Partial resection of presurgical fMRI activation is associated with a postsurgical loss of language function after frontal lobe epilepsy surgery

ABSTRACT

We describe five patients with frontal lobe epilepsy who underwent electrocortical stimulation (ES) for language localization and language functional magnetic resonance imaging (fMRI) prior to epilepsy surgery. Six months after surgery, three patients suffered from a drop of verbal fluency. In all of them, frontal areas with presurgical language fMRI activity were resected. Our results suggest that resection in regions of areas with presurgical fMRI activation is not without risk for a postsurgical loss of function, even when ES results were negative for language function in these areas. Using fMRI activations might be specifically helpful to plan the resection when ES delivered inconclusive results.

KEYWORDS:

• Frontal lobe epilepsy
• epilepsy surgery
• language
• electrocortical stimulation
• fMRI

Acknowledgment

We thank Prof. Dr. C.G. Bien for helpful comments and suggestions during the preparation of this manuscript.

Disclosure statement

No potential conflict of interest was reported by the authors.

Supplementary material

The supplemental data for this article can be accessed here.

Additional information

Funding

Kirsten Labudda holds a Junior-Professorship at the Bielefeld University endowed by the von Bodelschwinghsche Stiftungen Bethel. The funding source has had no influence on the study’s design, data collection, analyses, interpretation, manuscript preparation, and submission.