Objective
The goal of the current study was to examine the dynamics of language lateralization using magnetoencephalographic (MEG) imaging, to determine the sensitivity and specificity of MEG-imaging, and to determine if MEG-imaging can become a viable alternative to the intracarotid amobarbital procedure (IAP), the current gold-standard for preoperative language lateralization in neurosurgical candidates.
Methods
MEG was recorded during an auditory verb-generation task and imaging analysis of oscillatory activity was initially performed in 21 subjects with epilepsy, brain tumor, or arteriovenous malformation who had undergone IAP and MEG. Time-windows and brain regions-of-interest that best discriminated between IAP determined left or right dominant for language were identified. Parameters derived in the retrospective analysis, was applied to a prospective cohort of 14 patients and healthy controls.
Results
Power decreases in the beta-frequency band were consistently observed following auditory stimulation in inferior frontal, superior temporal, and parietal cortices; similar power decreases were also seen in inferior frontal cortex prior to and during overt verb generation. Language lateralization was clearly observed to be a dynamic process that is bilateral for several hundred milliseconds during periods of auditory perception and overt speech production. Correlation with the IAP was seen in 13 of 14 (93%) of prospective patients, with the test demonstrating a sensitivity of 100% and specificity of 92%.
Interpretation
Our results demonstrate excellent correlation between MEG imaging findings with the IAP for language lateralization, and provide new insights into the spatiotemporal dynamics of cortical speech processing.