Functional MRI, resting state fMRI, and DTI for predicting verbal fluency outcome following resective surgery for temporal lobe epilepsy.

OBJECTIVE: Predicting cognitive function following resective surgery remains an important clinical goal. Each MRI neuroimaging technique can potentially provide unique and distinct insight into changes that occur in the structural or functional organization of "at-risk" cognitive functions. The authors tested for the singular and combined power of 3 imaging techniques (functional MRI [fMRI], resting state fMRI, diffusion tensor imaging) to predict cognitive outcome following left (dominant) anterior temporal lobectomy for intractable epilepsy. METHODS; The authors calculated the degree of deviation from normal, determined the rate of change in this measure across the pre- and postsurgical imaging sessions, and then compared these measures for their ability to predict verbal fluency changes following surgery. RESULTS: The data show that the 3 neuroimaging techniques, in a combined model, can reliably predict cognitive outcome following anterior temporal lobectomy for medically intractable temporal lobe epilepsy. CONCLUSIONS: These findings suggest that these 3 imaging modalities can be used effectively, in an additive fashion, to predict functional reorganization and cognitive outcome following anterior temporal lobectomy.