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Selective temporal lobe amobarbital memory test

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Illustration of the main components of the selective temporal lobe amobarbital memory test developed and used in Zurich. The graph (top, left) summarizes the test, which consists of a storage phase and a recognition phase (memory). The stimulus material is illustrated at the top, right. The storage phase consists of 60 cards, each containing both a word and a figure. In the recognition phase, 128 cards are presented that contain either a word or a figure. Half of them have been shown during the storage phase (= 50% targets). The patient responds nonverbally by button press (button ipsilateral to the injection). Via a transfemorally inserted microcatheter, the territory of the anterior choroidal artery is co-injected with amobarbital and a SPECT-tracer (bottom left, selective angiography of the AChA). During the STLAMT, the EEG is inspected on-line. The depicted example shows the appearance of slow delta activity in mesial temporal depth-EEG recordings (bottom middle). The EEG changes due to the amobarbital can be quantitatively analyzed and plotted to estimate the duration of the inactivation, for example, by compressed spectral array (CSA, middle portion, right margin). After termination of the amobarbital test, the SPECT is done. The SPECT image is then fused with MRI to exactly visualize the inactivated brain area (bottom, right). (Contributed by Dr. Heinz Gregor Wieser.)