Language lateralization correlates with verbal memory performance in children with focal epilepsy

PURPOSE: Assessment of language dominance with functional magnetic resonance imaging (fMRI) and neuropsychological evaluation is often used prior to epilepsy surgery. This study explores whether language lateralization and cognitive performance are systematically related in young patients with focal epilepsy. METHODS: Language fMRI and neuropsychological data (language, visuospatial functions, and memory) of 40 patients (7-18 years of age) with unilateral, refractory focal epilepsy in temporal and/or frontal areas of the left (n = 23) or right hemisphere (n = 17) were analyzed. fMRI data of 18 healthy controls (7-18 years) served as a normative sample. A laterality index was computed to determine the lateralization of activation in three regions of interest (frontal, parietal, and temporal). RESULTS: Atypical language lateralization was demonstrated in 12 (30%) of 40 patients. A correlation between language lateralization and verbal memory performance occurred in patients with left-sided epilepsy over all three regions of interest, with bilateral or right-sided language lateralization being correlated with better verbal memory performance (Word Pairs Recall: frontal r = -0.4, p = 0.016; parietal r = -0.4, p = 0.043; temporal r = -0.4, p = 0.041). Verbal memory performance made the largest contribution to language lateralization, whereas handedness and side of seizures did not contribute to the variance in language lateralization. DISCUSSION: This finding reflects the association between neocortical language and hippocampal memory regions in patients with left-sided epilepsy. Atypical language lateralization is advantageous for verbal memory performance, presumably a result of transfer of verbal memory function. In children with focal epilepsy, verbal memory performance provides a better idea of language lateralization than handedness and side of epilepsy and lesion.

Zoë Wicomb's Ghosts. Uncanny Translocations in David's Story and The One That Got Away

This essay analyses Zoë Wicomb's novel David's Story and her latest collection of short stories, The One That Got Away, through the lense of cosmopolitanism and Jacques Derrida's concept of ‘hauntology’. Wicomb is a cosmopolitan author in a very precise sense: an author who embeds locally specific stories in a complex intertextual, historical and transnational web of cross-references. As settings, characters and objects move between Scotland and South Africa, it appears that the histories of these countries are mutually haunted by each other. Uncanny encounters with the past, and with memorials and art objects that take on a spectral quality, evoke an increasing sense of disorientation on the part of protagonists and readers alike. Assumptions about place, history and identity are thus constantly undermined and reconfigured.