Menstrual cycle corrupts reliable and valid assessment of language dominance: Consequences for presurgical evaluation of patients with epilepsy

Helmstaedter, Christoph; Jockwitz, Christiane

doi:10.1016/j.seizure.2015.02.010

Cited by 10 publications

(5 citation statements)

References 30 publications

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“…Thereby, fetal testosterone expression is thought to promote functional lateralization and morphological brain asymmetry 28,29 . Hemispheric dominance, though, is a local rather than a global phenomenon 17 and not static, but, for example, modulated by the menstrual cycle 30,31 . Possibly, differences in mean age (men: 33.39 ± 10.59 years; women: 39.36 ± 12.79 years) and frequency of temporal lobe seizure origin (TLE: men: n = 11; women: n = 19) have biased our results.…”

Section: Discussionmentioning

confidence: 84%

“…28,29 Hemispheric dominance, though, is a local rather than a global phenomenon 17 and not static, but, for example, modulated by the menstrual cycle. 30,31 patients which provides a very high reliability for localizing eloquent cortex areas. In addition, the used standardized handedness questionnaires are sufficiently reliable and valid and offer an adequate probability to estimate hemispheric dominance.…”

Section: Discussionmentioning

confidence: 99%

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Hemispheric differences in the duration of focal onset seizures

Seethaler

Lauseker

Ernst³

et al. 2020

Acta Neurol Scand

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Objective To assess hemispheric differences in the duration of focal onset seizures and its association with clinical and demographic factors. Methods A retrospective analysis was performed on adult patients with drug‐resistant unifocal epilepsy, who underwent intracranial EEG recording between 01/2006 and 06/2016. Seizure duration was determined based on the subdural and/or stereo‐EEG (sEEG) recordings. Hemispheric differences in seizure duration were statistically evaluated with regard to clinical and demographic data. Results In total, 69 patients and 654 focal onset seizures were included. The duration of seizures with left‐hemispheric onset (n = 297) was by trend longer (91.88 ± 93.92 s) than of right‐hemispheric seizures (n = 357; 71.03 ± 68.53 s; p = .193). Significant hemispheric differences in seizures duration were found in temporal lobe seizures (n = 225; p = .013), especially those with automotor manifestation (n = 156; p = .045). A prolonged duration was also found for left‐hemispheric onset seizures with secondary generalized commencing during waking state (n = 225; p = .034), but not during sleep. A similar hemispheric difference in seizure duration was found in female patients (p = .040), but not in men. Conclusions Hemispheric differences in seizure duration were revealed with significantly longer durations in case of left‐hemispheric seizure onset. The observed differences in seizure duration might result from brain asymmetry and add new aspects to the understanding of seizure propagation and termination.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 99%

Hemispheric differences in the duration of focal onset seizures

Seethaler

Lauseker

Ernst³

et al. 2020

Acta Neurol Scand

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“…fMRI, fTCD) are in addition influenced by dynamic factors which can interfere with dominance patterns. Variation of language dominance along the menstrual cycle would be one example [94,95]. At present non-invasive functional mapping seems good for raising hypotheses but surgical decisions, if eloquent cortex could be affected, should finally depend on stimulation results via implanted electrodes or during wake surgery in order to delineate the exact resection borders [96,97].…”

Section: Language Dominancementioning

confidence: 99%

Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments

Helmstaedter

Sadat-Hossieny

Kanner

et al. 2020

Seizure

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“…These changes are thought to reflect a decline in gray matter volume in the normal ageing brain, which requires recruitment of additional cortical regions to maintain normal performance [12, 13]. Impact of sex on language dominance assessment has also been proposed, including the possibly greater propensity for bilateral language representation in females [14–17]. In order to accurately interpret fMRI findings within a clinical context, it is important to understand the potential influence of these factors on fMRI paradigms.…”

Section: Introductionmentioning

confidence: 99%

Visual and Auditory fMRI Paradigms for Presurgical Language Mapping: Convergent Validity and Relationship to Individual Variables

Omisade

O'Grady

Schmidt

et al. 2019

Neurology Research International

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Functional MRI (fMRI) has emerged as a safe alternative to invasive procedures for determining hemispheric language dominance prior to neurosurgery. Despite this, there are currently no standardized fMRI protocols that have been explored in healthy controls to determine the influence of individual patient variables on the results, which poses challenges in clinical interpretation of ambiguous findings in patient populations. In addition, most fMRI protocols are not suitable for individuals with visual or intellectual disabilities (IQ<70). In the current study, 61 healthy adults (ages: 18-74 years) completed two fMRI paradigms for language mapping. One paradigm used visually based stimuli and has shown good face validity to date in our center. The second paradigm used auditory stimuli presented at slowed speed and was designed for individuals with visual or cognitive dysfunction but has not yet been used clinically. The paradigms demonstrated 97% agreement in classifying individuals as left-hemisphere, right-hemisphere, and bilaterally dominant. Cases that were classified differently showed bilateral dominance in response to either paradigm. Dominance classification rates for right- and left-handed individuals were largely in keeping with published data. Within the left-handed group, IQ and education were positively correlated with laterality indices generated by both paradigms (r values range: 0.44-0.95, p<0.01), suggesting that individuals with higher IQ and formal education were more likely to be classified as left-hemisphere dominant in the current sample. This study will help improve clinical interpretation of language fMRI maps by identifying factors that might impact results (like IQ). It also offers an alternative paradigm to make this procedure more accessible to a broader range of patients. Future studies will replicate results with a sample of patients with epilepsy across a broad range of intellectual abilities.

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Menstrual cycle corrupts reliable and valid assessment of language dominance: Consequences for presurgical evaluation of patients with epilepsy

Cited by 10 publications

References 30 publications

Hemispheric differences in the duration of focal onset seizures

Hemispheric differences in the duration of focal onset seizures

Cognitive disorders in epilepsy II: Clinical targets, indications and selection of test instruments

Visual and Auditory fMRI Paradigms for Presurgical Language Mapping: Convergent Validity and Relationship to Individual Variables

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