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      Language brain dominance in patients with refractory temporal lobe epilepsy: a comparative study between functional magnetic resonance imaging and dichotic listening test Translated title: Determinação de dominância cerebral para linguagem em pacientes com epilepsia refratária de lobo temporal: estudo comparativo entre ressonância magnética funcional e teste de escuta dicótica

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          Abstract

          PURPOSE: To identify brain dominance for language functions with DLT and correlate these results with those obtained from fMRI in patients suffering from intractable temporal lobe epilepsy. METHOD: This study reports on 13 patients who underwent pre-surgical epileptic evaluation between April and October 2004 at the Epilepsy Surgery Program, Hospital Sao Lucas, PUCRS. In DLT, dominance was assessed through a consonant-vowel task, whereas in fMRI patients performed a verb generation task. RESULTS: Our results identified a correlation between the fMRI lateralization index and the DLT ear predominance index and reply difference index (r=0.6, p=0.02; Pearson Correlation Coefficient), showing positive correlation between results obtained from fMRI and DLT. CONCLUSION: DLT was found to significantly correlate with fMRI. These findings indicate that DLT (a non-invasive procedure) could be a useful tool to evaluate language brain dominance in pre-surgical epileptic patients as it is cheaper to perform than fMRI.

          Translated abstract

          OBJETIVO: Identificar a dominância cerebral para funções de linguagem através do teste de escuta dicótica (TED) e correlacionar com os resultados de ressonância magnética funcional (RMf) em pacientes com epilepsia refratária de lobo temporal. MÉTODO: Foram estudados 13 pacientes com epilepsia refratária de lobo temporal, que realizaram avaliações pré-cirúrgicas no período de abril a outubro de 2004 no Programa de Cirurgia de Epilepsia do Hospital São Lucas da PUCRS. Realizada investigação da dominância hemisférica para linguagem através do TED Consoante-Vogal e da RMf pela geração de verbos. RESULTADOS: Verificou-se a existência de correlação entre os índices de lateralidade (RMf) e os índices de predomínio de orelha e de diferença de resposta (TED) (r=0,6, p=0,02). CONCLUSÃO: Existe correlação entre os resultados obtidos através da RMf (índice de lateralidade) e do TED (índice de predomínio de orelha e índice de diferença de resposta) em pacientes com epilepsia refratária de lobo temporal.

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          Most cited references32

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          Cem Bilhões de Neurônios: Conceitos Fundamentais de Neurociência

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            Functional brain reorganization in children.

            Developmental brain plasticity in association with focal brain injury is dependent on a number of factors, including age of the individual at the time of injury, size and topography of the brain lesion, maturational state of the brain system injured, integrity of brain areas surrounding and contralateral to the lesion, presence and duration of epilepsy, and medication effects. Recently developed functional neuroimaging tools now make it possible to study non-invasively several aspects of human brain functional reorganization in response to injury. Clinical models which are suitable for the study of developmental brain plasticity include patients who have undergone cortical resections for the alleviation of intractable epilepsy, patients who have sustained unilateral cerebrovascular insults at various periods of development, patients with chronic progressive unilateral brain injury such as in the Sturge-Weber syndrome, and patients with early sensory deprivation such as blind or deaf subjects. Although evidence of functional brain reorganization can be demonstrated in these models, it is emphasized that the neurobiological rules that govern intrahemispheric versus interhemispheric reorganization of function in the brain are, at present, poorly understood.
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              Perceptual asymmetry on the dichotic fused words test and cerebral speech lateralization determined by the carotid sodium amytal test.

              The rhymed fused dichotic words test was administered to 61 epileptic patients whose lesions were atrophic and predominantly unilateral. Subjects were categorized according to the side of speech representation, as determined by intracarotid sodium Amytal injection (left-hemisphere representation, 35 subjects; right-hemisphere representation, 4 subjects; bilateral representation, 22 subjects). Results indicated that 33 of the patients with left-hemisphere speech representation obtained right-ear advantages, and all four of the patients with right-hemisphere speech representation obtained left-ear advantages. The distribution of scores for patients with bilateral speech straddled the zero ear-advantage point, but overlapped both of the other two groups to some extent. Neither handedness, familial handedness, sex, nor side of epileptogenic focus had any significant effect on the observed asymmetries. It was also found that stimulus dominance effects have an important influence on the results, and must be taken into account in the interpretation of dichotic listening asymmetries. It is concluded that this test yields valid estimates of speech lateralization; it is also apparent that the magnitude of ear advantage may be an important variable insofar as the more extreme asymmetries appear to be exclusively associated with speech dominance of the contralateral hemisphere, whereas small-magnitude asymmetries are often associated with bilateral speech representation.
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                Author and article information

                Contributors
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Role: ND
                Journal
                anp
                Arquivos de Neuro-Psiquiatria
                Arq. Neuro-Psiquiatr.
                Academia Brasileira de Neurologia - ABNEURO (São Paulo )
                1678-4227
                March 2008
                : 66
                : 1
                : 34-39
                Affiliations
                [1 ] Pontifícia Universidade Católica do Rio Grande do Sul Brazil
                [2 ] Pontifícia Universidade Católica do Rio Grande do Sul Brazil
                Article
                S0004-282X2008000100009
                10.1590/S0004-282X2008000100009
                18392411
                a129f42a-1b12-40ef-b9ae-0ea1cc00c6ae

                http://creativecommons.org/licenses/by/4.0/

                History
                Product

                SciELO Brazil

                Self URI (journal page): http://www.scielo.br/scielo.php?script=sci_serial&pid=0004-282X&lng=en
                Categories
                NEUROSCIENCES
                PSYCHIATRY

                Neurosciences,Clinical Psychology & Psychiatry
                dichotic listening test,functional magnetic resonance imaging,refractory temporal lobe epilepsy,brain dominance,language,teste de escuta dicótica,ressonância magnética funcional,epilepsia temporal refratária,dominância cerebral,linguagem

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