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To use pre-treatment magnetic resonance imaging-based radiomics data with clinical data to predict radiation-induced temporal lobe injury (RTLI) in nasopharyngeal carcinoma (NPC) patients with stage T4/N0–3/M0 within 5 years after radiotherapy. This study retrospectively examined 98 patients (198 temporal lobes) with stage T4/N0–3/M0 NPC. Participants were enrolled into a training cohort or a validation cohort in a ratio of 7:3. Radiomics features were extracted from pre-treatment magnetic resonance imaging that were T1-and T2-weighted. Spearman rank correlation, the t -test and the least absolute shrinkage and selection operator (LASSO) algorithm were used to select significant radiomics features; machine-learning models were used to generate radiomics signatures (Rad-Scores). Rad-Scores and clinical factors were integrated into a nomogram for prediction of RTLI. Nomogram discrimination was evaluated using receiver operating characteristic analysis and clinical benefits were evaluated using decision curve analysis. Participants were enrolled into a training cohort (n = 139) or a validation cohort (n = 59). In total, 3568 radiomics features were initially extracted from T1-and T2-weighted images. Age, D max , D 1cc and 16 stable radiomics features (six from T1-weighted and 10 from T2-weighted images) were identified as independent predictive factors. A greater Rad-Score was associated with a greater risk of RTLI. The nomogram showed good discrimination, with a C-index of 0.85 (95% confidence interval 0.79–0.92) in the training cohort and 0.82 (95% confidence interval 0.71–0.92) in the validation cohort. We developed models for the prediction of RTLI in patients with stage T4/N0–3/M0 NPC using pre-treatment radiomics data and clinical data. Nomograms from these pre-treatment data improved the prediction of RTLI. These results may allow the selection of patients for earlier clinical interventions. • Interdisciplinary study that used pre-treatment MRI-based radiomics data for RTLI prediction in NPC patients. • Only included patients with stage T4/N0-3/M0 NPC, making the study more targeted. • Provide reliable risk stratification of RTLI by using non-invasive radiomics and clinical data. • Radiomics information was extracted from the routine MRI examinations without increasing healthcare costs. [ABSTRACT FROM AUTHOR]

We report the case of a 55-year-old woman presenting with progressive memory impairment secondary to a transsphenoidal encephalocele involving her dominant medial temporal lobe. Her clinical deterioration was accompanied by radiological progression in the encephalocele's size and associated encephalomalacia. Through a temporal craniotomy, her encephalocele was resected and the defect closed. Baseline neuropsychological assessment indicated global cognitive impairment, but post-operatively, she reported improved memory and concentration. Standardized assessment reflected an improvement in perceptual skills and an associated improved recall of a complex figure. This is the first case report to date of a patient's memory improving following treatment of a basal encephalocele. [ABSTRACT FROM AUTHOR]

Morphemes are the smallest meaning-carrying units in human language, and are among the most basic building blocks through which humans express specific ideas and concepts. By using time-resolved cortical stimulations, neural recordings, and focal lesion evaluations, we show that inhibition of a small cortical area within the left dominant posterior-superior temporal lobe selectively impairs the ability to produce appropriate functional morphemes but does not distinctly affect semantic and lexical retrieval, comprehension, or articulation. Additionally, neural recordings within this area reveal the localized encoding of morphological properties and their planned production prior to speech onset. Finally, small lesions localized to the gray matter in this area result in a selective functional morpheme-production deficit. Collectively, these findings reveal a detailed division of linguistic labor within the posterior-superior temporal lobe and suggest that functional morpheme processing constitutes an operationally discrete step in the series of computations essential to language production. [ABSTRACT FROM AUTHOR]

According to the competition account of lexical selection in word production, conceptually driven word retrieval involves the activation of a set of candidate words in left temporal cortex and competitive selection of the intended word from this set, regulated by frontal cortical mechanisms. However, the relative contribution of these brain regions to competitive lexical selection is uncertain. In the present study, five patients with left prefrontal cortex lesions (overlapping in ventral and dorsal lateral cortex), eight patients with left lateral temporal cortex lesions (overlapping in middle temporal gyrus), and 13 matched controls performed a picture-word interference task. Distractor words were semantically related or unrelated to the picture, or the name of the picture (congruent condition). Semantic interference (related vs. unrelated), tapping into competitive lexical selection, was examined. An overall semantic interference effect was observed for the control and left-temporal groups separately. The left-frontal patients did not show a reliable semantic interference effect as a group. The left-temporal patients had increased semantic interference in the error rates relative to controls. Error distribution analyses indicated that these patients had more hesitant responses for the related than for the unrelated condition. We propose that left middle temporal lesions affect the lexical activation component, making lexical selection more susceptible to errors. [ABSTRACT FROM AUTHOR]

Abstract: To determine predictive factors for temporal lobe injury (TLI) in nasopharyngeal carcinoma patient (NPC) treated with intensity‐modulated radiation therapy (IMRT). A total of 695 NPC cases treated with IMRT were retrospectively analyzed. TLI was diagnosed on MRI images. Volume‐dose histograms for 870 evaluable temporal lobes were analyzed, and the predictive factors for the occurrence of TLI was evaluated. Receiver operating characteristic curve (ROC) and Logistic regression analysis was used to determine volume‐dose parameters that predict temporal lobe injury (TLI). Univariate and multivariate analysis were used to analyze the predictive factors for TLI. The radiation dose‐tolerance model of temporal lobe was calculated by logistic dose‐response model. The median follow‐up time was 73 months. A total of 8.5% patients were diagnosed with TLI. Among all the volume‐dose parameters, logistic regression model showed D2cc (the dose Gray delivered to 2 cubic centimeter volume) was an only independent predictive factor. Multivariate analysis showed D2cc of temporal lobe, fraction size of prescription, T stage, and chemotherapy were the independent predictive factors for TLI. Logistic dose‐response model has indicated the TD5/5 and TD50/5 of D2cc are 60.3 Gy and 76.9 Gy, respectively. D2cc of temporal lobe, fraction size of prescription, T stage, and chemotherapy were the possible independent predictive factors for TLI after IMRT of NPC. Biologic effective doses (TD5/5 and TD50/5) of D2cc are considered to prevent TLI. [ABSTRACT FROM AUTHOR]

Neuroscientific evidence indicates that human social functioning is supported by a distributed network of frontal and temporal brain regions that undergoes significant development during childhood and adolescence. Clinical studies of individuals with early brain insults (EBI) to frontotemporal regions suggest that such lesions may interfere with the maturation of sociocognitive skills and lead to increased sociobehavioural problems. However, little attention has focussed on the direct assessment of sociocognitive skills, such as moral reasoning, following focal EBI. In the present study, the performance of 15 patients with focal EBI (8–16 years) was compared to that of 15 demographically matched controls on basic neuropsychological measures (IQ and executive functions), sociocognitive tasks (moral reasoning, moral decision-making and empathy) and parent reports of sociobehavioural problems and social adaptive skills. Patients with focal EBI had significantly lower levels of moral reasoning maturity, moral decision-making, and empathy than their matched controls, but did not differ on more general measures of cognition. Their parents also reported increased sociobehavioural problems. These findings suggest that focal EBI to frontotemporal regions can result in reduced sociocognitive capacities, more specifically moral reasoning, and increased vulnerability to sociobehavioural problems. [ABSTRACT FROM PUBLISHER]

Background: Although temporal lobe pathology may explain some of the symptoms of multiple sclerosis (MS), its role in the pathogenesis of seizures has not been clarified yet. Objectives: To investigate the role of temporal lobe damage in MS patients suffering from epilepsy, by the application of advanced multimodal 3T magnetic resonance imaging (MRI) analysis. Methods: A total of 23 relapsing remitting MS patients who had epileptic seizures (RRMS/E) and 23 disease duration matched RRMS patients without any history of seizures were enrolled. Each patient underwent advanced 3T MRI protocol specifically conceived to evaluate grey matter (GM) damage. This includes grey matter lesions (GMLs) identification, evaluation of regional cortical thickness and indices derived from the Neurite Orientation Dispersion and Density Imaging model. Results: Regional analysis revealed that in RRMS/E, the regions most affected by GMLs were the hippocampus (14.2%), the lateral temporal lobe (13.5%), the cingulate (10.0%) and the insula (8.4%). Cortical thinning and alteration of diffusion metrics were observed in several regions of temporal lobe, in insular cortex and in cingulate gyrus of RRMS/E compared to RRMS (p< 0.05 for all comparisons). Conclusions: Compared to RRMS, RRMS/E showed more severe damage of temporal lobe, which exceeds what would be expected on the basis of the global GM damage observed. [ABSTRACT FROM AUTHOR]

In two experiments, patients with damage to the medial temporal lobe (MTL) and healthy controls produced detailed autobiographical narratives as they remembered past events (recent and remote) and imagined future events (near and distant). All recent events occurred after the onset of memory impairment. The first experiment aimed to replicate the methods of Race et al. [Race E, KeaneMM, Verfaellie M (2011) J Neurosci 31(28):10262-10269]. Transcripts from that study were kindly made available for independent analysis, which largely reproduced the findings from that study. Our patients produced marginally fewer episodic details than controls. Patients from the earlier study were more impaired than our patients. Patients in both groups had difficulty in returning to their narratives after going on tangents, suggesting that anterograde memory impairment may have interfered with narrative construction. In experiment 2, the experimenter used supportive questioning to help keep participants on task and reduce the burden on anterograde memory. This procedure increased the number of details produced by all participants and rescued the performance of our patients for the distant past. Neither of the two patient groups had any special difficulty in producing spatial details. The findings suggest that constructing narratives about the remote past and the future does not depend on MTL structures, except to the extent that anterograde amnesia affects performance. The results further suggest that different findings about the status of autobiographical memory likely depend on differences in the location and extent of brain damage in different patient groups. [ABSTRACT FROM AUTHOR]

The hippocampus is important for autobiographical memory, but its role is unclear. In the study, patients with hippocampal damage and controls were taken on a 25-min walk on the University of California, San Diego, campus during which 11 planned events occurred. Memory was tested directly after the walk. In addition, a second group of controls took the same walk and were tested after 1 mo. Patients with hippocampal damage remembered fewer details than controls tested directly after the walk but remembered a similar number of details as controls tested after 1 mo. Notably, the details that were reported by patients had the characteristics of episodic recollection and included references to particular places and events. Patients exhibited no special difficulty remembering spatial details in comparison with nonspatial details. Last, whereas both control groups tended to recall the events of the walk in chronological order, the order in which patients recalled the events was unrelated to the order in which they occurred. The findings illuminate the role of the hippocampus in autobiographical memory and in the spatial and nonspatial aspects of episodic recollection. [ABSTRACT FROM AUTHOR]

Objective To determine the main factors influencing metabolic changes in mesial temporal lobe epilepsy ( MTLE) due to hippocampal sclerosis ( HS). Methods We prospectively studied 114 patients with MTLE (62 female; 60 left HS; 15- to 56-year-olds) with 18F-fluorodeoxyglucose-positron emission tomography and correlated the results with the side of HS, structural atrophy, electroclinical features, gender, age at onset, epilepsy duration, and seizure frequency. Imaging processing was performed using statistical parametric mapping. Results Ipsilateral hypometabolism involved temporal (mesial structures, pole, and lateral cortex) and extratemporal areas including the insula, frontal lobe, perisylvian regions, and thalamus, more extensively in right HS ( RHS). A relative increase of metabolism (hypermetabolism) was found in the nonepileptic temporal lobe and in posterior areas bilaterally. Voxel-based morphometry detected unilateral hippocampus atrophy and gray matter concentration decrease in both frontal lobes, more extensively in left HS ( LHS). Regardless of the structural alterations, the topography of hypometabolism correlated strongly with the extent of epileptic networks (mesial, anterior-mesiolateral, widespread mesiolateral, and bitemporal according to the ictal spread), which were larger in RHS. Notably, widespread perisylvian and bitemporal hypometabolism was found only in RHS. Mirror hypermetabolism was grossly proportional to the hypometabolic areas, coinciding partly with the default mode network. Gender-related effect was significant mainly in the contralateral frontal lobe, in which metabolism was higher in female patients. Epilepsy duration correlated with the contralateral temporal metabolism, positively in LHS and negatively in RHS. Opposite results were found with age at onset. High seizure frequency correlated negatively with the contralateral metabolism in LHS. Significance Epileptic networks, as assessed by electroclinical correlations, appear to be the main determinant of hypometabolism in MTLE. Compensatory mechanisms reflected by a relative hypermetabolism in the nonepileptic temporal lobe and in extratemporal areas seem more efficient in LHS and in female patients, whereas long duration, late onset of epilepsy, and high seizure frequency may reduce these adaptive changes. [ABSTRACT FROM AUTHOR]

Recent research dealing with the structures of the medial temporal lobe (MTL) has shifted away from exclusively investigating memory-related processes and has repeatedly incorporated the investigation of complex visual perception. Several studies have demonstrated that higher level visual tasks can recruit structures like the hippocampus and perirhinal cortex in order to successfully perform complex visual discriminations, leading to a perceptual-mnemonic or representational view of the medial temporal lobe. The current study employed a complex visual discrimination paradigm in two patients suffering from brain lesions with differing locations and origin. Both patients, one with extensive medial temporal lobe lesions (VG) and one with a small lesion of the anterior fornix (HJK), were impaired in complex discriminations while showing otherwise mostly intact cognitive functions. The current data confirmed previous results while also extending the perceptual-mnemonic theory of the MTL to the main output structure of the hippocampus, the fornix. [ABSTRACT FROM AUTHOR]

Bilateral anterior opercular syndrome and partial Kluver-Bucy syndrome are associated with bilateral middle cerebral artery lesions. The combination of these two syndromes has only been reported in a child with limbic encephalitis. In this case, a 44-year-old woman with bilateral middle cerebral artery infarction, which occurred 2 years prior, could walk independently. However, she showed automatic-voluntary dissociation and anarthria with preserved writing skills. She also presented hypersexuality, hypermetamorphosis, and memory disturbances. Here, we report a case of an adult stroke patient who suffered from bilateral anterior opercular syndrome accompanied by partial Kluver-Bucy syndrome. [ABSTRACT FROM AUTHOR]

Several anatomo-clinical investigations have shown that familiar face recognition disorders not due to high level perceptual defects are often observed in patients with lesions of the right anterior temporal lobe (ATL). The meaning of these findings is, however, controversial, because some authors claim that these patients show pure instances of modality-specific 'associative prosopagnosia', whereas other authors maintain that in these patients voice recognition is also impaired and that these patients have a 'multimodal person recognition disorder'. To solve the problem of the nature of famous faces recognition disorders in patients affected by right ATL lesions, it is therefore very important to verify with formal tests if these patients are or are not able to recognize others by voice, but a direct comparison between the two modalities is hindered by the fact that voice recognition is more difficult than face recognition. To circumvent this difficulty, we constructed a test battery in which subjects were requested to recognize the same persons (well-known at the national level) through their faces and voices, evaluating familiarity and identification processes. The present paper describes the 'Famous People Recognition Battery' and reports the normative data necessary to clarify the nature of person recognition disorders observed in patients affected by right ATL lesions. [ABSTRACT FROM AUTHOR]

We report a patient with ventral simultanagnosia, prosopagnosia for “unfamiliar faces” (dorsal prosopagnosia), spatial agraphia, and constructional disorder, particularly on the left spatial side, due to a lesion in the right posterior superior and middle temporal gyri and angular gyrus. The patient showed impairment of fundamental visual and visuospatial recognition, such as in object size, configuration, and horizontal point location, which probably underlay the mechanism of simultanagnosia and prosopagnosia. This case also suggests that the coexistence of simultanagnosia and prosopagnosia results from a right hemispheric insult, and damage to the temporoparietal area interrupts the incorporation of spatial information into object recognition. This disconnection of information flow, together with impaired object recognition per se, may impair the parallel processing of multiple objects, leading to object-by-object or part-by-part recognition. [ABSTRACT FROM PUBLISHER]

People often use spontaneous gestures when communicating spatial information. We investigated focal brain-injured individuals to test the hypotheses that (1) naming motion event components of manner-path (represented by verbs-prepositions in English) are impaired selectively, (2) gestures compensate for impaired naming. Patients with left or right hemisphere damage (LHD or RHD) and elderly control participants were asked to describe motion events (e.g., running across) depicted in brief videos. Damage to the left posterior middle frontal gyrus, left inferior frontal gyrus, and left anterior superior temporal gyrus (aSTG) produced impairments in naming paths of motion; lesions to the left caudate and adjacent white matter produced impairments in naming manners of motion. While the frequency of spontaneous gestures were low, lesions to the left aSTG significantly correlated with greater production of path gestures. These suggest that producing prepositions-verbs can be separately impaired and gesture production compensates for naming impairments when damage involves left aSTG. [ABSTRACT FROM AUTHOR]

A 12-year-old adolescent presented with refractory seizures and was found to have a mesial temporal lobe lesion. The patient underwent biopsy and was diagnosed with an arteriovenous malformation. Supratentorial lesions in the pediatric population can have a large variety of underlying etiologies, which can be challenging to differentiate on neuroimaging. In this report, we discuss the key features on MRI of several neoplastic, vascular, and infectious processes that can aide in the diagnosis. [ABSTRACT FROM AUTHOR]

Recent research suggests that the medial temporal lobe (MTL) is involved in perception as well as in declarative memory. Amnesic patients with focal MTL lesions and semantic dementia patients showed perceptual deficits when discriminating faces and objects. Interestingly, these two patient groups showed different profiles of impairment for familiar and unfamiliar stimuli. For MTL amnesics, the use of familiar relative to unfamiliar stimuli improved discrimination performance. By contrast, patients with semantic dementia—a neurodegenerative condition associated with anterolateral temporal lobe damage—showed no such facilitation from familiar stimuli. Given that the two patient groups had highly overlapping patterns of damage to the perirhinal cortex, hippocampus, and temporal pole, the neuroanatomical substrates underlying their performance discrepancy were unclear. Here, we addressed this question with a multivariate reanalysis of the data presented by Barense et al. (2011), using functional connectivity to examine how stimulus familiarity affected the broader networks with which the perirhinal cortex, hippocampus, and temporal poles interact. In this study, healthy participants were scanned while they performed an odd-one-out perceptual task involving familiar and novel faces or objects. Seed-based analyses revealed that functional connectivity of the right perirhinal cortex and right anterior hippocampus was modulated by the degree of stimulus familiarity. For familiar relative to unfamiliar faces and objects, both right perirhinal cortex and right anterior hippocampus showed enhanced functional correlations with anterior/lateral temporal cortex, temporal pole, and medial/lateral parietal cortex. These findings suggest that in order to benefit from stimulus familiarity, it is necessary to engage not only the perirhinal cortex and hippocampus, but also a network of regions known to represent semantic information. [ABSTRACT FROM AUTHOR]

Abstract: Mitochondria actively participate in neurotransmission by providing energy (ATP) and maintaining normative concentrations of reactive oxygen species (ROS) in both presynaptic and postsynaptic elements. In human and animal epilepsies, ATP-producing respiratory rates driven by mitochondrial respiratory complex (MRC) I are reduced, antioxidant systems are attenuated and oxidative damage is increased. We report that MRCI-driven respiration and functional uncoupling (an inducible antioxidant mechanism) are reduced and levels of H2O2 are elevated in mitochondria isolated from KO mice. Experimental impairment of MRCI in WT hippocampal slices via rotenone reduces paired-pulse ratios (PPRs) at mossy fiber-CA3 synapses (resembling KO PPRs), and exacerbates seizure-like events in vitro. Daily treatment with AATP [a combination therapy composed of ascorbic acid (AA), alpha-tocopherol (T), sodium pyruvate (P) designed to synergistically target mitochondrial impairments] improved mitochondrial functions, mossy fiber PPRs, and reduced seizure burden index (SBI) scores and seizure incidence in KO mice. AATP pretreatment reduced severity of KA-induced seizures resulting in 100% protection from the severe tonic–clonic seizures in WT mice. These data suggest that restoration of bioenergetic homeostasis in the brain may represent a viable anti-seizure target for temporal lobe epilepsy. [Copyright &y& Elsevier]

Objectives: To assess the feasibility and reliability of systematic evaluations of analgesia, sedation level, and delirium features in the neurologically critically ill and to determine whether delirium features are linked to clinical outcomes in this population. Design: Multicentered prospective observational study. Setting: Neurological, Neurosurgical, Neurosciences or Surgical Trauma ICUs from three hospitals (two in Canada and one in the United States). Patients: A convenience sample of adult NICU or neurologic, neurosurgical, neurosciences, or surgical trauma ICU patients admitted for greater than 12 hours from November 2011 to April 2012. Interventions: Systematic assessments were simultaneously and independently performed by a neurologist, intensivists, or trauma surgeon, and a nurse in three multispecialty ICUs. Pain was evaluated with the numeric rating scale or behavioral pain scale. Sedation was assessed using the Richmond AgitationSedation Scale. Patients with Richmond Agitation-Sedation Scale greater than or equal to -4 were screened for features of delirium with the Intensive Care Delirium Screening Checklist. Intraclass correlation coefficient was used to evaluate inter-rater reliability between the nurse and the physician for pain and sedation scales, and the kappa coefficient was calculated for concordance of the Intensive Care Delirium Screening Checklist items. Measurements and Main Results: 151 patients had 439 assessments. Pain and sedation were always assessable with excellent inter-rater reliability' (numeric rating scale intraclass correlation coefficient, 0.92; behavior pain scale intraclass correlation coefficient, 0.83; and Richmond Agitation-Sedation Scale intraclass correlation coefficient, 0.92). Patients were sufficiently alert for delirium screening 3/4 of the time; Intensive Care Delirium Screening Checklist items had good concordance (kappa coefficients between 0.58 and 0.91 for the eight Intensive Care Delirium Screening Checklist items). Nonevaluable items were most often orientation, hallucinations, and speech or mood content. Furthermore, each additional Intensive Care Delirium Screening Checklist item present in proportion to the total evaluable Intensive Care Delirium Screening Checklist score was associated with a 10% increase in ICU length of stay. cenc1u~ons: Pain and sedation can be systematically assessed in the neurologically critically ill; the majority can also be screened for delirium features with excellent inter-rater reliability. Increased proportion of Intensive Care Delirium Screening Checklist items is associated with worse outcomes. [ABSTRACT FROM AUTHOR]

Abstract: Studies of people with memory impairments have shown that a specific set of brain structures in the medial temporal lobe (MTL) is vital for memory function. However, whether these structures have a role outside of memory remains contentious. Recent studies of amnesic patients with damage to two structures within the MTL, the hippocampus and the perirhinal cortex, indicated that these patients also performed poorly on perceptual tasks. More specifically, they performed worse than controls when discriminating between objects, faces and scenes with overlapping features. In order to investigate whether these perceptual deficits are reflected in their viewing strategies, we tested a group of amnesic patients with MTL damage that included the hippocampus and perirhinal cortex on a series of oddity discrimination tasks in which they had to select an odd item from a visual array. Participants'' eye movements were monitored throughout the experiment. Results revealed that patients were impaired on tasks that required them to discriminate between items that shared many features, and tasks that required processing items from different viewpoints. An analysis of their eye movements revealed that they exhibited a similar viewing pattern as controls: they fixated more on the target item on trials answered correctly, but not on trials answered incorrectly. In addition, their impaired performance was not explained by an abnormal viewing-strategy that assessed their use of working memory. These results suggest that the perceptual deficits in the MTL patients are not a consequence of abnormal viewing patterns of the objects and scenes, but instead, could involve an inability to bind information gathered from several fixations into a cohesive percept. These data also support the view that MTL structures are important not only for long-term memory, but are also involved in perceptual tasks. [Copyright &y& Elsevier]

Abstract: Background and purpose: To evaluate the temporal lobe injury (TLI) in nasopharyngeal carcinoma (NPC) patients who had received intensity modulated radiotherapy (IMRT) and to assess the dosimetric parameters associated with TLI. Materials and methods: Forty of 870 patients were diagnosed with TLI after IMRT, the clinical and dosimetric characteristics of these TLI were analyzed. Results: A total of 4.6% (40/870) patients have developed TLI. However, TLI is not observed in T1–2 patients, the incidences are 3.1% and 13.4% in T3 and T4 patients respectively. The Dmax (maximum point dose, Gy) and D1cc (the dose delivered to the 1 cubic centimeter volume, Gy) in injured temporal lobes (TLs) are greater than that in normal TLs (P <0.01). TLI is not observed in TLs with Dmax<64Gy or D1cc<52Gy, and the 5-year incidence of TLI in patients with Dmax 64–68Gy or D1cc 52–58Gy is <5.0%. A linear regression demonstrates a 2.6% augment of TLI per Gy of Dmax exceeding 64Gy and a 2.5% augment of TLI per Gy of D1cc exceeding 52Gy; TLI is correlated with Dmax (r =0.89, P <0.01) and D1cc (r =0.87, P <0.01) respectively. Conclusions: The incidence of TLI is relatively high, especially for patients with advanced T-stage NPC, and correlated with Dmax and D1cc. IMRT with Dmax<68Gy or D1cc<58Gy in TLs is relatively safe. [Copyright &y& Elsevier]

Patients with medial temporal lobe (MTL) damage are sometimes impaired at remembering visual information across delays as short as a few seconds. Such impairments could reflect either impaired visual working memory capacity or impaired long-term memory (because attention has been diverted or because working memory capacity has been exceeded). Using a standard change-detection task, we asked whether visual working memory capacity is intact or impaired afterMTLdamage. Five patients with hippocampal lesions and one patient with large MTL lesions saw an array of 1, 2, 3, 4, or 6 colored squares, followed after 3, 4, or 8 s by a second array where one of the colored squares was cued. The task was to decide whether the cued square had the same color as the corresponding square in the first array or a different color. At the 1 s delay typically used to assess working memory capacity, patients performed as well as controls at all array sizes. At the longer delays, patients performed as well as controls at small array sizes, thought to be within the capacity limit, and worse than controls at large array sizes, thought to exceed the capacity limit. The findings suggest that visual working memory capacity in humans is intact after damage to the MTL structures and that damage to these structures impairs performance only when visual working memory is insufficient to support performance. [ABSTRACT FROM AUTHOR]

Medial temporal lobe (MTL) contributions to the brief maintenance of visual representations were evaluated by studying a group of patients with MTL damage. Eye movements of patients and healthy comparison subjects were tracked while performing a visual search for a target among complex stimuli of varying similarity to that target. Despite the task having no imposed delays, patients were impaired behaviorally, and eye movement measures showed abnormally rapid degradation of target representations in the patients. Eye movement data showed a modulation of the duration of fixations as a function of the similarity of fixated array lures to the target, but the effect was attenuated in patients during long fixation paths away from the sample target. This effect manifested despite patients' shorter searches and more frequent fixations of the sample target. Novel techniques provided unique insight into visual representation without healthy MTL, which may support maintenance of information through hippocampal-dependent relational binding. [ABSTRACT FROM AUTHOR]

Working memory has traditionally been viewed as independent of the hippocampus and related medial temporal lobe structures. Yet memory-impaired patients with medial temporal lobe damage are sometimes impaired at remembering relational information (e.g., an object and its location) across delays as short as a few seconds. This observation has raised the possibility that medial temporal lobe structures are sometimes critical for maintaining relational information, regardless of whether the task depends on working or long-term memory. An alternative possibility is that these structures are critical formaintainingrelationalinformationonlywhenthe taskexceedsworkingmemorycapacity anddependsinsteadonlong termmemory.Totesttheseideas,we drew on a method used previously in a classic study of digitspanin patientHM that distinguished immediate memory from long-term memory. In two experiments, we assessed the ability of four patients with medial temporal lobe lesions to maintain varying numbers of object–location associations across a 1 s retention interval. In both experiments, the patients exhibited a similar pattern of performance. They performed similarly to controls when only a small number of object–location associations needed to be maintained, and they exhibited an abrupt discontinuity in performance with larger set sizes. This pattern of results supports the idea that maintenance of relational information in workingmemoryis intact after damage to the hippocampus and related medial temporal lobe structures and that damage to these structures impairs performance only when the task depends on long-term memory. [ABSTRACT FROM AUTHOR]

To examine the developmental trajectory of object recognition memory and its neural substrate, 10--12-d-old monkeys (Macaca mulatta) received sham operations or neurotoxic hippocampallesions and were tested at the ages of 1.5, 6, and 18 month son the visual paired-comparison task using delays of 10, 30, 60, and 120 s. In sham-operated controls, incidental recognition memory was present at 1.5 months, became more robust at 6 months, and was delay-dependent by 18 months of age, suggesting that the brain structures mediating these early developing recognition abilities may undergo significant modifications after 6 months of age in monkeys. A similar developmental progression was also observed in animals with neonatal hippocampal lesions, although the delay-dependent effect at 18 months was significantly more pronounced after the neonatal hippocampal lesions, suggesting that with maturation animals with neonatal hippocampal lesions grow into a recognition-memory deficit. These findings suggest not only that the medial temporal cortical areas, known to mediate incidental recognition memory processes in adulthood, could support these processes in early infancy even when long delays are used, but also that later in development, after reaching functional maturity, the hippocampus begins to interact with the medial temporal cortical areas to mediate this function. [ABSTRACT FROM AUTHOR]

Accumulating evidence indicates action naming may rely more on frontal-subcortical circuits, and noun naming may rely more on temporal cortex. Therefore, noun versus action fluency might distinguish frontal and subcortical dementias from cortical dementias primarily affecting temporal and/or parietal cortex such as Alzheimer's disease (AD). We hypothesized patients with subcortical dementia, e.g., normal pressure hydrocephalus (NPH) and patients with dementias predominantly affecting frontal cortex, e.g., behavioral variant frontotemporal dementia (bv-FTD) and progressive nonfluent aphasia (PNFA) have more difficulty on action fluency versus noun fluency (e.g., animal naming). Patients with AD, who have temporo parietal cortical dysfunction, should have more difficulty on noun versus verb fluency. A total of 234 participants, including healthy controls (n = 20) and patients diagnosed with NPH (n =144), AD (n = 33), bv-FTD (n = 22) or PNFA (n =15) were administered animal fluency, action fluency, and letter fluency tasks, and the Mini-Mental State Examination (MMSE, to control for dementia severity). NPH and bv-FTD/PNFA patients had significantly higher MMSE scores and animal fluency than AD patients (after adjusting for age), but their action fluency tended to be lower than in AD. Only NPH and bvFTD/PNFA patients showed significantly lower action verb than animal fluency. Results provide novel evidence that action naming relies more on frontal-subcortical circuits while noun naming relies more on temporoparietal cortex, indicating action verb fluency may be more sensitive than noun fluency, particularly for detecting frontal-subcortical dysfunction. [ABSTRACT FROM AUTHOR]

Previous studies of auditory hallucinations in schizophrenia found that the hallucinations were reduced by the application of transcranial magnetic stimulation (rTMS). Here we describe a case of traumatic brain injury associated with continuous music hallucinations. An MRI scan showed a structural lesion of the right temporal pole and a PET scan indicated a hyperactive area of the posterior right temporal lobe. We hypothesized that rTMS applied to the right temporal area would reduce this activity and the corresponding hallucinations. The patient's music hallucinations were significantly reduced by rTMS treatment. A PET scan following treatment also indicated that rTMS treatment reduced brain activity in the right temporal lobe. This case provides initial evidence that rTMS may be a successful treatment of syndromes associated with hyperactive brain areas. [ABSTRACT FROM AUTHOR]

Traumatic brain injury through vibration waves impact force can no visible external injuries caused by a variety of binocular vision disorders. The study was conducted on a sample of 65 patients in group 20 to 40 years with traumatic brain injury, and the main difficulty is their inability to sense the distance and depth in space. The main aim of this paper is to determine the correlation between damage to the global stereopsis depending on the region injury. Using prisms of traumatic brain injury with difficulties and inability to sense the depth of the space represents a new therapeutic approach to spatial changes. Testing patients may show that violation of temporal lobe damage global stereopsis and whether patients in whom stereovision damaged following injury of other parts of the brain, show unbroken global stereopsis on dots stereo grams small disparities. In our research, we get a statistically significant difference p <0.01 compared to the region that has been violated. [ABSTRACT FROM AUTHOR]

Abstract: Background: Six term newborns presented with apnoea and temporal lobe haemorrhage. Aim: In this observational study, we described involvement of the limbic system in apnoeic term newborns with temporal lobe injury. Methods: Six term newborns presented to the neonatal care unit with apnoea within the first 2 days of life. Ultrasound (US) and MRI of the brain were obtained in the first week of life. Results: Apnoea was related to temporal lobe haemorrhage in all. During apnoeic periods four had focal epileptic activity on EEG. All lesions were detected first with US. On MRI, haemorrhages were located in the parenchyma, the subdural and/or subarachnoid space. Three haemorrhages were surrounded by infarction in the temporal lobe. In three infants hippocampus and mesial temporal cortex were affected. In two basal temporal cortex only was involved. Vascular anomalies were excluded by MRA, serial MRI or serial US with Doppler imaging. Conclusion: Term infants with seizure associated apnoea may present with haemorrhage and/or infarction to hippocampus, mesial and basal temporal cortex. This study supports the existence and possible disruption of descending influences from the temporal cortex and/or amygdala on brainstem breathing centres in the term newborn. [Copyright &y& Elsevier]

Seizures have both local and remote effects on nervous system function. Whereas propagated seizures are known to disrupt cerebral activity, little work has been done on remote network effects of seizures that do not propagate. Human focal temporal lobe seizures demonstrate remote changes including slow waves on electroencephalography (EEG) and decreased cerebral blood flow (CBF) in the neocortex. Ictal neocortical slow waves have been interpreted as seizure propagation; however, we hypothesize that they reflect a depressed cortical state resembling sleep or coma. To investigate this hypothesis, we performed multimodal studies of partial and secondarily generalized limbic seizures in rats. Video/EEG monitoring of spontaneous seizures revealed slow waves in the frontal cortex during behaviorally mild partial seizures, contrasted with fast polyspike activity during convulsive generalized seizures. Seizures induced by hippocampal stimulation produced a similar pattern, and were used to perform functional magnetic resonance imaging weighted for blood oxygenation and blood volume, demonstrating increased signals in hippocampus, thalamus and septum, but decreases in orbitofrontal, cingulate, and retrosplenial cortex during partial seizures, and increases in all of these regions during propagated seizures. Combining these results with neuronal recordings and CBF measurements, we related neocortical slow waves to reduced neuronal activity and cerebral metabolism during partial seizures, but found increased neuronal activity and metabolism during propagated seizures. These findings suggest that ictal neocortical slow waves represent an altered cortical state of depressed function, not propagated seizure activity. This remote effect of partial seizures may cause impaired cerebral functions, including loss of consciousness. [ABSTRACT FROM AUTHOR]

Abstract: We investigated with fMRI the cortical correlates of recovery of semantic processing in a patient (DL) with left temporal damage. Names of animals, plant, and artifacts (semantic conditions) and reversed words (baseline condition) were auditorily presented to the patient and nine control subjects in a category monitoring task. Data analyses showed large differences between the patterns of domain-specific semantic activation observed in DL and the control subjects, which could be attributed to a cortical reorganization compensating for the damaged part of the semantic processing system in DL. Such reorganization relied on three main mechanisms, first, upholding of a subset of the structurally intact domain-specific regions, second, functional changes (both decreases and increases) of the domain specificity in several structurally intact regions that are normally engaged in the domain-specific network and, third, recruitment of supplementary domain-specific areas. Thus, in DL, animal-specific processing engaged supplementary areas in the left lingual gyrus and right cuneus, which correspond to animal-specific regions usually engaged in more demanding semantic tasks whereas the supplementary areas recruited for artifact-specific processing within the left superior/middle occipital lobe and right angular gyrus probably are endowed with a related but not domain-specific, semantic function. In contrast, no supplementary area contributed to plant-specific processing in DL. These findings suggest that the pattern of cortical reorganization consecutive to damage to the semantic processing network depends on the particular domain-specific function sustained by the damaged areas and the capacity of the remaining areas to assume this function. [Copyright &y& Elsevier]

The present study examines 2 factors that might moderate the object-recognition deficit seen after perirhinal cortex damage. Object recognition by normal rats was improved by extending (from 4 to 8 mm) the sample period during which an object was first explored. Furthermore, there was a significant positive correlation between time spent in close exploration of the sample object and degree of successful novelty discrimination. In contrast, rats with perirhinal cortex lesions failed to benefit from increased close exploration and did not discriminate the novel object after even the longest sample period. Nevertheless, the lesions did not disrupt habituation across repeated exposure to the same object. The second factor was extent of perirhinal cortex damage. A significant correlation was found between total perirhinal cortex loss and degree of recognition impairment. Within the perirhinal cortex, only damage to the caudal perirhinal cortex correlated significantly with recognition memory deficits. This study highlights the critical importance of the perirhinal cortex within the temporal lobe for recognition memory and shows that the lesion-induced deficit occurs despite seemingly normal levels of close object exploration. [ABSTRACT FROM AUTHOR]

It has been suggested that both conceptual knowledge and the ability to infer function from structure can support object use. By contrast, we propose that object use requires solely the ability to reason about technical ends. Technical ends (e.g., cutting) are not purposes (e.g., eating), but the technical way to achieve them. This perspective suggests that there is no mutual relationship between technical ends and purposes since the same purpose (e.g., writing) can be achieved thanks to distinct technical ends (graving, tracing), and, inversely, the same technical end (e.g., tracing) can achieve different purposes (making up, writing). Thus, conceptual knowledge might determine which technical end is usually associated with a given purpose. To contribute to the discussion, we described the behaviour of a female patient with left temporal lobe lesions and bilateral frontal lobe lesions following a closed-head injury. Conceptual knowledge was impaired. She encountered difficulties in demonstrating the use of objects in isolation (e.g., using a screwdriver without the screw). The presence of a recipient (e.g., using a screwdriver with the screw) improved her performance. The performance was also normal when asked to perform unusual applications of objects to achieve a goal for which the usually applied object was not provided (e.g., screwing a screw with a knife). Consistent with the theoretical framework supported here, her performance profile suggests an intact ability to reason about technical ends (i.e., utilization), in the presence of a defective ability to determine the usual relationship between technical ends and purposes (i.e., usage). [ABSTRACT FROM AUTHOR]

Background: It has been proposed that anomia following left inferior temporal lobe lesions may have two different underlying mechanisms with distinct neural substrates. Specifically, naming impairment following damage to more posterior regions (BA 37) has been considered to result from a disconnection between preserved semantic knowledge and phonological word forms (pure anomia), whereas anomia following damage to anterior temporal regions (BAs 38, 20/21) has been attributed to the degradation of semantic representations (semantic anomia). However, the integrity of semantic knowledge in patients with pure anomia has not been demonstrated convincingly, nor were lesions in these cases necessarily confined to BA 37. Furthermore, evidence of semantic anomia often comes from individuals with bilateral temporal lobe damage, so it is unclear whether unilateral temporal lobe lesions are sufficient to produce significant semantic impairment. Aims: The main goals of this study were to determine whether anomia following unilateral left inferior temporal lobe damage reflected a loss of semantic knowledge or a post-semantic deficit in lexical retrieval and to identify the neuroanatomical correlates of the naming impairment. Methods & Procedures: Eight individuals who underwent left anterior temporal lobectomy (L ATL) and eight individuals who sustained left posterior cerebral artery strokes (L PCA) completed a battery of language measures that assessed lexical retrieval and semantic processing, and 16 age- and education-matched controls also completed this battery. High-resolution structural brain scans were collected to conduct lesion analyses. Outcomes & Results: Performance of L ATL and L PCA patients was strikingly similar, with both groups demonstrating naming performance ranging from moderately impaired to unimpaired. Anomia in both groups occurred in the context of mild deficits to semantic knowledge, which manifested primarily as greater difficulty in naming living things than nonliving things and greater difficulty in processing visual/perceptual as opposed to functional/associative semantic attributes. Lesion analyses indicated that both patient groups sustained damage to anterior inferior temporal lobe regions implicated in semantic processing. Conclusions: These results contribute to a better understanding of the cognitive mechanism of naming impairment in patients with temporal lobe damage and support the notion that pure anomia and semantic anomia represent two endpoints along a continuum of semantic impairment. Unilateral left temporal lobe lesions in our patients resulted in relatively mild semantic deficits that were apparent primarily in lexical production tasks, whereas severe semantic impairment likely requires bilateral temporal lobe damage. [ABSTRACT FROM AUTHOR]

Apnea as an isolated manifestation of seizures is well described in neonates but is only occasionally observed in infants. This article reports 3 infants presenting with apneic events as the main manifestation of seizure, documented by video electroencephalogram, all with mesial temporal lobe lesions. The 3 infants, after normal pregnancy and delivery at term, showed the first apnea at the age of 4 to 10 months. Although the interictal electroencephalogram result was often normal, ictal video electroencephalogram in all infants showed focal rhythmic discharges with or without generalization. Magnetic resonance imaging showed an inferior mesial temporal lobe mass lesion in all infants. All patients underwent lesion removal, and they are seizure free with normal psychomotor development. [ABSTRACT FROM AUTHOR]

Mild traumatic brain injury (mTBI) in contact sport is a problem of such magnitude that improved approaches to diagnosis, investigation and management are urgent. Concussion has traditionally been described as a transient, fully reversible, cerebral dysfunction. However, this seemingly 'mild' injury sometimes results in long-lasting and disabling post-concussion symptoms (PCS) and abnormal neuropsychological profiles characteristic of frontal and/or temporal lobe dysfunction. At present, the pathological changes following concussion remain unclear, but it is now widely accepted that concussion results mainly in functional disturbance rather than structural damage. Therefore, functional imaging techniques can help in demonstrating brain abnormalities undetectable by structural imaging methods. This paper will review the use of functional magnetic resonance imaging (fMRI) in studies of concussion. Our existing and ongoing fMRI studies will be described as examples to highlight the potential and contribution of this non-invasive functional neuroimaging technique in the assessment of sports-related concussion and its management. [ABSTRACT FROM AUTHOR]

Damage to the hippocampal region and related medial temporal lobe structures (perirhinal, entorhinal, and parahippocampal cortices) impairs new learning (anterograde amnesia) as well as memory for information that was acquired before the damage occurred (retrograde amnesia). We assessed retrograde amnesia with the Autobiographical Memory Interview (AMI) and with a news events test in six patients with damage limited primarily to the hippocampal region (H group) and two patients with large medial temporal lobe lesions (MTL group). On the news event test, the H group exhibited temporally limited retrograde amnesia covering ∼5 years. On the same test, the MTL group exhibited an extensive retrograde amnesia covering decades. Nevertheless, performance was relatively spared for very remote time periods. On the AMI, all patients had intact remote autobiographical memory. Because our patients with hippocampal lesions, as well as our patients with large MTL lesions, performed normally on the AMI, patients who perform poorly on the same test presumably have damage beyond the hippocampus and related structures in the medial temporal lobe. The findings emphasize the difference in the extent of retrograde amnesia associated with hippocampal lesions and large MTL lesions. [ABSTRACT FROM AUTHOR]

Abstract: A card ordering task was developed to evaluate the role of the temporal lobe in perceiving subtle featural displacements of faces that contribute to judgments of facial expression and identity. Individuals with varying degrees of temporal lobe damage and healthy controls were required to manually sort cards depicting morphs of facial expressions or facial identities so that the cards were sequentially ordered from one morph endpoint to another. Four morph progressions were used—three emotion morphs (neutral-to-anger, neutral-to-fear, and fear-to-anger) and an identity morph. Five exemplars were given per morph type. Debriefing verified that participants were using feature-level cues to sort the cards. A patient with bilateral amygdala damage due to epilepsy did not differ in her sorting abilities from unilateral temporal lobectomy patients or controls. In contrast, a post-encephalitic patient with widespread left temporal lobe damage showed impairments that were most marked on the fear-to-anger and identity sorts. These results show that amygdala-damaged individuals can use information contained in facial expressions to solve tasks that rely on feature-level analysis, which recruits processing in other temporal lobe regions involved in making fine featural distinctions. [Copyright &y& Elsevier]

Abstract: There is a growing interest both in identifying the neural mechanisms of magnitude estimation and in identifying forms of bias that can explain aspects of behavioral syndromes like unilateral neglect. Magnitude estimation is associated with activation of temporo-parietal cortex in both cerebral hemispheres of normal subjects; however, it is unclear if and how left hemisphere lesions bias magnitude estimation because the infrequency of neglect and the presence of aphasia in these subjects confound examination. In contrast, we examined magnitude estimation using 12 different types of sensory stimuli that spanned five sensory domains in two patients with very different clinical presentations following unilateral left hemisphere stroke. One patient had neglect sub-acutely without aphasia. The other had aphasia chronically after a temporo-parietal lesion but not neglect. The neglect patient was re-examined 48h after being treated with modafinil (Provigil) for decreased arousal. Both patients demonstrated bias in magnitude estimation relative to normal subjects (n =83). Alertness improved in the neglect patient after taking modafinil. His neglect also resolved and his magnitude estimates more closely resembled those of normal subjects. This is the first evidence, to our knowledge, that left hemisphere injury can bias magnitude estimation in a manner similar but not identical to that associated with right hemisphere injury. [Copyright &y& Elsevier]

Abstract: Previous work has reported that in the Iowa gambling task (IGT) advantageous decisions may be taken before the advantageous strategy is known [Bechara, A., Damasio, H., Tranel, D., & Damasio, A. R. (1997). Deciding advantageously before knowing the advantageous strategy. Science, 275, 1293–1295]. In order to test whether explicit memory is essential for the acquisition of a behavioural preference for advantageous choices, we measured behavioural performance and skin conductance responses (SCRs) in five patients with dense amnesia following damage to the basal forebrain and orbitofrontal cortex, six amnesic patients with damage to the medial temporal lobe or the diencephalon, and eight control subjects performing the IGT. Across 100 trials healthy participants acquired a preference for advantageous choices and generated large SCRs to high levels of punishment. In addition, their anticipatory SCRs to disadvantageous choices were larger than to advantageous choices. However, this dissociation occurred much later than the behavioural preference for advantageous alternatives. In contrast, though exhibiting discriminatory autonomic SCRs to different levels of punishment, 9 of 11 amnesic patients performed at chance and did not show differential anticipatory SCRs to advantageous and disadvantageous choices. Further, the magnitude of anticipatory SCRs did not correlate with behavioural performance. These results suggest that the acquisition of a behavioural preference – be it for advantageous or disadvantageous choices – depends on the memory of previous reinforcements encountered in the task, a capacity requiring intact explicit memory. [Copyright &y& Elsevier]

Abstract: It has been suggested that Parkinson''s disease (PD) impairs the ability to learn on the basis of reward or reinforcing feedback i.e., by trial-and-error. In many learning tasks, particular ‘dimensions’ of stimulus information are relevant whilst others are irrelevant; therefore, efficient performance depends on identifying the dimensions of these ‘compound’ stimuli and selecting the relevant dimension for further processing. We investigated the ability of patients with PD, as well as patients with Huntington''s disease and patients with frontal or temporal lobe lesions, to learn visual discriminations which required either a number of associations to be learned concurrently (the ‘eight-pair’ task) or the selection of information from compound stimuli (the ‘five-dimension’ task), both tasks being learned by trial-and-error. None of the basal ganglia disorder patient groups was impaired on the eight-pair task, militating against a crucial role for these brain structures in trial-and-error learning per se. Patients with mild, medicated PD, but not unmedicated PD patients, were impaired at identifying all five feature dimensions in the five-dimension task, implying dopaminergic ‘overdosing’ of the ability to analyse compound stimuli in terms of their component dimensions. Temporal lobe lesion patients performed similarly, suggesting that the temporal lobe may be the site of the medication overdose effect. Patients with severe, medicated PD were impaired at compound discrimination learning on the five-dimension task in the absence of an underlying impairment in identifying component stimulus dimensions; this pattern resembled that seen in Huntington''s disease and frontal lobe lesion patients, implying that fronto-striatal circuitry is involved in the formation of rules based upon selected stimulus dimensions. [Copyright &y& Elsevier]

Examines predisposing factors for primary progressive aphasia (PPA). Development of PPA in patients with a background of mild left hemicranial hypoplasia; Observations of PPA in patients with dyslexia and childhood injury to the left temporal lobe.

Summary: Purpose: We sought to detect the incidence and the risk factors of posttraumatic epilepsy (PTE) in rehabilitation patients; to define the influence of PTE for late clinical and functional outcome; and to assess the cognitive and behavioral features of the patients with PTE. Methods: Patients were examined with (a) cognitive and behavioral examinations, which included a clinical interview and psychometric tests performed by an expert clinical psychologist; (b) single-photon emission computed tomography (SPECT) and magnetic resonance imaging (MRI); and (c) functional evaluation including the Glasgow Outcome Scale (GOS) and the Functional Independence Measure (FIM). Results: Of the 143 patients examined in this study, in 27 (19%), seizures developed after a mean time from trauma of 11.9 ± 8.6 months. The occurrence of PTE was significantly correlated with the hypoperfusion in temporal lobes (p < 0.004), the degree of hydrocephalus (p < 0.04), the evidence of intracerebral hematoma (p < 0.01), and operative brain injury (p < 0.001). Patients with epilepsy showed a significantly higher incidence of personality disorders than did patients without epilepsy. The disinhibited behavior, irritability, and agitated and aggressive behavior were significantly more frequent and severe in PTE patients. The psychometric tests intended to explore memory, language, intelligence, attention, and spatial cognition did not show any significant difference between those with and without epilepsy. PTE also was significantly correlated with a worse functional outcome 1 year after the trauma. Conclusions: The degrees of hydrocephalus and of hypoperfusion in the temporal lobes are significant risk factors for late PTE. Another main finding of our study is the absence of influence of epilepsy on cognitive disorders; its influence on neurobehavioral disorders and functional outcome is discussed. [ABSTRACT FROM AUTHOR]

Abstract Monkeys with excitotoxic lesions of the CA1/subiculum region in the right hemisphere and with immunotoxic lesions of the cholinergic cells of the diagonal band in the left hemisphere were impaired on a visual conditional task. In this task, correct choice of one of two objects depends on which of two background fields both objects are presented against, irrespective of the spatial positions of the objects. They were not impaired on simple object or shape discrimination tasks. The pattern of impairments is the same as that seen after bilateral excitotoxic lesions of CA1/subiculum, implying that the diagonal band lesion disables the ipsilateral CA1/subiculum. It also argues that CA1/subiculum, sustained by its cholinergic input, is necessary for some forms of nonspatial conditional learning. Addition of an inferotemporal (IT) cortical ablation to the left hemisphere did not affect simple visual discrimination learning, although all the monkeys then failed to learn a new visual conditional task. This demonstrates that intact IT cortex in only one hemisphere is sufficient to sustain simple visual discrimination learning but implies that the cholinergic input and the inferotemporal cortical input to the hippocampus both contribute to visual conditional learning. The subsequent addition of an immunotoxic lesion of the basal nucleus of Meynert in the right hemisphere resulted in an additional impairment on a difficult shape discrimination. This argues that it is the cholinergic projection to the inferotemporal cortex, rather than to the rest of the cortex, which contributes to visual discrimination learning and memory. [ABSTRACT FROM AUTHOR]

Medial temporal lobe (MTL) lesions typically produce retrograde amnesia characterized by the disproportionate loss of recently acquired memories. Temporally graded memory loss is interpreted traditionally as evidence for a consolidation process guided by the MTL. Here, using functional magnetic resonance imaging (fMRI), we show temporally graded changes in MTL activity in healthy older adults taking a famous faces remote memory test. Evidence for temporally graded change in the hippocampal formation was mixed, suggesting it may participate only in consolidation processes lasting a few years. Entorhinal cortex was associated with temporally graded changes extending up to 20 years. These findings support the basic tenets of consolidation theory and suggest that the entorhinal cortex, rather than the hippocampal formation, participates in memory consolidation over decades. [ABSTRACT FROM AUTHOR]

Describes a case involving a patient who developed severe temporal lobe radiation injury five years after irradiation for a rhinopharyngeal carcinoma. Extensive involvement of microcirculation found after post-mortem; Radiaton effects on vessels.

Objective: To determine the incidence of intracranial injury, specifically in the temporal lobe, in patients with longitudinal fractures of the temporal bone. Design: Prospective inception cohort. Setting: University of Maryland Division of Otolaryngology–Head and Neck Surgery and the Maryland Shock Trauma Center, Baltimore. Patients: Twenty-seven consecutive patients with unilateral or bilateral temporal bone fractures. Main Outcome Measures: Evaluation of temporal bone and intracranial trauma using computed tomography (CT) and magnetic resonance imaging (MRI). Results: Of the 27 patients enrolled in the study, 12 had the complete battery of MRI, CT, and physical and audiological examinations. In all 12 patients, MRI demonstrated adjacent middle cranial fossa meningeal enhancement. Results of non–contrast-enhanced CT and MRI demonstrated ipsilateral temporal lobe contusions in 6 of the 13 fractures for an overall incidence of 46%. In addition, MRI demonstrated 4 cerebral contusions not seen in the results of non–contrast-enhanced CT. Conclusions: While high-resolution CT remains the criterion standard for evaluation of temporal bone fractures, MRI revealed a higher incidence of related temporal lobe injuries. Magnetic resonance imaging data may be valuable in preoperative evaluation of patients who require surgical intervention through a middle cranial fossa approach to document pre-existing injury and potential morbidity before retraction of the middle cranial fossa dura mater and temporal lobe. [ABSTRACT FROM AUTHOR]

Klüver-Bucy syndrome [KBS] is a neurobehavioral disorder, less frequently reported in neurotrauma patients. We report a case of post-traumatic Klüver-Bucy syndrome in a young patient who had moderate head injury. Patient had symptoms of hyperorality, hypersexuality, placidity and dietary changes. Patient improved with conservative treatment. Only few cases of post-traumatic KBS are reported in literature. According to available reports this is first case of post-traumatic KBS being reported from India.