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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

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