Hard-Wired or Soft-Wired ? Evidence for the Structural Plasticity of White Matter Networks Following Anterior Temporal Lobectomy

Mahinda Yogarajah¹, Niels Focke², Silvia Bonelli¹, Pam Thompson¹, Christian Vollmar¹, Andrew McEvoy³, Mark Symms¹, Matthias Koepp¹, John Duncan¹

Epilepsy is the most chronic, common neurological condition. Many patients with temporal lobe epilepsy undergo anterior temporal lobe resection, but up to 40% of patients are at risk of language decline after surgery. We carried out a longitudinal study using diffusion tensor imaging to assess the structural reorganisation of white matter after surgery. In patients undergoing surgery in the language dominant hemisphere, there is an increase in FA in white matter connecting fronto-temporal regions. The location of these increases and their correlation with language function suggest they may represent the structural plasticity of language networks after surgery.