The ability to produce the correct words while speaking is critical for normal social, academic and occupational functioning. Unfortunately, for many children with uncontrolled epilepsy, surgical treatment for seizure control can place these vital language skills at risk. Extensive research in adults with refractory epilepsy has shown significant risk to word production or ?naming? ability that can be predicted before surgery based on clinical factors and, in some cases, prevented using preoperative language mapping. In marked contrast, we are currently unable to predict risk to expressive language in children, and the mapping techniques currently utilized have failed to reliably identify and protect language cortex in children. This represents a serious gap in clinical care, as prediction and protection of language are critical during development. A key problem has been the approach to naming in children, both in behavioral assessment and in preoperative language mapping. Significant advances in the neuroscience of naming have shown that traditional methods, which rely solely on visual object naming without regard to speed of response and other cognitive features of naming, can miss true naming deficits in assessment, and fail to identify essential naming areas in cortical language mapping. In adults, the addition of auditory description naming to preoperative assessment has assisted in lateralization of dysfunction related to epileptogenic cortex, and has improved mapping efficacy by identifying critical language cortex that otherwise remained undetected. We recently developed pediatric auditory naming and complementary visual naming measures that showed significant sensitivity to lateralized epilepsy-related dysfunction in preoperative children with refractory epilepsy. These measures now enable accurate and detailed assessment of naming in children. This project will use these recently developed tests, pre and postoperatively, and in cortical language mapping to: 1) identify the factors that predict both short- and long- term postoperative decline, 2) determine when decline is global or limited to one modality, and 3) determine whether modality-based naming can more effectively identify and protect language cortex in children. Results promise empirically based knowledge of risk to postoperative verbal skills in children with refractory epilepsy, improved language mapping in children, and advances in the cognitive neuroscience of language development and recovery. With increasing numbers of children undergoing epilepsy surgery, we can expect a growing need for accurate prediction, protection and measurement of pediatric language outcome.
Word finding or ?naming? decline is a risk of surgical treatment for seizures that are not controlled by medication. Although research has provided methods to help predict and sometimes protect naming abilities in adults, we are unable to provide these same benefits to children with epilepsy. This work aims to determine how to predict and ultimately protect word production skills in children who undergo epilepsy surgery.
| Hamberger, Marla J; Seidel, William T; MacAllister, William S et al. (2018) Auditory and visual naming tests for children. Child Neuropsychol 24:903-922 |
| Munger Clary, Heidi M; Snively, Beverly M; Hamberger, Marla J (2018) Anxiety is common and independently associated with clinical features of epilepsy. Epilepsy Behav 85:64-71 |
| Hamberger, Marla J; Miozzo, Michele; Schevon, Catherine A et al. (2016) Functional differences among stimulation-identified cortical naming sites in the temporal region. Epilepsy Behav 60:124-129 |
| Miozzo, Michele; Hamberger, Marla J (2015) Preserved meaning in the context of impaired naming in temporal lobe epilepsy. Neuropsychology 29:274-81 |
| Hamberger, Marla J (2015) Object naming in epilepsy and epilepsy surgery. Epilepsy Behav 46:27-33 |
| Hamberger, Marla J; Williams, Alicia C; Schevon, Catherine A (2014) Extraoperative neurostimulation mapping: results from an international survey of epilepsy surgery programs. Epilepsia 55:933-9 |
| Bank, Anna M; Schevon, Catherine A; Hamberger, Marla J (2014) Characteristics and clinical impact of stimulation-evoked seizures during extraoperative cortical mapping. Epilepsy Behav 34:6-8 |
| Hamberger, Marla J; Habeck, Christian G; Pantazatos, Spiro P et al. (2014) Shared space, separate processes: Neural activation patterns for auditory description and visual object naming in healthy adults. Hum Brain Mapp 35:2507-20 |
| Hamberger, Marla J; Cole, Jeffrey (2011) Language organization and reorganization in epilepsy. Neuropsychol Rev 21:240-51 |
| Hamberger, Marla J; Seidel, William T; McKhann 2nd, Guy M et al. (2010) Game-changing, or business as usual? New findings on naming skills after temporal lobe surgery. Neurology 75:1572 |
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