Presurgical Language fMRI in Children, Adolescents and Young Adults

Meinhold, Theresa; Höfer, W; Pieper, Tom; Kudernatsch, Manfred; Staudt, Martin

doi:10.1007/s00062-019-00852-7

Cited by 11 publications

(25 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…For the determination of language lateralization, all patients with left-sided lesions underwent fMRI and performed the Vowel Identification Task (32) as a word generation task. Methodological details have been described elsewhere (32)(33)(34). In brief, pictures of everyday objects were presented visually to the participants, who were asked to decide if the name of the object contained the phoneme <i> by silently generating the name of the object.…”

Section: Structural and Functional Magnetic Resonance Imagingmentioning

confidence: 99%

Non-verbal Intelligence in Unilateral Perinatal Stroke Patients With and Without Epilepsies

et al. 2021

Self Cite

View full text Add to dashboard Cite

Background: The risk factors for impaired cognitive development after unilateral perinatal stroke are poorly understood. Non-verbal intelligence seems to be at particular risk, since language can shift to the right hemisphere and may thereby reduce the capacity of the right hemisphere for its originary functions. Pharmaco-refractory epilepsies, a frequent complication of perinatal strokes, often lead to impaired intelligence. Yet, the role of well-controlled epilepsies is less well-understood. Here, we investigated whether well-controlled epilepsies, motor impairment, lesion size, lesion side, and lateralization of language functions influence non-verbal functions.Methods: We recruited 8 patients with well-controlled epilepsies (9–26 years), 15 patients without epilepsies (8–23 years), and 23 healthy controls (8–27 years). All underwent the Test of Non-verbal Intelligence, a motor-independent test, which excludes biased results due to motor impairment. Language lateralization was determined with functional MRI, lesion size with MRI-based volumetry, and hand motor impairment with the Jebson-Taylor Hand Function-Test.Results: Patients with epilepsies showed significantly impaired non-verbal intelligence [Md = 89.5, interquartile range (IQR) = 13.5] compared with controls (Md = 103, IQR = 17). In contrast, patients without epilepsies (Md = 97, IQR = 15.0) performed within the range of typically developing children. A multiple regression analysis revealed only epilepsy as a significant risk factor for impaired non-verbal functions.Conclusion: In patients with unilateral perinatal strokes without epilepsies, the neuroplastic potential of one healthy hemisphere is able to support the development of normal non-verbal cognitive abilities, regardless of lesion size, lesion side, or language lateralization. In contrast, epilepsy substantially reduces this neuroplastic potential; even seizure-free patients exhibit below-average non-verbal cognitive functions.

show abstract

Section: Structural and Functional Magnetic Resonance Imagingmentioning

confidence: 99%

Non-verbal Intelligence in Unilateral Perinatal Stroke Patients With and Without Epilepsies

et al. 2021

Self Cite

View full text Add to dashboard Cite

show abstract

“…1 Flowchart of process of patient inclusion and classification of hemispheric language dominance. ROI region of interest; VLRold/VLRnew validly lateralizing ROIs from our validation study (VLRold [1]) and from the current study (VLRnew) and Turkish (n = 1) (Supplementary Table 1). Pathologies (radiological or, whenever available, histopathological) comprised focal cortical dysplasia (n = 37), benign tumor (n = 23), stroke (n = 17), mesial temporal sclerosis (n = 9), traumatic brain injury (n = 5), tuberous sclerosis (n = 3), polymicrogyria (n = 2), Sturge-Weber syndrome (n = 2), mild malformation of cortical development (n = 1), autoimmune encephalitis (n = 1), brain abscess after sinusitis (n = 1), and herpes encephalitis (n = 1).…”

Section: Patient Cohortmentioning

confidence: 99%

“…In patients with drug-resistant focal epilepsy, surgical resection is often the only treatment option to achieve lasting relief from seizures. Prior to brain surgery near language areas, identification of hemispheric language dominance is crucial [1][2][3][4]. In patients with neurologic disorders, such as epilepsy or structural brain lesions, particularly pediatric patients with early onset of disease, atypical language representation is up to 77% more frequent than in healthy subjects [2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

“…In a recent fMRI validation study [ 1 ] 28 patients who underwent fMRI and the Wada test and/or experienced unchanged linguistic abilities after hemispherotomy were analyzed. The Wada test and unchanged language after hemispherotomy were used as the gold standard for validation.…”

Section: Introductionmentioning

confidence: 99%

“…The Wada test and unchanged language after hemispherotomy were used as the gold standard for validation. Using a region-specific evaluation of activation patterns, our group introduced, for each of these four tasks, task-specific regions of interest (ROIs) as valid for lateralization [ 1 ]. Thus, 13 valid, task-specific ROIs were identified, i.e., for WCT frontal operculum (FOP), inferior frontal gyrus (IFG), middle frontal gyrus (MFG), intraparietal sulcus (IPS) and cerebellum (CBM).…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Clinical Speech fMRI in Children and Adolescents

Staudt

2021

Clin Neuroradiol

Self Cite

View full text Add to dashboard Cite

Purpose In patients with drug-resistant focal epilepsy, surgical resection is often the only treatment option to achieve long-term seizure control. Prior to brain surgery involving potential language areas, identification of hemispheric language dominance is crucial. Our group developed and validated a functional magnetic resonance imaging (fMRI) battery of four pediatric language tasks. The present study aimed at optimizing fMRI data acquisition and analysis using these tasks. Methods We retrospectively analyzed speech fMRI examinations of 114 neuropediatric patients (age range 5.8–17.8 years) who were examined prior to possible epilepsy surgery. In order to evaluate hemispheric language dominance, 1–4 language tasks (vowel identification task VIT, word-chain task WCT, beep-story task BST, synonym task SYT) were measured. Results Language dominance was classified using fMRI activation in the 13 validly lateralizing ROIs (VLR) in frontal, temporal and parietal lobes and cerebellum of the recent validation study from our group: 47/114 patients were classified as left-dominant, 34/114 as bilateral and 6/114 as right-dominant. In an attempt to enlarge the set of VLR, we then compared for each task agreement of these ROI activations with the classified language dominance. We found four additional task-specific ROIs showing concordant activation and activation in ≥ 10 sessions, which we termed validly lateralizing (VLRnew). The new VLRs were: for VIT the temporal language area and for SYT the middle frontal gyrus, the intraparietal sulcus and cerebellum. Finally, in order to find the optimal sequence of measuring the different tasks, we analyzed the success rates of single tasks and all possible task combinations. The sequence 1) VIT 2) WCT 3) BST 4) SYT was identified as the optimal sequence, yielding the highest chance to obtain reliable results even when the fMRI examination has to be stopped, e.g., due to lack of cooperation. Conclusion Our suggested task order together with the enlarged set of VLRnew may contribute to optimize pediatric speech fMRI in a clinical setting.

show abstract