The proposed research study will explore the cortical dynamics of episodic memory processing in patients with temporal lobe epilepsy (TLE) by combining whole-head magnetoencephalography (MEG) and electroencephalography (EEG) with high-resolution structural MRI. The goals of this research are to elucidate 1) what brain regions are involved in memory processing in TLE, 2) when they are involved, and 3) whether or not MEG/EEG activation patterns can be used to predict memory dysfunction in TLE. These goals will be accomplished using the following methods. First, the time course and spatial extent of neural activations will be compared in patients with TLE and healthy controls during MEG/EEG tasks of verbal and nonverbal memory. Second, structural pathology will be quantified in patients with TLE using high-resolution MRI. Third, neurophysiological (MEG/EEG) and structural (MRI) data will be used to predict neuropsychological performances in TLE. This study has great clinical utility in that identifying the timing and distribution of brain regions involved in memory can assist with preoperative planning in TLE and possibly reduce morbidity associated with removal of eloquent cortex. The goals of this proposal are also aligned with the NIH/NINDS Benchmarks for Epilepsy Research, which encourage the use of improved technology for obtaining and analyzing detailed brain images of patients with epilepsy. This research project will be part of a programmatic, long-term line of MEG/EEG research in patients with temporal and extratemporal epilepsy that will eventually incorporate other cutting-edge multimodal imaging tools (i.e., MEG/fMRI) to understand cognitive dysfunction in epilepsy. The research plan described in this proposal will enable the applicant to 1) develop expertise in MEG/EEG and structural MRI data collection and analysis and 2) apply these newly learned skills to the study of cognitive dysfunction in an important clinical population. Epilepsy is a common neurological disease that costs the healthcare system approximately $12.5 billion annually and can negatively impact an individual's quality of life, employment, and health status. The current project has strong implications for public health because it strives to improve the presurgical evaluation of patients with epilepsy by using new, improved technology to identify regions of brain dysfunction in epilepsy. This information may facilitate surgical planning and reduce the potential for postoperative cognitive decline.
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