Cognitive fMRI in Temporal Lobe Epilepsy
Research type
Research Study
Full title
Longitudinal Cognitive fMRI: Rehabilitation and Surgery in Temporal Lobe Epilepsy
IRAS ID
229811
Contact name
Meneka Sidhu
Contact email
Sponsor organisation
University college London Hospitals
Duration of Study in the UK
2 years, 10 months, 30 days
Research summary
People with temporal lobe epilepsy (TLE) have significant language and memory impairments and epilepsy surgery to remove the diseased temporal lobe may cause further cognitive decline. Despite this recognised risk of epilepsy surgery, a reliable standardised method of predicting cognitive outcome after surgery has not been described.
Cognitive rehabilitation (CR) to improve cognitive functions has been recommended in those with TLE but is still not widely adopted. It is still unknown if CR pre-surgically may be protective against memory decline after epilepsy surgery. In clinical practise, the aim would be to stratify those at risk of memory decline after surgery and to try to minimise this risk. After surgery, it is also important to understand the long term memory effects and factors that may predict more favourable long-term memory outcome, a marker of improved quality of life.
Cognitive networks ‘adapt’ and 'reorganise' as a consequence of both epilepsy and surgery by a process called plasticity and this can be studied using functional MRI. We previously described memory ‘plasticity’ 4 and 12 months after surgery (in patients operated on between 2010 and 2013). Importantly we also described a method of predicting memory outcome after anterior temporal lobe resection. This has important implications for pre-surgical counselling for patients and their families.
In this study we aim to:
1. Validate our memory fMRI prediction method as a clinically applicable tool that can be used across epilepsy surgical centres.
2. Study the effects of CR on language and memory networks before and four months after surgery using novel techniques including multi-variate pattern analysis and connectivity.
3. Asses ‘long-term’ memory networks (seven to ten years) after epilepsy surgery in those who had epilepsy surgery for TLE between 2010 and 2013 in our previous study; providing invaluable knowledge on long-term memory effects after epilepsy surgery.REC name
London - Stanmore Research Ethics Committee
REC reference
18/LO/1447
Date of REC Opinion
5 Nov 2018
REC opinion
Further Information Favourable Opinion