INTRODUCTION: Functional MRI (fMRI) is a promising technique for replacing the Wada test as the standard examination of memory lateralization. Currently fMRI can already be used to estimate lateralization of memory in the medial temporal lobes, but some variables should be treated to guarantee good-quality results, such as magnetic-field strength and design types. OBJECTIVE: In this article, we review the latest advances in functional neuroimaging of memory and attempt to elucidate the future role of functional MRI as a preoperative tool in epilepsy surgery. CONCLUSIONS: At this point, blocked design still is preferable (over event-related and other approaches) and patients need to be compared to a control group, so the laterality indices may be more clinically meaningful. Functional MRI of memory will evolve by the use of high-strength field magnets (3T) and novel mathematical techniques for estimating laterality indices. In the future, it will be combined with other functional mapping techniques, such as tractography, intracranial EEG, and magnetoencephalography, to produce multi-modality maps. Rather than a picture, future memory maps will most likely be presented as functional movies.
epilepsy; memory; fMRI; epilepsy surgery