Prediction of Naming Outcome With fMRI Language Lateralization in Left Temporal Epilepsy Surgery.

BACKGROUND AND OBJECTIVES: Naming decline after left temporal lobe epilepsy (TLE) surgery is common and difficult to predict. Preoperative language fMRI may predict naming decline, but this application is still lacking evidence. We performed a large multicenter cohort study of the effectiveness of fMRI in predicting naming deficits after left TLE surgery. METHODS: At 10 US epilepsy centers, 81 patients with left TLE were prospectively recruited and given the Boston Naming Test (BNT) before and ≈7 months after anterior temporal lobectomy. An fMRI language laterality index (LI) was measured with an auditory semantic decision-tone decision task contrast. Correlations and a multiple regression model were built with a priori chosen predictors. RESULTS: Naming decline occurred in 56% of patients and correlated with fMRI LI (r = -0.41, p < 0.001), age at epilepsy onset (r = -0.30, p = 0.006), age at surgery (r = -0.23, p = 0.039), and years of education (r = 0.24, p = 0.032). Preoperative BNT score and duration of epilepsy were not correlated with naming decline. The regression model explained 31% of the variance, with fMRI contributing 14%, with a 96% sensitivity and 44% specificity for predicting meaningful naming decline. Cross-validation resulted in an average prediction error of 6 points. DISCUSSION: An fMRI-based regression model predicted naming outcome after left TLE surgery in a large, prospective multicenter sample, with fMRI as the strongest predictor. These results provide evidence supporting the use of preoperative language fMRI to predict language outcome in patients undergoing left TLE surgery. CLASSIFICATION OF EVIDENCE: This study provides Class I evidence that fMRI language lateralization can help in predicting naming decline after left TLE surgery.

Cannabinoid Receptor 1 and Fatty Acid Amide Hydrolase Contribute to Operant Sensation Seeking in Mice.

A large body of evidence in humans and preclinical models supports a role for the endocannabinoid system in the proper execution of motivated or goal-directed behaviors. Operant sensation seeking (OSS) is a task that uses varied sensory stimuli as a reinforcer to maintain operant responding in mice. The purpose of the studies in this report was to begin to explore the role of endocannabinoid signaling in OSS utilizing cannabinoid receptor 1 (CB1R) and fatty acid amide hydrolase (FAAH) knock out mice. Compared to wild type littermate controls, CB1R knock out mice exhibited significantly fewer active responses and earned significantly fewer reinforcers in fixed ratio and progressive ratio schedules. On the other hand, FAAH knock out mice exhibited increased active responses and earned more reinforcers than wild type littermates in fixed ratio but not progressive ratio schedules. These findings support the role of endocannabinoid signaling in motivated behaviors and also expand our understanding of the signaling processes involved in OSS.

A quantitative comparison of the efferent projections of the anterior and posterior subdivisions of the medial amygdala in female mice.

In rodents, many aspects of sociosexual behavior are mediated by chemosignals released by opposite-sex conspecifics. These chemosignals are relayed via the main (MOS) and accessory olfactory systems (AOS) to the medial amygdala (Me). The Me is subdivided into anterior (MeA) and posterior (MeP) subnuclei, and lesions targeting these regions have different effects on proceptive courtship behaviors in female mice. Differential behavioral effects of MeA vs. MeP lesions could reflect a difference in the projections of neurons located in these Me subnuclei. To examine this question, we injected female mice with the anterograde tracer, Fluoro-Ruby into either the MeA or MeP and quantified labeled puncta in 11 forebrain target sites implicated in courtship behaviors using confocal fluorescence microscopy. We found that the MeP more densely innervates the medial and intermediate regions of the posterior bed nucleus of the stria terminalis (pBNST) and the posteromedial cortical amygdala (PMCo), while the MeA more densely innervates the horizontal diagonal band of Broca (HDB) and the medial olfactory tubercle (mOT), a region that may be a component of the circuitry responsible for olfactory-mediated motivated behaviors.