Does cortical mapping protect naming if surgery includes hippocampal resection?

Marla J. Hamberger, William T. Seidel, Robert R. Goodman, Guy M. McKhann

Research output: Contribution to journalArticlepeer-review

24 Scopus citations

Abstract

Objective: Preresection electrical stimulation mapping is frequently used to identify cortical sites critical for visual object naming. These sites are typically spared from surgical resection with the goal of preserving postoperative language. Recent studies, however, suggest a potential role of the hippocampus in naming, although this is inconsistent with neurocognitive models of language and memory. We sought to determine whether preservation of visual naming sites identi.ed via cortical stimulation mapping protects against naming decline when resection includes the hippocampal region. Methods: We assessed postoperative changes in visual naming in 33 patients, 14 who underwent left temporal resection including hippocampal removal and 19 who had left temporal resection without hippocampal removal. All patients had preresection cortical language mapping. Visual object naming sites identified via electrical stimulation were always preserved. Results: Patients without hippocampal resection showed no ficant naming decline, suggesting a clinical benefit from cortical mapping. In contrast, patients who had hippocampal resection exhibited significant postoperative naming decline, despite preresection mapping and preservation of all visual naming sites (p ≤ 0.02). These group effects were also evident in individual patients (p = 0.02). More detailed, post hoc examination of patients who had hippocampal resection revealed that overall, patients who declined were those with a preoperative, structurally intact hippocampus, whereas patients with preoperative hippocampal sclerosis did not exhibit ficant decline. Interpretation: Despite cortical language mapping with preservation of visual naming sites from resection, removal of an intact dominant hippocampus will likely result in visual naming decline postoperatively.

Original languageEnglish
Pages (from-to)345-352
Number of pages8
JournalAnnals of Neurology
Volume67
Issue number3
DOIs
StatePublished - Mar 2010
Externally publishedYes

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