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Functional imaging

A number of fMRI paradigms have been developed to localise language function in adults
and children and fMRI paradigms have also recently been used to examine memory function
in prospective temporal lobectomy patients. Asymmetric fMRI activations during memory
tasks are concordant with asymmetric memory performances observed during the IAP. These
techniques have begun to supersede the complex and invasive IAP procedure in language
lateralisation and are beginning to be combined with our traditional memory tests to further
enhance the role of neuropsychology in providing lateralising and prognostic information for
presurgical patients with temporal lobe epilepsy.6 See Binder et al6 and Beers et al7 for useful
summaries of this literature.

References

1. WILSON S, BAXENDALE S, BARR W et al. Indications and expectations for neuropsychological
assessment in routine epilepsy care: Report of the ILAE Neuropsychology Task Force, Diagnostic Methods
Commission, 2013-2017. Epilepsia 2015;56(5):674-81.

2. WITT JA, ALPHERTS W, HELMSTAEDTER C. Computerized neuropsychological testing in epilepsy:
overview of available tools. Seizure 2013;22(6):416-23.

3. BAXENDALE S, MCGRATH K, THOMPSON PJ. Epilepsy and IQ: the clinical utility of the Wechsler Adult
Intelligence Scale-Fourth Edition (WAIS-IV) indices in the neuropsychological assessment of people with
epilepsy. J Clin Exp Neuropsychol 2014;36(2):137-43.

4. MATHERN GW, BENINSIG L, NEHLIG A. From the Editors: Epilepsia’s survey on the necessity of the
Wada test and intracranial electrodes for cortical mapping. Epilepsia 2014;55(12):1887-9.

5. PAPANICOLAOU AC, REZAIE R, NARAYANA S et al. Is it time to replace the Wada test and put awake
craniotomy to sleep? Epilepsia 2014;55(5):629-32.

6. BINDER JR. Functional MRI is a valid noninvasive alternative to Wada testing. Epilepsy Behav
2011;20(2):214-22. Review.

7. BEERS CA, FEDERICO P. Functional MRI applications in epilepsy surgery. Can J Neurol Sci
2012;39(3):271-85. Review.

Further reading

BAXENDALE S, THOMPSON P. Beyond localisation: the role of traditional neuropsychological tests in an age if
imaging. Epilepsia 2010;51:2225-30.
BAXENDALE S, HEANEY D, THOMPSON PJ, DUNCAN JS. Cognitive consequences of childhood-onset temporal
lobe epilepsy across the adult lifespan. Neurology 2010;75:705-11.
CENTENO M, THOMPSON PJ, KOEPP MJ, HELMSTAEDTER C, DUNCAN JS. Memory in frontal lobe epilepsy.
Epilepsy Res 2010:91:123-32.
HELMSTAEDTER C, ELGER CE. Chronic temporal lobe epilepsy: a neurodevelopmental or progressively dementing
disease? Brain 2009;132:2822-30.