Relation of cortical language distribution and cognitive function in surgical epilepsy patients

Purpose: To investigate the relation between the number and spatial distrib ution of language sites and specific patient- and epilepsy-related variable s. Methods: Patients with stimulation-induced reading or naming errors from an terior or inferior temporal cortex (i.e., atypical temporal language sites) were compared with those with language sites confined to Wernicke's area ( WA) in the posterosuperior temporal and inferior parietal perisylvian area. In a consecutive series of 44 left hemisphere language dominant patients w ith complex partial seizures before left temporal lobectomy, correlations w ere compared between cortical language distribution and measures of cogniti ve function. Results: Patients with atypical temporal language sites (group 1) had signi ficantly fewer years of education that did patients with language sites in WA (group 2). Patients in group 1 had poorer verbal learning and fluency th an did patients in group 2. Patients with IQ <80 were significantly more li kely to have multiple sites where stimulation disrupted language than did p atients with normal IQ. Number of language sites had significant negative c orrelations with full-scale IQ, and measures of confrontation naming, verba l fluency, and immediate verbal memory. Conclusions: Language cortex has a wider spatial distribution in epilepsy s urgery patients with lower intelligence, poorer education, and worse verbal and memory skills.