Contralateral language network integration predicts and protects against naming decline after temporal lobe resection

Area of Science:

• Neuroscience
• Neurosurgery
• Epilepsy Research

Background:

• Anterior temporal lobe resection (ATLR) effectively treats drug-resistant temporal lobe epilepsy (TLE).
• ATLR carries a significant risk of language deficits, particularly affecting naming abilities.
• Predicting language outcomes after ATLR remains a clinical challenge.

Purpose of the Study:

• To investigate the short-term effects of ATLR on the functional language connectome.
• To understand the role of the nondominant hemisphere in language function post-ATLR.
• To identify predictors of naming impairment following ATLR.

Main Methods:

• Functional magnetic resonance imaging (fMRI) was used to assess language network connectivity.
• 44 TLE patients (24 left, 20 right) underwent fMRI and neuropsychological testing pre- and post-ATLR.
• Changes in functional connectivity were correlated with neuropsychological performance.

Main Results:

• ATLR caused widespread functional connectivity alterations, including ipsilateral disruptions and contralateral compensation.
• Left ATLR impacted interhemispheric temporal connectivity; right ATLR affected bilateral frontal connections.
• Preoperative right temporal lobe connectivity predicted naming performance, and machine learning models improved prediction of naming decline.

Conclusions:

• The right temporal lobe plays a crucial role in supporting naming after left ATLR.
• Preoperative connectivity assessment may enhance the prediction of postoperative language outcomes.
• Functional connectivity patterns offer valuable insights into language reorganization post-neurosurgery.