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Decreased Resting-State Functional Connectivity of Periaqueductal Gray in Temporal Lobe Epilepsy Comorbid With Migraine.

Front Neurol 2021 26;12:636202. Epub 2021 May 26.

Department of Neurology, The First Affiliated Hospital of Anhui Medical University, Hefei, China.

Patients with temporal lobe epilepsy (TLE) are at high risk for having a comorbid condition of migraine, and these two common diseases are proposed to have some shared pathophysiological mechanisms. Our recent study indicated the dysfunction of periaqueductal gray (PAG), a key pain-modulating structure, contributes to the development of pain hypersensitivity and epileptogenesis in epilepsy. This study is to investigate the functional connectivity of PAG network in epilepsy comorbid with migraine. Read More

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Prognostic value of histopathologic pattern for long-term surgical outcomes of 198 patients with confirmed mesial temporal lobe epilepsy.

Hum Pathol 2021 Jun 10. Epub 2021 Jun 10.

Department of Neurosurgery, Sanbo Brain Hospital, Capital Medical University, Beijing, China; Beijing Key Laboratory of Epilepsy. Electronic address:

Objective: Hippocampal sclerosis (HS) is the most common neuropathologic findings in patients with intractable temporal lobe epilepsy (TLE). The international league against epilepsy (ILAE) has proposed a new classification of HS based on pyramidal cell loss on different subfields to facilitate the study of HS pathology in patients after ATL, and the influence of these HS patterns on the prognosis of TLE patients is contradictory. This study aims to investigate the relationship between different HS subtypes and postoperative seizure outcomes for intractable TLE patients. Read More

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Structural brain assessment of temporal lobe epilepsy based on voxel-based and surface-based morphological features.

Neurol Neurochir Pol 2021 Jun 2. Epub 2021 Jun 2.

Department of Neurosurgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.

Aim Of The Study: This study aimed to assess the cerebral voxel-based and surface-based morphological abnormalities of patients with temporal lobe epilepsy (TLE).

Materials And Methods: A total of 100 healthy adults and 73 patients with TLE were enrolled in this study, and their 3D T1-weighted MRI data were collected. Voxel-based morphology (VBM) and surface-based morphology (SBM) tools were used to compare the morphological differences between healthy adults and patients with TLE. Read More

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Aberrant cerebral intrinsic activity and cerebro-cerebellar functional connectivity in right temporal lobe epilepsy: a resting-state functional MRI study.

Neuroreport 2021 Jun 1. Epub 2021 Jun 1.

Department of Neurology, the People's Hospital of Guangxi Zhuang Autonomous Region Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Objective: Numerous neuroimaging studies have demonstrated that functional brain aberrations are associated with cognitive impairments in temporal lobe epilepsy (TLE). Here, we aimed to investigate the neural substrates of attention deficits by combining assessment of regional intrinsic brain activities with large-scale functional connectivity in patients with right TLE (rTLE).

Methods: Thirty-five patients with rTLE and 33 matched healthy controls were recruited. Read More

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Exploring the Semantic Structure of WMS-IV Verbal Paired Associates using the Hub-and-Spoke Model.

J Int Neuropsychol Soc 2021 May 24:1-9. Epub 2021 May 24.

Comprehensive Epilepsy Program, St. Vincent's Hospital, Melbourne, Australia.

Objectives: This study aimed to identify a well-fitting and theoretically justified item-level latent factor structure for the Wechsler Memory Scales (WMS)-IV verbal paired associates (VerbalPA) subtest to facilitate the ease and accuracy of score interpretations for patients with lateralized temporal lobe epilepsy (TLE).

Methods: Archival data were used from 250 heterogeneous neurosciences patients who were administered the WMS-IV as part of a standard neuropsychological assessment. Three theoretically motivated models for the latent structure of VerbalPA were tested using confirmatory factor analysis. Read More

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Volumetric and shape analysis of the hippocampus in temporal lobe epilepsy with GAD65 antibodies compared with non-immune epilepsy.

Sci Rep 2021 May 13;11(1):10199. Epub 2021 May 13.

Magnetic Resonance Imaging Core Facility, IDIBAPS, Barcelona, Spain.

Glutamic acid decarboxylase 65 antibodies (anti-GAD65) have been found in patients with late-onset chronic temporal lobe epilepsy (TLE). No prior neuroimaging studies have addressed how they affect hippocampal volume and shape and how they relate to cognitive abnormalities. We aimed to investigate both brain structure and function in patients with isolated TLE and high anti-GAD65 levels (RIA ≥ 2000 U/ml) compared to 8 non-immune mesial TLE (niTLE) and 8 healthy controls (HC). Read More

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Long-term survival following transvenous lead extraction: Importance of indication and comorbidities.

Heart Rhythm 2021 May 10. Epub 2021 May 10.

Cardiology Department, Guy's and St Thomas' NHS Foundation Trust, London, United Kingdom; School of Biomedical Engineering and Imaging Sciences, King's College London, United Kingdom.

Background: Long-term outcomes are poorly understood, and data in patients undergoing transvenous lead extraction (TLE) are lacking.

Objective: The purpose of this study was to evaluate factors influencing survival in patients undergoing TLE depending on extraction indication.

Methods: Clinical data from consecutive patients undergoing TLE in the reference center between 2000 and 2019 were prospectively collected. Read More

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Automated detection of hippocampal sclerosis: Comparison of a composite MRI-based index with conventional MRI measures.

Epilepsy Res 2021 Aug 9;174:106638. Epub 2021 Apr 9.

Department of Radiology, Sanbo Brain Hospital, Capital Medical University, China. Electronic address:

Purpose: This study aims to compare the performance of an MRI-based composite index (HSI) with conventional MRI-based measures in hippocampal sclerosis (HS) detection and postoperative outcome estimation.

Methods: Seventy-two temporal lobe epilepsy (TLE) patients with pathologically confirmed HS and fifteen TLE patients without HS were included retrospectively. The T1-weighted and FLAIR images of these patients were processed with AccuBrain to quantify the hippocampal volume (HV) and the hippocampal FLAIR signal. Read More

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Temporal lobe epilepsy alters neural responses to human and avatar facial expressions in the face perception network.

Brain Behav 2021 Jun 5;11(6):e02140. Epub 2021 May 5.

Swiss Epilepsy Center, Zurich, Switzerland.

Background And Objective: Although avatars are now widely used in advertisement, entertainment, and business today, no study has investigated whether brain lesions in neurological patients interfere with brain activation in response to dynamic avatar facial expressions. The aim of our event-related fMRI study was to compare brain activation differences in people with epilepsy and controls during the processing of fearful and neutral dynamic expressions displayed by human or avatar faces.

Methods: Using functional magnetic resonance imaging (fMRI), we examined brain responses to dynamic facial expressions of trained actors and their avatar look-alikes in 16 people with temporal lobe epilepsy (TLE) and 26 controls. Read More

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Factors affecting interictal unilateral and bilateral discharges and ictal diffusion patterns of scalp electroencephalogram in temporal lobe epilepsy.

Neurol Sci 2021 May 4. Epub 2021 May 4.

Department of Neurology, Shengjing Hospital of China Medical University, 39 Huaxiang Road, Shenyang, 110022, China.

Background: The interictal discharges of temporal lobe epilepsy (TLE) can be unilateral or bilateral. In addition, the ictal electroencephalogram (EEG) showed the discharges also tend to spread to the contralateral brain in TLE.

Objective: The factors influencing unilateral and bilateral interictal discharges in TLE as well as ictal diffusion patterns in scalp EEG during onset of seizure were evaluated in the present study. Read More

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Altered interhemispheric functional homotopy and connectivity in temporal lobe epilepsy based on fMRI and multivariate pattern analysis.

Neuroradiology 2021 May 3. Epub 2021 May 3.

Department of Neurology, the First Affiliated Hospital of Guangxi Medical University, Nanning, China.

Purpose: This study aimed to investigate how the functional homotopy and further functional connectivity (FC) of whole brain changed in temporal lobe epilepsy (TLE). We also evaluated which brain regions played a decisive role in classification by using functional magnetic resonance imaging (fMRI).

Methods: Patients with TLE and matched healthy controls were included to collect the fMRI data and perform the voxel-mirrored homotopic connectivity (VMHC) and FC analyses. Read More

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Feature of cognitive dysfunction in patients with temporal lobe epilepsy and its clinical influencing factors.

Zhong Nan Da Xue Xue Bao Yi Xue Ban 2021 Mar;46(3):240-248

Department of Neurology, Xiangya Hospital, Central South University, Changsha 410008, China.

Objectives: To comprehensively analyze the characteristics of cognitive impairment of temporal lobe epilepsy (TLE), and to explore the effects of different lateral patients' cognitive impairment and different clinical factors on cognitive impairment of TLE.

Methods: A total of 84 patients, who met the diagnostic criteria for TLE in the Department of Neurology, Xiangya Hospital, were collected as a patient group, with 36 cases of left TLE and 48 cases of right TLE. A total of 79 healthy volunteers with matching gender, age and education level were selected as a control group. Read More

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Unexpected pain with electrocortical stimulation in a teenager with temporal encephalocele.

Epilepsy Behav Rep 2021 31;16:100444. Epub 2021 Mar 31.

Department of Neurology, University of Wisconsin-Madison School of Medicine and Public Health, 1685 Highland Ave, Madison, WI 53705, United States.

Temporal lobe encephalocele has emerged as a potentially unrecognized cause of drug-resistant temporal lobe epilepsy (TLE) that can be effectively treated with epilepsy surgery. Here we present a case in which a 17-year-old male with drug-resistant epilepsy and left temporal encephalocele underwent workup for epilepsy surgery, and experienced unexpected pain with electrocortical stimulation. Stimulation of stereo-EEG electrodes in the left temporal pole resulted in severe, unilateral left-sided facial pain due to inadvertent stimulation of the trigeminal nerve. Read More

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Endovascular occlusion balloon-related thrombosis during transvenous lead extraction.

Europace 2021 Apr 5. Epub 2021 Apr 5.

Electrophysiology Section, Division of Cardiovascular Medicine, Perelman School of Medicine at the University of Pennsylvania, 3400 Spruce Street, Philadelphia, PA 19104, USA.

Aims: The aim of this study is to evaluate the incidence, predictors, and outcomes of balloon-related thrombosis (BRT) in patients undergoing transvenous lead extraction (TLE). Use of an endovascular occlusion balloon has improved outcomes of superior vena cava injuries during TLE. Its thrombogenicity in clinical practice is unknown. Read More

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Short-Term Amygdala Low-Frequency Stimulation Does not Influence Hippocampal Interneuron Changes Observed in the Pilocarpine Model of Epilepsy.

Cells 2021 Mar 1;10(3). Epub 2021 Mar 1.

Department of Physiology, Faculty of Medicine, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Târgu Mureș, 540142 Târgu Mureș, Romania.

Temporal lobe epilepsy (TLE) is characterized by changes in interneuron numbers in the hippocampus. Deep brain stimulation (DBS) is an emerging tool to treat TLE seizures, although its mechanisms are not fully deciphered. We aimed to depict the effect of amygdala DBS on the density of the most common interneuron types in the CA1 hippocampal subfield in the lithium-pilocarpine model of epilepsy. Read More

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Facial memory ability and self-awareness in patients with temporal lobe epilepsy after anterior temporal lobectomy.

PLoS One 2021 1;16(4):e0248785. Epub 2021 Apr 1.

Department of Behavioral Neurology and Cognitive Neuroscience, Tohoku University Graduate School of Medicine, Sendai, Japan.

Anterior temporal lobectomy (ATL) is the most common surgical treatment for drug-resistant temporal lobe epilepsy (TLE). Right ATL has been reported to reduce facial memory ability in patients with TLE, as indicated by poor performance on the Warrington Recognition Memory Test for Faces (RMF), which is commonly used to evaluate visual memory in these patients. However, little is known about whether patients with TLE exhibit difficulties in identifying faces in daily life after ATL. Read More

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Left Hemisphere Lateralization of Epileptic Focus Can Be More Frequent in Temporal Lobe Epilepsy Surgical Patients with No Consensus Associated with Depression Lateralization.

Dev Neurosci 2021 31;43(1):1-8. Epub 2021 Mar 31.

Brain Institute of Rio Grande do Sul (BraIns), Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.

Temporal lobe epilepsy (TLE) is considered to be the most common form of epilepsy, and it has been seen that most patients are refractory to antiepileptic drugs. A strong association of this ailment has been established with psychiatric comorbidities, primarily mood and anxiety disorders. The side of epileptogenic may contribute to depressive and anxiety symptoms; thus, in this study, we performed a systematic review to evaluate the prevalence of depression in TLE in surgical patients. Read More

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Transvenous lead extraction in patients with persistent left superior vena cava.

J Cardiovasc Electrophysiol 2021 May 16;32(5):1407-1410. Epub 2021 Apr 16.

Cardiology Department, Spedali Civili Brescia, Brescia, Italy.

Purpose: Predictors of difficulty and complications of transvenous lead extraction (TLE) have been investigated in several studies; however, little is known about the venous anatomical characteristics that can have an impact on procedural outcomes. Among them, the persistent left superior vena cava (PLSVC) is a common anomaly often discovered incidentally during cardiac device implantation and could raise concerns if TLE is indicated. We report technical considerations and outcomes of TLE for two patients with leads implanted via PLSVC. Read More

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Utility of fluoroscopy alone for monitoring of intrathoracic bleeding complications during transvenous lead extraction.

J Cardiovasc Electrophysiol 2021 Jun 22;32(6):1724-1732. Epub 2021 Mar 22.

Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA.

Background: Transvenous lead extraction (TLE) carries a significant risk of major complications, namely bleeding into the pericardial sac or thoracic cavity. While echocardiographic imaging has been recommended for intraprocedural monitoring for those complications, no studies had examined the potential benefits of fluoroscopy alone as an alternative to echocardiography. The aim of this study was to evaluate the utility of fluoroscopy for monitoring intrathoracic bleeding complications during TLE. Read More

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Quantitative Meta-Analyses: Lateralization of Memory Functions Before and After Surgery in Children with Temporal Lobe Epilepsy.

Neuropsychol Rev 2021 Mar 6. Epub 2021 Mar 6.

School of Behavioral Sciences, Academic College of Tel Aviv-Jaffa, P.O.B. 8401, 61083, Tel-Aviv-Jaffa, Israel.

Rationale: Memory deficits in children with epilepsy have been reported in some but not all studies assessing the effects of side of seizures and resection from the temporal lobe on cognitive performance. This meta-analysis provides a quantitative systematic review of previous studies on this issue.

Method: A critical review and meta-analysis of the literature on memory performance in children with Temporal Lobe Epilepsy (TLE) was conducted. Read More

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Nonverbal fluency assessed by the five-point test in epilepsy patients with unilateral mesial temporal sclerosis-a Brazilian study.

Clin Neuropsychol 2021 Feb 24:1-12. Epub 2021 Feb 24.

Epilepsy and EEG Center, Hospital de Clínicas-Federal University of Paraná, Curitiba, Paraná, Brazil.

Objective: To investigate the performance of epilepsy patients diagnosed with unilateral mesial temporal sclerosis (MTS) on a nonverbal fluency measure using the five-point test (FPT). Our secondary aim was to investigate any differences in FPT and verbal fluency test (VFT) scores between left and right MTS. We hypothesized that scores on the FPT, commonly utilized in the assessment of individuals with presumed frontal lobe damage, would be lower in patients with temporal lobe dysfunction. Read More

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February 2021

A PET imaging study of the brain changes of glucose metabolism in patients with temporal lobe epilepsy and depressive disorder.

BMC Med Imaging 2021 02 22;21(1):33. Epub 2021 Feb 22.

Department of Psychiatry, Guangdong, The First Affiliated Hospital of Jinan University, No.613, West Huangpu Avenue, Tianhe District, Guangzhou, 510630, China.

Background: This study aims to compare the difference of the brain changes of glucose metabolism between temporal lobe epilepsy patients (TLE) with major depressive disorder and temporal TLE without major depressive disorder.

Methods: A total of 24 TLE patients, who met the inclusion criteria of our hospital, were enrolled in this study. They were divided into a TLE with depression group (n = 11) and a TLE without depression group (n = 13), according to the results of the HAMD-24 Scale. Read More

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February 2021

Regional and global resting-state functional MR connectivity in temporal lobe epilepsy: Results from the Epilepsy Connectome Project.

Epilepsy Behav 2021 04 18;117:107841. Epub 2021 Feb 18.

University of Wisconsin-Madison, Department of Neurology, United States.

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. Read More

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Resting-state hippocampal networks related to language processing reveal unique patterns in temporal lobe epilepsy.

Epilepsy Behav 2021 04 18;117:107834. Epub 2021 Feb 18.

Institute of Imaging Science, Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, USA; Department of Neurological Surgery, Vanderbilt University Medical Center, USA; Department of Biomedical Engineering, Vanderbilt University, USA. Electronic address:

Objective: Patients with temporal lobe epilepsy (TLE) commonly experience a broad range of language impairments. These deficits are thought to arise from repeated seizure activity that damages language regions. However, connectivity between the seizure onset region in the hippocampus and regions related to language processing has rarely been studied, and could also have a strong impact on language function. Read More

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Longitudinal analysis of interictal electroencephalograms in patients with temporal lobe epilepsy with hippocampal sclerosis.

Seizure 2021 Feb 12. Epub 2021 Feb 12.

Department of Neurology, University of Campinas (UNICAMP), Campinas, SP, Brazil. Electronic address:

Background: While studies have shown the progression of atrophy in temporal lobe epilepsy (TLE) with hippocampal sclerosis (HS), little is known about the long-term dynamics of interictal epileptiform discharges (IEDs).

Objectives: To investigate long-term IEDs distribution in routine EEGs.

Methods: We evaluated 314 patients with TLE and MRI signs of HS (TLE-HS). Read More

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February 2021

Semantic and episodic memory in adults with temporal lobe epilepsy.

Appl Neuropsychol Adult 2021 Feb 17:1-10. Epub 2021 Feb 17.

School of Psychology, University of Sydney, Sydney, Australia.

The primary aims were to (1) identify the factor structure of tests thought to measure semantic and episodic memory and (2) examine whether patterns of impairment would show a double dissociation between these two memory systems at an individual level in patients with temporal lobe epilepsy (TLE). The secondary aim was to explore the impact of epilepsy-related variables on performance. This retrospective study involved a cohort of 54 adults who had been diagnosed with TLE and had undergone a neuropsychological assessment that included four memory tests traditionally used to measure either semantic memory (picture naming, animal fluency) or episodic memory (story recall, word list recall) at a single epilepsy surgery center in Australia. Read More

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February 2021

Functional connectivity of hippocampus in temporal lobe epilepsy depends on hippocampal dominance: a systematic review of the literature.

J Neurol 2021 Feb 10. Epub 2021 Feb 10.

Department of Neurosurgery, University of Oklahoma Health Sciences Center, 1000 N Lincoln Boulevard, Suite 4000, Oklahoma City, Oklahoma, 73104, USA.

Background: Lateralized alterations in hippocampal function in the resting-state have been demonstrated for patients with temporal lobe epilepsy (TLE). However, resting-state fMRI of the hippocampus has yet to be substantiated as an adjunct to standard pre-operative assessments of the seizure focus.

Objective: Here we report the results of a systematic review of resting-state fMRI studies investigating laterality of hippocampal network connectivity in TLE patients. Read More

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February 2021

Lateralizing magnetic resonance imaging findings in mesial temporal sclerosis and correlation with seizure and neurocognitive outcome after temporal lobectomy.

Epilepsy Res 2021 Mar 18;171:106562. Epub 2021 Jan 18.

Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Neurosurgery, Toronto Western Hospital, Toronto, ON, Canada; Institute of Biomaterials and Biomedical Engineering, University of Toronto, Toronto, ON, Canada.

Background: Mesial temporal sclerosis (MTS) is the most common cause of temporal lobe epilepsy (TLE). While MTS is associated with a high cure rate after temporal lobectomy (TL), postoperative neurocognitive deficits are common, and a subset of patients may continue to have refractory seizures.

Objective: To use magnetic resonance (MR) volumetry to identify features of the mesial temporal lobe in patients with MTS that correlate with seizure and neurocognitive outcome after temporal lobectomy. Read More

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Prognosis of patients with severe left ventricular dysfunction after transvenous lead extraction and the need for additional hemodynamic support in the perioperative period.

Heart Rhythm 2021 Jun 29;18(6):962-969. Epub 2021 Jan 29.

Department of Cardiovascular Medicine, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama, Japan.

Background: Transvenous lead extraction (TLE) is necessary because of system infection, lead malfunction, or system upgrade. Patients with severe left ventricular dysfunction (SLVD) undergoing TLE may be at a higher risk because hemodynamic parameters may change unfavorably during or after TLE; however, this has not yet been clarified.

Objective: The purpose of this study was to examine whether patients with SLVD undergoing TLE have higher mortality. Read More

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The impact of hippocampal impairment on task-positive and task-negative language networks in temporal lobe epilepsy.

Clin Neurophysiol 2021 Feb 3;132(2):404-411. Epub 2020 Dec 3.

Department of Neurology, Medical University of Vienna, Währinger Gürtel 18-20, 1090 Vienna, Austria. Electronic address:

Objective: To study hippocampal integration within task-positive and task-negative language networks and the impact of a diseased left and right hippocampus on the language connectome in temporal lobe epilepsy (TLE).

Methods: We used functional magnetic resonance imaging (fMRI) to study a homogenous group of 32 patients with TLE (17 left) and 14 healthy controls during a verb-generation task. We performed functional connectivity analysis and quantified alterations within the language connectome and evaluated disruptions of the functional dissociation along the anterior-posterior axis of the hippocampi. Read More

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February 2021