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Abstract：
This study assessed the pre-operative chronic condition and effect of epilepsy surgery in a 21-year-old Japanese woman with drug-resistant right temporal lobe epilepsy (TLE). For this patient, it was crucially important to preserve language and her music capabilities, including absolute pitch (AP), which is found in the general population at less than 0.1%. The patient became seizure free, and her AP capability was preserved after selective amygdalohippocampectomy in the non-dominant right hemisphere. Most of the neuropsychological test (WAIS-III and WMS-R) scores remained in the normal range, except for low scores in verbal memory and markedly improved attention/concentration index. The patient\'s pre- and postoperative brain function related to language and music capabilities were investigated using functional magnetic resonance imaging (fMRI) based on two language tasks and a music task (listening to melodies). While task performance was similar in pre- and postoperative examinations, her brain activation patterns markedly differed. The most striking difference was during the music task: areas with significant activation existed in the bilateral frontal and temporal lobes before surgery, whereas postoperative activation was confined to a very limited region in the left angular gyrus. The authors speculate that the surgery triggered some change in functional organization in the brain, which contributed to preserving her capabilities.
摘要：
这项研究评估了一名21岁的日本女性耐药右颞叶癫痫（TLE）的术前慢性病和癫痫手术的效果。对这个病人来说,保持语言和她的音乐能力至关重要，包括绝对音高（AP），在一般人群中发现不到0.1%。病人没有癫痫发作，在非优势性右半球选择性杏仁核海马切除术后，她的AP能力得以保留。大部分神经心理学测验(WAIS-III和WMS-R)得分保持在正常范围,除了言语记忆得分低和注意力/注意力指数明显提高。使用基于两种语言任务和一种音乐任务（听旋律）的功能磁共振成像（fMRI）研究了患者的与语言和音乐能力相关的术前和术后脑功能。虽然术前和术后检查的任务表现相似，她的大脑激活模式明显不同。最显著的差异是在音乐任务期间：手术前双侧额叶和颞叶存在显著激活的区域，而术后激活仅限于左角回的非常有限的区域。作者推测手术引发了大脑功能组织的一些变化，这有助于保持她的能力。
