Left parietal structural connectivity mediates typical and atypical language laterality in temporal lobe epilepsy

IF 6.6 1区医学 Q1 CLINICAL NEUROLOGY Epilepsia Pub Date : 2025-03-08 DOI:10.1111/epi.18298

Salvatore Citro, Sam S. Javidi, Ankeeta Ankeeta, Xiaosong He, Qirui Zhang, Yolanda Kry, Michael R. Sperling, Joseph I. Tracy

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Abstract

Objective

Subjects with left temporal lobe epilepsy may either show altered hemispheric language lateralization or retain typical, left lateralization. Examining the integrity of white matter pathways involved in the adaptation or maintenance of language lateralization in these patients could have important clinical implications for preserving or potentiating compensatory language mechanisms.

Methods

We combined task functional magnetic resonance imaging and structural diffusion metrics to determine the dependency of lobe-based language laterality on white matter integrity in healthy participants and left temporal lobe epilepsy (TLE) patients. We tested for differences between individuals who expressed typical, left hemisphere laterality compared to those with atypical laterality patterns (bilateral or right hemisphere biased).

Results

A total of 41 left TLE patients and 51 sex- and age-matched healthy participants (HPs) were enrolled. In left temporal lobe epilepsy, typical patterns of frontal and temporal lateralities were less conditioned by the language-related white matter connections of the left temporal lobe. In typically organized epilepsy subjects, temporal lobe language laterality was dependent upon the structural connectivities of the left parietal lobe. Among atypically organized individuals, compared to HPs, TLE patients displayed frontal and parietal language lateralities mediated by the structural connectivities of the left parietal lobe.

Significance

Language-related left parietal lobe connections were critical both for maintaining typical left hemisphere-biased language processing in the temporal lobe and for the formation of noncanonical, potentially adaptive language processing asymmetries in the frontal and parietal lobes. Assessments of the laterality and integrity of language skills in left temporal lobe epilepsy will require modeling white matter structural influences.

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左顶叶结构连通性介导颞叶癫痫的典型和非典型语言偏侧。

目的：左颞叶癫痫患者可能表现出半球语言偏侧功能的改变或保持典型的左侧偏侧功能。检查这些患者中涉及语言侧化适应或维持的白质通路的完整性，对于保留或增强代偿性语言机制具有重要的临床意义。方法：我们结合任务功能磁共振成像和结构扩散指标来确定健康参与者和左颞叶癫痫（TLE）患者基于脑叶的语言偏侧性对白质完整性的依赖。我们测试了典型的左半球偏侧与非典型偏侧（双侧或右半球偏侧）个体之间的差异。结果：共有41名TLE患者和51名性别和年龄匹配的健康参与者（HPs）入组。在左颞叶癫痫中，典型的额侧和颞侧模式较少受到左颞叶语言相关白质连接的制约。在典型的组织性癫痫患者中，颞叶语言偏侧性依赖于左顶叶的结构连通性。在非典型组织个体中，与hp相比，TLE患者表现出由左顶叶结构连接介导的额叶和顶叶语言偏侧。意义：语言相关的左顶叶连接对于维持颞叶中典型的左半球偏倚语言处理以及在额叶和顶叶中形成非规范的、潜在的适应性语言处理不对称至关重要。评估左颞叶癫痫的语言技能的偏侧性和完整性需要模拟白质结构的影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Epilepsia 医学-临床神经学

CiteScore

10.90

自引率

10.70%

发文量

319

审稿时长

2-4 weeks

期刊介绍： Epilepsia is the leading, authoritative source for innovative clinical and basic science research for all aspects of epilepsy and seizures. In addition, Epilepsia publishes critical reviews, opinion pieces, and guidelines that foster understanding and aim to improve the diagnosis and treatment of people with seizures and epilepsy.