1. Imaging Variability in Disease: Epilepsy & Functional Reorganization of Language William Davis Gaillard Children’s National Medical Center G eo Washington & Georgetown Universities Washington DC Clinical Epilepsy Section, NINDS,NIH Bethesda MD Supported by: Federal Grants R01 NS44280 NINDS, RO1 MH65395 NIMH, P30HD40677 NICHD, U54 MH066417, & Clinical Epilepsy Section NINDS, NIH

2. Auditory Description Decision Task (ADDT) Group Map: Expected Pattern Individual Maps: Normal & Pathological Variability

3. Left Partial Epilepsy, MRI, & Atypical Language (n=102) *** *p<0.05 Gaillard, et al. Neurology 2007

4. ADDT: Inter & Intra-hemispheric Variance Individual vs. group normal SPM voxelwise comparison to id voxels with z>2.0 to generate a patient variance map PCA with hierarchical clustering patient variance maps then grouped into patterns of variance my Kmeans clustering Data displayed as % (penetrance) for voxels with z>2 for each voxel for each group

5. ADDT: Inter & Intra-hemispheric Variance Normal control SPM map (n=19; mean age 24.8) Patients (n=45; mean age 22.8, onset 13.3), all left hemisphere focus; 73% typical language.

6. Typical Patient Atypical Patient Individual Patients Compared to Mean Controls

7. 2b 2a 1a 1b 2a&b PCA Identifies Four Groups ADDT n=9 n=16 n=14 n=6