Download Statistics
Download Statistics
Binding, Lawrence Peter;
(2024)
Preventing Language Decline after Temporal Lobe Epilepsy Surgery.
Doctoral thesis (Ph.D), UCL (University College London).
Preview |
Text
Thesis_corrected_final_clean.pdf - Accepted Version Download (56MB) | Preview |
Abstract
BACKGROUND: Temporal lobe resection for focal, drug-resistant temporal lobe epilepsy (TLE) causes language and memory deficits in around half of the operated patients, with naming and verbal memory deficits occurring after language-dominant resections. This thesis explores the contribution of white matter fibre bundle transection and the change in network metrics (graph theory) to these deficits. METHOD: The graded naming test (picture naming) and verbal encoding (immediate) and retrieval (delayed) memory tasks are utilised as the patient’s cognitive outcome. A new tractography method is developed and tested on 126 TLE cases. Statistical analyses are used to associate the transection of white matter fibre bundles to naming/verbal memory decline. A support vector classifier and graph theory in a machine learning framework is utilised to predict which patients undergo decline at 3- and 12-months. RESULTS: Increased resection of the inferior fronto-occipital fasciculus (IFOF) in a language dominant and middle longitudinal fasciculus (MLF) in language nondominant resections were associated with greater picture naming decline at 3- months. Combined network metrics and strength best predicted patients’ neuropsychology classification at 3- and 12-months respectively. Utilising longitudinal (chained) support vector classifier betweenness centrality best-classified patients’ outcome at 3- and then again at 12-months. Atlas-based disconnection of the ventral cingulum (vCing), medial occipital longitudinal tract (MOLT) and fornix were all related to worse verbal immediate and delayed memory scores. Increased transection of the MOLT and fornix were related to increased immediate and delayed verbal decline, respectively at 3- and 12- months. DISCUSSION: These results highlight the potential role that white matter resection plays in naming/memory change at 3- and 12-months post-operatively. There are significant limitations in clinical utility and interpretability which should be taken into account when applying these findings.
| Type: | Thesis (Doctoral) |
|---|---|
| Qualification: | Ph.D |
| Title: | Preventing Language Decline after Temporal Lobe Epilepsy Surgery |
| Open access status: | An open access version is available from UCL Discovery |
| Language: | English |
| Additional information: | Copyright © The Author 2024. Original content in this thesis is licensed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International (CC BY-NC 4.0) Licence (https://creativecommons.org/licenses/by-nc/4.0/). Any third-party copyright material present remains the property of its respective owner(s) and is licensed under its existing terms. Access may initially be restricted at the author’s request. |
| UCL classification: | UCL UCL > Provost and Vice Provost Offices > UCL BEAMS UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science UCL > Provost and Vice Provost Offices > UCL BEAMS > Faculty of Engineering Science > Dept of Computer Science |
| URI: | https://discovery.ucl.ac.uk/id/eprint/10190160 |
Loading...
Loading...Loading...Loading...Archive Staff Only
 |
View Item |
