Objective:The present study aimed to examine and compare memory processing in patients with unilateral temporal lobe epilepsy (TLE) before and after surgery using functional magnetic resonance imaging (fMRI).Methods:Seventeen preoperative patients with unilateral TLE (nine left, eight right) and eight healthy controls were recruited. They performed a complex visual scene-encoding task during fMRI to measure memory activation in the mesial temporal lobe. Their memory performance was evaluated using standardised neuropsychological tests. After unilateral temporal lobe resection (either temporal lobectomy, selective amygdalohippocampectomy or lesionectomy), the same fMRI paradigm and neuropsychological tests were administered to the patient group.Results:Left-TLE patients demonstrated a decline in verbal memory after left temporal lobe resection. Their postoperative verbal and visual memory performance was positively associated with postoperative functional activation in the right mesial temporal lobe, whereas the postoperative memory performance of right-TLE patients was positively associated with postoperative functional activation in the left mesial temporal lobe, contralateral to their respective side of resection.Conclusion:Postoperative memory performance was significantly associated with functional activation contralateral to the side of resection in patients with unilateral TLE, and the function of the contralateral mesial temporal lobe might play an important role in supporting memory performance after temporal lobe resection.

Background The ongoing COVID-19 pandemic has resulted in the suspension of face-to-face classes and a considerable increase in the use of telepractice services in speech-language pathology. However, little is known about parents’ and students’ satisfaction with telepractice services and their preferences for different service delivery modes. These factors may affect therapy effectiveness and the future adoption of telepractice. Objective We evaluated students’ and parents’ perceptions of telepractice efficacy and their preferences for different service delivery modes (ie, on-site practice vs telepractice). We also identified factors that affect parents’ and students’ preferences for different service delivery modes during the COVID-19 pandemic. Methods A 19-question survey on telepractice satisfaction and preferences was administered to 41 Hong Kong Chinese students and 85 parents who received telepractice services from school-based speech-language pathologists during the COVID-19 class suspension period. In addition to providing demographic information and data on the implementation of telepractice services, all participants were asked to rate their perceptions of the efficacy of telepractice services and compare on-site practices to telepractice on a 5-point Likert scale (ie, 1=strongly disagree/prefer the use of on-site speech-language therapy services and 5=strongly agree/prefer the use of telepractice services). Results Despite the fact that telepractice efficacy was highly rated by parents (95% CI 3.30-3.66) and students (95% CI 3.21-3.76), both groups believed that telepractice was less effective than on-site practices (parents: 95% CI 2.14-2.52; students: 95% CI 2.08-2.65). Moreover, parents preferred on-site practices over telepractice (95% CI 2.04-2.43), whereas students did not prefer one mode of practice over the other (95% CI 2.74-3.41). A significant association between telepractice efficacy and a preference for telepractice services was found only among the students (τ=.43, P<.001), not the parents (τ=.07; P=.44). Conclusions Although telepractice is an acceptable alternative service delivery option for providing speech and language therapy services to school-aged individuals, speech-language therapists and parents must play a more proactive role in telepractice services to facilitate effective communication between clinicians and parents.

Summary:Purpose: To examine the effects of illness duration on the neural processing of memory in patients with temporal lobe epilepsy (TLE) by using functional MRI.Methods: Twenty-three TLE patients (16 left, seven right) performed a complex visual scene-encoding task during functional MRI. Region-of-interest (ROI) analyses were used to quantity functional activation in the mesial temporal and frontal lobes. The patients' verbal and visual memory performances were evaluated by standardized neuropsychological tests. Analyses included group comparison and correlations of duration of epilepsy with functional activation and memory performance.Results: Compared with normal controls, TLE patients demonstrated reduced activation bilaterally in the mesial temporal lobe (p = 0.003), and the reduction was more pronounced on the ipsilateral side of the seizure focus. Moreover, a longer duration of illness was associated with fewer voxels activated in both the left (p = 0.038) and right (p = 0.017) mesial temporal lobe. Furthermore, the duration of illness was found to be significantly and negatively correlated with both verbal (p = 0.020) and visual (p = 0.000) memory functioning.Conclusions: TLE seems to affect the memory processes in the mesial temporal lobes progressively (i.e., the longer the duration of illness, the lower the brain activation). In turn, the reduction of brain activation negatively affects memory functioning. Finally, the reduction is not limited to the side of seizure but also is observed in the contralateral hemisphere.

BACKGROUND The coronavirus disease 2019 (COVID-19) pandemic has resulted in face-to-face class suspensions and a boom in the use of telepractice in speech-language pathology. However, little is known about caregivers’ and students’ telepractice satisfaction and service delivery mode preferences. OBJECTIVE This study evaluated perceived telepractice efficacy and preference between onsite practice and telepractice as well as factors affecting service delivery mode preferences among caregivers and students during COVID-19. METHODS A 20-question survey on telepractice satisfaction and preference was administered to 41 Chinese students and 85 caregivers who received telepractice from school-based speech-language pathologists in Hong Kong during the COVID-19 pandemic class suspension period. They were asked to 1) report the implementation of telepractice, 2) rate their perceptions of the efficacy of telepractice on a 5-point Likert scale (1 = strongly disagree to 5 = strongly agree), 3) compare the efficacy of telepractice to onsite practice, and 4) state their preference between telepractice and onsite practice. RESULTS Despite a high rating for telepractice efficacy from caregivers (95% CI 3.30-3.66) and students (95% CI 3.21-3.76), both groups perceived that telepractice was less effective than onsite practice (caregivers: 95% CI 2.14-2.52; students: 95% CI 2.08-2.65). Moreover, the caregivers preferred onsite practice over telepractice (95% CI 2.04-2.43), whereas the students showed no preference for the mode of practice (95% CI 2.74-3.41). A significant association between telepractice efficacy and preference was found only among the students (τ = .43, P < .001), not the caregivers. CONCLUSIONS Although telepractice can be considered an acceptable alternative service delivery option for school-aged speech and language therapy services, a more proactive role of speech-language therapists and caregivers in telepractice is needed to facilitate the engagement of caregivers and effective communication between clinicians and caregivers.

Background Face‐to‐face class suspensions during the coronavirus disease (COVID‐19) pandemic in 2019 increased telepractice in speech and language therapy. However, little is known about speech and language therapists’ (SLTs) perceived effectiveness of telepractice and its antecedents. Aims To examine the use of telepractice and the factors affecting its perceived effectiveness in Hong Kong mainstream schools during COVID‐19. Methods & Procedures Seventy‐two school‐based Hong Kong SLTs completed a 110‐item online survey with six structural components: (1) concerns, (2) adoption, (3) student selection criteria, (4) perceived effectiveness, (5) continuous professional development and (6) attitudes/beliefs. Outcomes & Results Over 90% of respondents adopted telepractice during the pandemic. Confirmatory factor analysis identified reliable constructs from their component measures. These participants reported great telepractice difficulties (especially in therapy preparation and managing students’ attention and/or communication). Mixed‐response analysis revealed that psychosocial factors (i.e., students’ engagement and SLTs’ attitudes towards telepractice) but not professional practice skill factors (i.e., student client selection criteria and SLTs’ years of experience in school settings) contributed to SLTs’ self‐perceived effectiveness of telepractice. Conclusions & Implications Our findings suggest that psychosocial factors play a more important role than professional practice skill factors in the self‐perceived effectiveness of telepractice. WHAT THIS PAPER ADDS What is already known on the subject Previous surveys reported that although SLTs were interested in using telepractice before the COVID‐19 pandemic, they showed concern about its effectiveness, resulting in a low adoption rate. One critical question naturally arises: What factors may affect the perceived effectiveness of telepractice by SLTs? What this paper adds to existing knowledge This study demonstrates for the first time that despite the high adoption rate of telepractice during the COVID‐19 pandemic, school‐based SLTs exhibited great difficulties, and the SLTs’ self‐perceived effectiveness of telepractice was related to psychosocial factors instead of professional practice skill factors. What are the potential or actual clinical implications of this work Professional support is needed to alter the attitudes of SLTs towards telepractice for enhancing their self‐perceived effectiveness and positive clinical practice experience.