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Functional MRI Study of Verbal Fluency in a Patient with Subcortical Laminar Heterotopia

Published online by Cambridge University Press:  16 February 2016

Daniel L. Keene ,
Janet Olds  and
William J. Logan
Daniel L. Keene*
Affiliation:
Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario Canada Division of Neurology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
Janet Olds
Affiliation:
Neurocognitive Program, Mental Health, Children's Hospital of Eastern Ontario, Ottawa, Ontario Canada Division of Neurology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
William J. Logan
Affiliation:
Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, Ontario Canada Division of Neurology, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada
*
Division of Neurology, Department of Pediatrics, Children's Hospital of Eastern Ontario, 401 Smyth Road, Ottawa, Ontario, Canada K1H 8L1
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Abstract

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Rationale:

Double cortex syndrome is a malformation in which there is a band of subcortical heterotopic grey matter separated from the cortex by white matter. The functional activity of the heterotopic neurons is unclear.

Patient:

A 13-year-old female was evaluated for seizures. The EEG showed bifrontal spike wave disturbance. Band heterotopia, in association with mild reduction of sulcation of the cerebral hemispheres, was found on MRI. Psychological assessment indicated the presence of variable cognitive abilities, with verbal IQ [82] generally better than nonverbal IQ [59], and specific difficulties in language comprehension and mathematics.

Method:

Functional MRI was used to localize the areas of language and motor activation. The language activation paradigm was a visual verb generation task with a visual fixation baseline. The motor paradigm consisted of alternating blocks of sequential finger tapping and rest. Coronal functional and anatomical images were obtained.

Results:

The motor paradigm produced activation of the primary motor cortex, the band heterotopia and the supplementary motor cortex. The language paradigm produced activation of the left inferior frontal gyrus and left supplementary motor area, but not of the band heterotopia.

Conclusions:

The activation of heterotopic grey matter during a motor task demonstrates a hemodynamic association with motor activity and suggests that this tissue may be functional. Such association was not seen with the language task. We speculate that later maturing functions such as language are restricted in their development to the normal situated superficial cortex in our patient.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 31 , Issue 2 , May 2004 , pp. 261 - 264
Copyright
Copyright © The Canadian Journal of Neurological 2004

References

1.Ianetti, P, Raucci, U, Basile, A, et al. Neuronal migrational disorders: diffuse cortical dysplasia or ‘double cortex’ syndrome. Acta Paediatrica 1993;82:501–503.Google Scholar
2.Barkovitch, AJ, Guerrini, R, Battaglia, G, et al. Band heterotopia: correlation of outcome with magnetic resonance imaging parameters. Ann Neurol 1994;36:609–617.CrossRefGoogle Scholar
3.Morrell, F, Whisler, T, Hoeppner, T. Electrophysiology of heterotopic gray matter in the “double cortex” syndrome. Epilepsia 1992;33(S3):77 (abstract).Google Scholar
4.de Volder, A, Gadisseux, J-F, Michel, C, Maloteaux, JM, Bol, AC. Brain glucose utilization in band heterotopia: synaptic activity of “double cortex”. Pediatr Neurol 1994;11:290–294.CrossRefGoogle ScholarPubMed
5.Miura, K, Watanaba, K, Maeda, N, et al. agnetic resonance imaging and positron emission tomography of band heterotopia. Brain Dev 1993;15:288–290.CrossRefGoogle Scholar
6.Weschler, D., Weschler Intelligence Scales for Children-III, the Psychological Corporation, San Antonio, Texas,1971.Google Scholar
7.Harrison, PL, Oakland. Adaptive Behavior Assessment System. The Psychological Corporation, San Antonio, Texas, 2000.Google Scholar
8.Cohen, M. Children’s Memory Scales. The Psychology Corporation, San Antonio, Texas 1997.Google Scholar
9.Sheslow, D, Adams, W. WRAML, Wide Range Assessment of Memory and Learning. Wilmington, Delaware: Wide Range Inc 1990.Google Scholar
10.Dunn, LM, Dunn, LM. Peabody Picture Vocabulary Test. Third Edition, American Guidance Service, Circle Pines, MN, 1997.Google Scholar
11.Wig, E, Second, W. Test of Language Competence. The Psychology Corporation, San Antonio, Texas 1989.Google Scholar
12.Weschler Individual Achievement Test. The Psychological Corporation, San Antonio, Texas, 1992.Google Scholar
13.Beery, KE, Development Test of Visual-Motor Integration. Administration and Scoring Manual. Chicago: Fullett Publishing 1967.Google Scholar
14.Strupp, JP. Stimulate: a GUI base fMRI analysis software package. Neuroimage 1996;3:S607.CrossRefGoogle Scholar
15.Pinard, J-M, Feydy, A, Carlier, R, et al. Functional MRI in double cortex: functionality of heteropia. Neurology 2000;54:1531–1533.CrossRefGoogle Scholar
16.Spreer, J, Martin, P, Greenlee, M, et al. Functional MRI in patients with band heterotopia. Neuroimage 2001;14:357–365.CrossRefGoogle ScholarPubMed
17.Iannetti, P, Spalice, A, Raucci, U, Perla, F. Functional neuroradio-logical investigations in band heterotopia. Pediatr Neurol 2001;24:159–163.CrossRefGoogle ScholarPubMed
18.Binder, JR, Swanson, SJ, Hammeke, TA, et al. Determination of language dominance using functional MRI: a comparison with the Wada test. Neurology 1996;46:978–984.CrossRefGoogle ScholarPubMed
19.FitzGerald, D, Cosgrove, G, Ronner, S, et al. Location of language in the cortex: a comparison between functional MR imaging and electrocortical stimulation. AJNR AM J Neuroradiol 1997; 18:1529–1539.Google ScholarPubMed
20.Hertz-Pannier, L, Gaillard, WD, Mott, SH, et al. Noninvasive assessment of language dominance in children and adolescents with functional MRI: a preliminary study. Neurology 1997; 48:1003–1012.CrossRefGoogle ScholarPubMed
21.Yetkin, F, Meuller, W, Morris, G, et al. Functional MR activation correlated with intraoperative cortical mapping. AJNR Am J Neuroradiol 1997;18:1311–1315.Google ScholarPubMed
22.Yousry, T, Schmid, UD, Jassoy, AG, et al. Topography of the cortical motor hand area: prospective study of functional MR imaging and direct motor mapping at surgery. Radiology 1995;195:23–29.CrossRefGoogle ScholarPubMed