***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: In most people the left hemisphere of the brain is dominant for language . Because of the increased incidence of atypical right-hemispheric language in left-h and ed neurological patients , a systematic association between h and edness and dominance has long been suspected . To clarify the relationship between h and edness and language dominance in healthy subjects , we measured lateralization directly by functional transcranial Doppler sonography  in 326 healthy individuals using a word-generation task . The incidence of right-hemisphere language dominance was found to increase linearly with the degree of left-h and edness , from 4 % in strong right-h and ers ( h and edness = 100 ) to 15 % in ambidextrous individuals and 27 % in strong left-h and ers ( h and edness = -100 ) . The relationship could be approximated by the formula : f1.gif " BORDER="0">. These results clearly demonstrate that the relationship between h and edness and language dominance is not an artefact of cerebral pathology but a natural phenomenon Objective : To evaluate the reliability of temporal and frontal functional MRI ( fMRI ) activation for the assessment of language dominance , as compared with the Wada test . Patients and Methods : Ten patients with temporal lobe epilepsy were studied using blood oxygen level dependent fMRI and echoplanar imaging ( 1.5-T ) . Three tasks were used : semantic verbal fluency , covert sentence repetition , and story listening . Data were analyzed using pixel by pixel autocorrelation and cross-correlation . fMRI laterality indices were defined for several regions of interest as the ratio ( L − R)/(L + R ) , L being the number of activated voxels in the left hemisphere and R in the right hemisphere . Wada laterality indices were defined as the difference in the percentages of errors in language tests between left and right carotid injections . Results : Semantic verbal fluency : The asymmetry of frontal activation was correlated with Wada laterality indices . The strongest correlation was observed in the pre central /middle frontal gyrus/inferior frontal sulcus area . Story listening : The asymmetry of frontal , but not temporal , activation was correlated with Wada laterality indices . Covert sentence repetition : No correlation was observed . Conclusions : There was a good congruence between hemispheric dominance for language as assessed with the Wada test and fMRI laterality indices in the frontal but not in the temporal lobes . The story listening and the covert sentence repetition tasks increased the sensitivity of detection of posterior language sites that may be useful for brain lesion surgery PURPOSE Selective amygdalohippocampectomy ( SAH ) is a surgical treatment option for patients with medically intractable mesial temporal lobe epilepsy . In contrast to st and ard anterior temporal lobectomy , resection of unaffected tissue is limited , although it achieves equal seizure outcomes in selected patients . In SAH , the mesial structures can be approached by different routes , the transsylvian approach and the transcortical approach . Advantages or disadvantages with respect to postoperative cognitive outcome are still a matter of debate . METHODS Eighty r and omized patients were included in the analyses . In 41 patients , the  transsylvian approach , and in 39 patients , the transcortical approach was performed . All patients received comprehensive neuropsychological testing of verbal and nonverbal memory , attention , and executive functions before and 6 months or 1 year after SAH . RESULTS Seventy-five percent of patients became completely seizure free with no difference depending on the chosen approach . Repeated measures multivariate analysis of variance ( MANOVA ) showed that cognitive outcomes after both approaches were essentially the same . The only exception was phonemic fluency , which was significantly improved after transcortical but not after transsylvian SAH . CONCLUSIONS The results indicate that either surgical approach can be chosen independent of cognitive outcome criteria . Improvement in phonemic fluency after transcortical SAH may reflect selective normalization of cognitive function after epilepsy surgery , whereas frontal lobe manipulation might have hindered recovery of this function after transsylvian SAH OBJECT The aim of this study was to analyze the national health care burden of patients diagnosed with epilepsy in the US and to analyze any changes in the length of stay , mean charges , in-hospital deaths ( mortality ) , and disposition at discharge . METHODS A retrospective review of the  Nationwide Inpatient Sample ( NIS ) data base for epilepsy admissions was completed for the years from 1993 to 2008 . The NIS is maintained by the Agency for Healthcare Research and Quality and represents a 20 % r and om stratified sample of all discharges from nonfederal hospitals within the U.S. Patients with epilepsy were identified using ICD-9 codes beginning with 345.XX . Approximately 1.1 million hospital admissions were identified over a span of 15 years . RESULTS Over this 15-year period ( between 1993 and 2008 ) , the average hospital charge per admission for patients with epilepsy has increased significantly ( p < 0.001 ) from $ 10,050 to $ 23,909 , an increase of 137.9 % . This is in spite of a 33 % decrease in average length of stay from 5.9 days to 3.9 days . There has been a decrease in the percentage of in-hospital deaths by 57.9 % and an increase in discharge to outside medical institutions . CONCLUSIONS The total national charges associated with epilepsy in 2008 were in excess of $ 2.7 billion ( U.S. dollars , normalized ) . During the studied period , the cost per day for patients rose from $ 1703.39 to $ 6130.51 . In spite of this drastic increase in health care cost to the patient , medical and surgical treatment for epilepsy has not changed significantly , and epilepsy remains a major source of morbidity Over an 18-month period , all incident cases of neurological disorders were ascertained prospect ively in an unselected urban population based in 13 general practice s in the London area by a General Practice Linkage Scheme with the National Hospital for Neurology and Neurosurgery . In three of these practice s , the lifetime prevalence of neurological disorders was also assessed . A population of 100 230 patients registered with participating general practice s was followed prospect ively for the onset of neurological disorders . Multiple methods of case finding were used to maintain accuracy . The age- and sex-adjusted incidence rates of neurological disorders were calculated . The lifetime prevalence of neurological disorders was surveyed in 27 658 of the patients . The age- and sex-adjusted incidence rates were calculated for major neurological conditions . [ These are expressed as rates per 100 000 persons per annum , with 95 % confidence intervals ( CI ) in parentheses ] . The commonest of these were first cerebrovascular events , 205 ( CI : 183 , 230 ) ; shingles , 140 ( CI : 104 , 184 ) ; diabetic polyneuropathy , 54 ( CI : 33 , 83 ) ; compressive neuropathies , 49 ( CI : 39 , 61 ) ; epilepsy , 46 ( CI : 36 , 60 ) ; Parkinson 's disease , 19 ( CI : 12 , 27 ) ; peripheral neuropathies , 15 ( CI : 9 , 23 ) ; CNS infections , 12 ( CI : 5 , 13 ) ; post-herpetic neuralgia , 11 ( CI : 6 , 17 ) ; and major neurological injuries , 10 ( CI : 4 , 11 ) . Lifetime prevalence rates are also reported ( expressed as rate per 1000 persons with 95 % CI ) . The most prevalent conditions were : completed stroke , 9 ( CI : 8 , 11 ) ; transient ischaemic attacks , 5 ( CI : 4 , 6 ) ; active epilepsy , 4 ( CI : 4 , 5 ) ; congenital neurological deficit , 3 ( CI : 3 , 4 ) ; Parkinson 's disease , 2 ( CI : 1 , 3 ) ; multiple sclerosis , 2 ( CI : 2 , 3 ) ; diabetic polyneuropathy , 2 ( CI : 1 , 3 ) ; compressive mononeuropathies , 2 ( CI : 2 , 3 ) ; and sub-arachnoid haemorrhage , 1 ( CI : 0.8 , 2 ) . Overall , the onset of 625 neurological disorders was observed per 100 000 population annually . Six percent of the population had at some time had a neurological disorder . This is the first study of the incidence and lifetime prevalence of neurological disorders in recent times ; we found that these disorders give rise to significant morbidity in the community The aim of this work was to determine whether productive and perceptive language functions are differentially affected in homogeneous groups of epilepsy patients with right and left temporal lobe epilepsy ( TLE ) . Eighteen patients with left TLE , 18 with right TLE , and 17 healthy volunteers were studied using fMRI during performance of three tasks assessing the productive and perceptive aspects of language ( covert semantic verbal fluency , covert sentence repetition , and story listening ) . Hemispheric dominance for language was calculated in the frontal and temporal regions using laterality indices ( LI ) . Atypical lateralization was defined as a right-sided LI ( LI<-0.20 ) in the frontal lobes during the verbal fluency task or in the temporal lobes during the story listening task . Control subjects and right TLE patients demonstrated a strong left lateralization for language in the frontal lobes during the fluency task , whereas activation was less lateralized to the left hemisphere in left TLE patients , although the difference did not reach significance . In the story listening and the repetition tasks , activation was significantly more right sided in the temporal lobes of patients with left TLE . Atypical language representation was found in 19 % of TLE patients ( five left and two right TLE ) . The shift toward the right hemisphere was significantly larger in the temporal than the frontal lobes in patients with atypical language lateralization compared to TLE patients with a typical language lateralization . Neuropsychological performances of patients with atypical language patterns were better than those of patients with typical patterns , suggesting that this reorganization may represent a compensatory mechanism WE examined whether 53 adult non-aphasic patients with either left ( 22 ) or right temporal lobe lesions ( 31 ) demonstrate dissociable patterns of hemispheric asymmetries in category-specific word fluency tasks . The patients were asked to articulate as many appropriate words as possible within 60 or 90 s in response to six target categories . There was no effect of patient groups on the overall fluency . However , patients with a leftsided temporal lobe lesion were impaired retrieving words to ‘ initial letters ’ and to the category ‘ animals ’ . Right temporal lobe patients were impaired retrieving ‘ tools ’ and words referring to specific visual attributes . There were no fluency differences for ‘ food-supermarket goods ’ and ‘ flat interior ’ . We conclude that temporal lobe damage can result in category-specific impairments in word retrieval depending on the affected hemisphere BACKGROUND R and omized trials of surgery for epilepsy have not been conducted , because of the difficulties involved in design ing and implementing feasible studies . The lack of data supporting the therapeutic usefulness of surgery precludes making strong recommendations for patients with epilepsy . We conducted a r and omized , controlled trial to assess the efficacy and safety of surgery for temporal-lobe epilepsy . METHODS Eighty patients with temporal-lobe epilepsy were r and omly assigned to surgery ( 40 patients ) or treatment with antiepileptic drugs for one year ( 40 patients ) .  Optimal medical therapy and primary outcomes were assessed by epileptologists who were unaware of the patients ' treatment assignments . The primary outcome was freedom from seizures that impair awareness of self and surroundings . Secondary outcomes were the frequency and severity of seizures , the quality of life , disability , and death . RESULTS At one year , the cumulative proportion of patients who were free of seizures impairing awareness was 58 percent in the surgical group and 8 percent in the medical group ( P<0.001 ) . The patients in the surgical group had fewer seizures impairing awareness and a significantly better quality of life ( P<0.001 for both comparisons ) than the patients in the medical group . Four patients ( 10 percent ) had adverse effects of surgery . One patient in the medical group died . CONCLUSIONS In temporal-lobe epilepsy , surgery is superior to prolonged medical therapy . R and omized trials of surgery for epilepsy are feasible and appear to yield precise estimates of treatment effects OBJECTIVES The correlation between clinical measures of memory and subjectively reported memory is often poor . Regarding this we investigated in patients with temporal lobe epilepsy ( TLE ) whether there is evidence that persons mistake other cognitive performances for memory due to subjective memory theories . METHODS a neuropsychological test battery comprising measures of attention , verbal/figural memory and other visual or language related functions was applied in patients with left ( L-TLE , n=24 ) or right temporal lobe epilepsy ( R-TLE , n=21 ) and healthy volunteers ( n=20 ) . In addition , subjective self- and other-reported  memories  were assessed by the subjective memory question naire ( SMQ ) . RESULTS subjective measures as well as objective measures indicate significant cognitive impairment in TLE and in L-TLE in particular . Self-reports and other-reports are interrelated but only self-reported memory correlates significantly with objective memory performance . Regression analysis indicates that self-reported memory is best predicted by word fluency followed by ver 
    Output:
    
Both patients with left- and right sided TLE were impaired on SVF and PVF compared to HC .
Patients with left-sided TLE were slightly more impaired than patients with right-sided TLE .
Patients with FLE showed a larger impairment in PVF than patients with TLE , whereas on SVF there was no difference between FLE and TLE .
Semantic verbal fluency might not differentiate between FLE and TLE .
While verbal fluency impairment was anticipated , especially in left-sided TLE and FLE patients , the impairment in patients with right-sided TLE was larger than expected .