Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients

Abstract

BACKGROUND AND PURPOSE Language task‐based functional MRI (fMRI) is increasingly used for presurgical planning in patients with brain lesions. Different paradigms elicit activations of different components of the language network. The aim of this study is to optimize fMRI clinical usage by comparing the effectiveness of three language tasks for language lateralization and localization in a large group of patients with brain lesions. METHODS We analyzed fMRI data from a sequential retrospective cohort of 51 patients with brain lesions who underwent presurgical fMRI language mapping. We compared the effectiveness of three language tasks (Antonym Generation, Sentence Completion (SC), and Auditory Naming) for lateralizing language function and for activating cortex within patient‐specific regions‐of‐interest representing eloquent language areas, and assessed the degree of spatial overlap of the areas of activation elicited by each task. RESULTS The tasks were similarly effective for lateralizing language within the anterior language areas. The SC task produced higher laterality indices within the posterior language areas and had a significantly higher agreement with the clinical report. Dice coefficients between the task pairs were in the range of .351‐.458, confirming substantial variation in the components of the language network activated by each task. CONCLUSIONS SC task consistently produced large activations within the dominant hemisphere and was more effective for lateralizing language within the posterior language areas. The low degree of spatial overlap among the tasks strongly supports the practice of using a battery of tasks to help the surgeon to avoid eloquent language areas.

Remembering a name: Neuropsychological validity studies and a computer proposal for detection of anomia

“…9,12,18 Considering brain laterality and naming, some new perspectives have emerged (focused mainly on specific brain areas or pathologies), and there is now a substantial body of work about this issue. 12,13,[19][20][21][22][23][24][25][26][27][28] Despite using a different approach to the one employed in the present study, these perspectives aid understanding and encour-age validity studies. For example, there are a number of areas involved in aspects of language comprehension and production in both hemispheres and neuroimaging results suggest that various cognitive tasks that make use of similar representations or processes frequently share component sub-functions with other tasks including non-linguistic ones.…”

Sex Effect on Presurgical Language Mapping in Patients With a Brain Tumor

“…The lesion-free anterior and posterior language ROIs, and their combination (anterior + posterior), in each hemisphere, were used to compute the LI using a Lesion-Adjusted Formula (Dietz et al, 2016) , where active voxels were tallied only within the non-lesioned portion of each ROI. Language lateralization was defined as left (LI ≥ 0.2), right (LI ≤ −0.2), or bilateral (−0.2 < LI < 0.2) (Binder et al, 1996;Unadkat et al, 2019).…”

“…The American Society of Functional Neuroradiology (ASFNR) recommends for adults a three-task battery consisting of sentence completion (SC) and silent word generation, followed by either rhyming, object naming, or passive story listening (Black et al, 2017). Our recent retrospective study comparing three language tasks used for presurgical planning [SC, antonym generation (AG), and auditory naming] demonstrated in a large cohort of brain lesion patients that SC relative to the other tasks elicited a greater extent of activation within the posterior language areas of the dominant hemisphere, and was therefore considered more effective for determining language laterality in the brain (Unadkat et al, 2019). Despite the progress in evaluating language paradigms for fMRI presurgical mapping in brain tumor patients (Tie et al, 2014(Tie et al, , 2015Black et al, 2017), the influence of demographic factors such as sex has not yet been systematically evaluated.…”

Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

“…To detect activation in the putative language areas, the patient-specific language regions-of-interest (ROIs) were generated based on a set of anatomically defined language ROIs in the standard Montreal Neurological Institute (MNI) space. 20,21 For activation volume calculation, the MarsBar toolbox 22 was used to measure the activation volume within the language ROIs using the thresholded t-map including clusters with volume larger than 400 mm 3 . This particular threshold was chosen to include at least one significant cluster in the activation map.…”