Fifteen children ages 7 to 9 years who had persistent reading difficulties despite adequate instruction were provided with intensive tutorial interventions. The interventions targeted deficient phonological processing and decoding skills for 8 weeks (2 hours per day) followed by an 8-week, 1-hour-per-day intervention that focused on the development of reading fluency skills. Spatiotemporal brain activation profiles were obtained at baseline and after each 8-week intervention program using magnetoencephalography during the performance of an oral sight-word reading task. Changes in brain activity were found in the posterior part of the middle temporal gyrus (Brodmann's Area [BA] 21: increased degree of activity and reduced onset latency), the lateral occipitotemporal region (BA 19/37: decreased onset latency of activation), and the premotor cortex (increased onset latency). Overall changes associated with the intervention were primarily normalizing, as indicated by (a) increased activity in a region that is typically involved in lexical--semantic processing (BA 21) and (b) a shift in the relative timing of regional activity in temporal and frontal cortices to a pattern typically seen in unimpaired readers. These findings extend previous results in demonstrating significant changes in the spatiotemporal profile of activation associated with word reading in response to reading remediation.
There is an increased probability of a partial or total displacement of key components of the brain mechanism responsible for receptive language function to the nondominant hemisphere in mesial temporal sclerosis patients. Early onset of seizures is strongly associated with atypical language lateralization. Lesions in the dominant hemisphere tend to result in an intrahemispheric reorganization of linguistic function.
Interhemispheric functional reorganization of language-specific areas may occur in patients undergoing left anterior temporal lobectomy. Intrahemispheric reorganization may take place even when the resection does not directly impinge upon Wernicke's area.
The authors compared the localization accuracy of interictal magnetoencephalography (MEG) with ictal and interictal invasive video electroencephalography (VEEG) in identifying the epileptogenic zone in epilepsy surgery candidates. Forty-one patients, 29 with temporal lobe epilepsy (TLE) and 12 with extratemporal lobe epilepsy (ETLE), participated. Only patients with interictal changes during the MEG recordings were included. A comparison of the accuracy of invasive VEEG and MEG seizure zone identification was based on the degree of overlap between the location of the actual surgical resection and the zone identified by each method, and the success of surgery in reducing seizure activity. No statistical differences were observed between the accuracy of invasive VEEG and MEG in determining the location of the seizure zone across TLE and ETLE cases. Invasive VEEG and MEG localization judgments were correct in 54% and 56% of the cases, respectively. Separate group analyses suggested that MEG may be less beneficial relative to invasive VEEG in ETLE than TLE cases. MEG is of statistically equivalent accuracy to invasive VEEG, despite the fact that its use has not reached optimal conditions. The authors predict the replacement of the more invasive procedure with MEG in the near future for TLE cases, subsequent to the optimization of the conditions under which preoperative MEG is performed.
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