Objective

To investigate alterations of language networks and their relation to impaired naming performance in temporal lobe epilepsy (TLE) using functional MRI.

Methods

Seventy-two adult TLE patients (41 left) and 36 controls were studied with overt auditory and picture naming fMRI tasks to assess temporal lobe language areas, and a covert verbal fluency task to probe frontal lobe language regions. Correlation of fMRI activation with clinical naming scores, and alteration of language network patterns in relation to epilepsy duration, age at onset and seizure frequency, were investigated with whole-brain multiple regression analyses.

Results

Auditory and picture naming fMRI activated the left posterior temporal lobe, and stronger activation correlated with better clinical naming scores. Verbal fluency MRI mainly activated frontal lobe regions. In left and right TLE, a later age of epilepsy onset related to stronger temporal lobe activations, while earlier age of onset was associated with impaired deactivation of extratemporal regions. In left TLE patients, longer disease duration and higher seizure frequency were associated with reduced deactivation. Frontal lobe language networks were unaffected by disease characteristics.

Conclusions

While frontal lobe language regions appear spared, temporal lobe language areas are susceptible to dysfunction and reorganisation, particularly in left TLE. Early onset and long duration of epilepsy, and high seizure frequency, were associated with compromised activation and deactivation patterns of task-associated regions, which might account for impaired naming performance in individuals with TLE.

中文翻译：

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颞叶癫痫的命名性能受损：语言功能磁共振成像反应受疾病特征调节。

目的

使用功能性MRI研究语言网络的变化及其与颞叶癫痫（TLE）命名能力受损的关系。

方法

研究人员对72名成人TLE患者（左41名）和36名对照进行了明确的听觉和图片命名功能性核磁共振成像任务，以评估颞叶语言区域，并进行隐性口语流利度任务，以探查额叶语言区域。通过全脑多元回归分析研究了功能磁共振成像激活与临床命名评分的相关性，以及与癫痫持续时间，发作年龄和癫痫发作频率有关的语言网络模式的变化。

结果

听觉和图片命名功能磁共振成像激活了左后颞叶，并且更强的激活与更好的临床命名分数相关。口语流利性MRI主要激活额叶区域。在左TLE和右TLE中，癫痫发作的较晚年龄与较强的颞叶激活有关，而较早的发作年龄与颞外区域的失活有关。在左TLE患者中，更长的疾病持续时间和更高的癫痫发作频率与减少的失活有关。额叶语言网络不受疾病特征的影响。

结论

尽管额叶语言区域显得比较宽容，但颞叶语言区域容易出现功能障碍和重组，尤其是在左TLE中。癫痫的早期发作和持续时间长，癫痫发作频率高，与任务相关区域的激活和失活模式受损有关，这可能是TLE个体命名能力受损的原因。