03.012

Multimodal imaging of language reorganization in patients with left temporal lobe epilepsy

Brain Lang. 2017 Jul:170:82-92. doi: 10.1016/j.bandl.2017.03.012. Epub 2017 Apr 20.

Authors

Affiliations

¹ Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: yuc023@ucsd.edu.
² Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: nkemmotsu@ucsd.edu.
³ Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: kmleyden@gmail.com.
⁴ SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. Electronic address: erkut@ucsd.edu.
⁵ Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: viragui@ucsd.edu.
⁶ Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: etecoma@ucsd.edu.
⁷ Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: lkansal@ucsd.edu.
⁸ Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: mnorman@ucsd.edu.
⁹ Department of Neurosciences, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: rcompton@ucsd.edu.
¹⁰ Palo Alto University, 1971 Arastradero Drive, Palo Alto, CA 94304, USA. Electronic address: tehrlich@paloaltou.edu.
¹¹ Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA. Electronic address: vuttarwar@ucsd.edu.
¹² Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. Electronic address: anr086@ucsd.edu.
¹³ Department of Neurology, University of California - San Francisco, San Francisco, CA, USA; UCSF Comprehensive Epilepsy Center, San Francisco, CA, USA. Electronic address: Brianna.Paul@ucsf.edu.
¹⁴ Center for Multimodal Imaging and Genetics, University of California - San Diego, 9452 Medical Center Drive, La Jolla, CA 92037, USA; Department of Psychiatry, University of California - San Diego, 9500 Gilman Drive, La Jolla, CA 92093, USA; SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA. Electronic address: camcdonald@ucsd.edu.

Abstract

This study explored the relationships among multimodal imaging, clinical features, and language impairment in patients with left temporal lobe epilepsy (LTLE). Fourteen patients with LTLE and 26 controls underwent structural MRI, functional MRI, diffusion tensor imaging, and neuropsychological language tasks. Laterality indices were calculated for each imaging modality and a principal component (PC) was derived from language measures. Correlations were performed among imaging measures, as well as to the language PC. In controls, better language performance was associated with stronger left-lateralized temporo-parietal and temporo-occipital activations. In LTLE, better language performance was associated with stronger right-lateralized inferior frontal, temporo-parietal, and temporo-occipital activations. These right-lateralized activations in LTLE were associated with right-lateralized arcuate fasciculus fractional anisotropy. These data suggest that interhemispheric language reorganization in LTLE is associated with alterations to perisylvian white matter. These concurrent structural and functional shifts from left to right may help to mitigate language impairment in LTLE.

Keywords: Cortical thickness; DTI; Functional MRI; Language; Temporal lobe epilepsy.

MeSH terms

Adult
Anisotropy
Brain Mapping
Cerebral Cortex / pathology
Cerebral Cortex / physiopathology*
Diffusion Tensor Imaging
Epilepsy, Temporal Lobe / complications*
Epilepsy, Temporal Lobe / pathology
Epilepsy, Temporal Lobe / physiopathology*
Female
Functional Laterality
Humans
Language Disorders / complications*
Language Disorders / pathology
Language Disorders / physiopathology*
Language*
Magnetic Resonance Imaging
Male
Middle Aged
Multimodal Imaging*
Nerve Net / pathology
Nerve Net / physiopathology
Neuropsychological Tests
Temporal Lobe / pathology
Temporal Lobe / physiopathology
White Matter / pathology
White Matter / physiopathology

Grants and funding

R01 NS065838/NS/NINDS NIH HHS/United States