Crossed Cerebrocerebellar Language Lateralization: An Additional Diagnostic Feature for Assessing Atypical Language Representation in Presurgical Functional MR Imaging

Orellana, Carolina Méndez; Visch-Brink, Evy; Vernooij, Meike W.; Kalloe, S.; Satoer, Djaina; Vincent, Audrey; Lugt, Aad van der; Smits, Marion

doi:10.3174/ajnr.a4147

Cited by 27 publications

(7 citation statements)

References 32 publications

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“…In our clinical experience, some degree of lateralisation is also often apparent in subcortical (e.g. basal ganglia ( Donnan et al, 1991 , Booth et al, 2007 ) and cerebellar regions ( Booth et al, 2007 , O'Halloran et al, 2012 , Gelinas et al, 2014 , Orellana et al, 2015 ). In the present work we therefore extend the consideration of regional lateralisation to encompass these non-cortical areas as well, to evaluate whether they might be suitable for consideration as prognostic markers.…”

Section: Introductionmentioning

confidence: 63%

The diminishing dominance of the dominant hemisphere: Language fMRI in focal epilepsy

Tailby

Abbott

Jackson

2017

NeuroImage: Clinical

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“Which is the dominant hemisphere?” is a question that arises frequently in patients considered for neurosurgery. The concept of the dominant hemisphere implies uniformity of language lateralisation throughout the brain. It is increasingly recognised that this is not the case in the healthy control brain, and it is especially not so in neurological diseases such as epilepsy.In the present work we adapt our published objective lateralisation method (based on the construction of laterality curves) for use with sub-lobar cortical, subcortical and cerebellar regions of interest (ROIs). We apply this method to investigate regional lateralisation of language activation in 12 healthy controls and 18 focal epilepsy patients, using three different block design language fMRI paradigms, each tapping different aspects of language processing. We compared lateralisation within each ROI across tasks, and investigated how the quantity of data collected affected the ability to robustly estimate laterality across ROIs.In controls, lateralisation was stronger, and the variance across individuals smaller, in cortical ROIs, particularly in the Inferior Frontal (Broca) region. Lateralisation within temporal ROIs was dependent on the nature of the language task employed. One of the healthy controls was left lateralised anteriorly and right lateralised posteriorly. Consistent with previous work, departures from normality occurred in ~ 15–50% of focal epilepsy patients across the different ROIs, with atypicality most common in the Lateral Temporal (Wernicke) region. Across tasks and ROIs the absolute magnitude of the laterality estimate increased and its across participant variance decreased as more cycles of task and rest were included, stabilising at ~ 4 cycles (~ 4 min of data collection).Our data highlight the importance of considering language as a complex task where lateralisation varies at the subhemispheric scale. This is especially important for presurgical planning for focal resections where the concept of ‘hemispheric dominance’ may be misleading. This is a precision medicine approach that enables objective evaluation of language dominance within specific brain regions and can reveal surprising and unexpected anomalies that may be clinically important for individual cases.

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Section: Introductionmentioning

confidence: 63%

The diminishing dominance of the dominant hemisphere: Language fMRI in focal epilepsy

Tailby

Abbott

Jackson

2017

NeuroImage: Clinical

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“…As there is no perfect modality, the clinician should assess language hemispheric dominance in brain tumor patients individually, using multiple diagnostic indicators. For example, recent literature proposed that crossed cerebrocerebellar lateralization can be used as an additional diagnostic feature to determine language dominance in brain tumor patients [47]. When language lateralization based on BA is equivocal, additional indicators can be helpful.…”

Section: Discussionmentioning

confidence: 99%

fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca’s area

et al. 2016

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Introduction Functional MRI (fMRI) can assess language lateralization in brain tumor patients; however, this can be limited if the primary language area—Broca's area (BA)—is affected by the tumor. We hypothesized that the middle frontal gyrus (MFG) can be used as a clinical indicator of hemispheric dominance for language during presurgical workup. Methods Fifty-two right-handed subjects with solitary left-hemispheric primary brain tumors were retrospectively studied. Subjects performed a verbal fluency task during fMRI. The MFG was compared to BA for fMRI voxel activation, language laterality index (LI), and the effect of tumor grade on the LI. Results Language fMRI (verbal fluency) activated more voxels in MFG than in BA (MFG = 315, BA = 216, p < 0.001). Voxel activations in the left-hemispheric MFG and BA were positively correlated (r = 0.69, p < 0.001). Mean LI in the MFG was comparable to that in BA (MFG = 0.48, BA = 0.39, p = 0.06). LIs in MFG and BA were positively correlated (r = 0.62, p < 0.001). Subjects with high-grade tumors demonstrate lower language lateralization than those with low-grade tumors in both BA and MFG (p = 0.02, p = 0.02, respectively). Conclusion MFG is comparable to BA in its ability to indicate hemispheric dominance for language using a measure of verbal fluency and may be an adjunct measure in the clinical determination of language laterality for presurgical planning.

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“…1 These studies highlighted a limbic area corresponding to lobules VI and VII, 31 left lateralization of the activation on visuospatial tasks, right activation in linguistic and working memory tasks, 2 and activation of the anterior lobes in language articulation, whereas the posterior lobules were activated in silent langage. 32 Our study has some limitations. First, our study population consisted of nonconsecutive cases examined retrospectively.…”

Section: Discussionmentioning

confidence: 89%

Biometry of the Cerebellar Vermis and Brain Stem in Children: MR Imaging Reference Data from Measurements in 718 Children

Jandeaux¹,

Kuchcinski²,

Ternynck³

et al. 2019

AJNR Am J Neuroradiol

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Crossed Cerebrocerebellar Language Lateralization: An Additional Diagnostic Feature for Assessing Atypical Language Representation in Presurgical Functional MR Imaging

Cited by 27 publications

References 32 publications

The diminishing dominance of the dominant hemisphere: Language fMRI in focal epilepsy

The diminishing dominance of the dominant hemisphere: Language fMRI in focal epilepsy

fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca’s area

Biometry of the Cerebellar Vermis and Brain Stem in Children: MR Imaging Reference Data from Measurements in 718 Children

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