Presentation
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Temporal disconnection associated with naming deficits in postoperative temporal lobe epilepsy
Poster C21 in Poster Session C, Friday, October 7, 10:15 am - 12:00 pm EDT, Millennium Hall
Ezequiel Gleichgerrcht1, Natalie L. Voets2, Rebecca Roth3, Kathryn A. Davis4, Nigel P. Pedersen3, Deqiang Qiu3, Kelsey C. Hewitt3, Jon T. Willie5, David W. Loring3, Robert E. Gross3, Ruben Kuzniecky6, Julius Fridriksson7, Daniel L. Drane3, Leonardo Bonilha3; 1Medical University of South Carolina, 2University of Oxford, 3Emory University, 4University of Pennsylvania, 5Washington University in St. Louis, 6Hofstra University / Northwell, 7University of South Carolina
Background: Picture naming relies on a widespread network of anatomical structures, which explains why naming deficits can be detected across distinct types of neurologic disorders. Here, we aimed to comprehensively evaluate the critical temporal lobe neuroanatomy associated with naming in a visual confrontation task by applying a combination of classical voxel-based symptom mapping with a novel approach to infer white matter disconnections across different brain regions. To do this, we studied a cohort of patients with drug-resistant temporal lobe epilepsy (TLE) who underwent surgery. Indeed, surgery can lead to seizure control in many patients but removal (e.g., anterior temporal lobectomy) or destruction (e.g., laser ablation) of temporal brain areas is often associated with post-operative language deficits, particularly in naming. We hypothesized that disconnections of different sub-regions within the temporal lobes would be associated with anomia after TLE surgery. Method: We tested our hypothesis in a cohort of 56 patients with TLE who underwent epilepsy surgery by applying lesion-symptom mapping with pre- vs. post-operative performance changes on the Boston Naming Test. Results: Our findings reveal that the integrity of a temporal lobe network linking the temporal pole, basal temporal structures, and lateral temporal language regions is crucial for preserving visual naming performance in patients with TLE undergoing surgery to treat seizures. Discussion: While prior lesion-symptom mapping studies pointed to a crucial role for different areas within the temporal lobe having a crucial role in naming impairments (anterior temporal pole vs. basal temporal region), our findings offer a unifying explanation by demonstrating that a loss of white fiber tracts connecting these regions are critically associated with anomia in TLE. These findings offer a neurobiological mechanism for an integrative role of ventral stream pathways in visual naming.
Topic Areas: Disorders: Acquired, Methods