Utilization of functional MRI language paradigms for pre-operative mapping: a systematic review
Functional MRI (fMRI) can be employed to non-invasively localize brain regions involved in functional areas of language in patients with brain tumour, for applications including pre-operative mapping. The present systematic review was conducted to explore prevalence of different language paradigms utilised in conjunction with fMRI approaches for pre-operative mapping, with the aim of assessing their effectiveness and suitability.
A systematic literature search of brain tumours in the context of fMRI methods applied to pre-operative mapping for language functional areas was conducted using PubMed/MEDLINE and Scopus electronic database following PRISMA guidelines. The article search was conducted between the earliest record and March 1, 2019. References and citations were checked in Google Scholar database.
Twenty-nine independent studies were identified, comprising 1031 adult participants with 976 patients characterised with different types and sizes of brain tumours, and the remaining 55 being healthy controls. These studies evaluated functional language areas in patients with brain tumours prior to surgical interventions using language-based fMRI. Results demonstrated that 86% of the studies used a Word Generation Task (WGT) to evoke functional language areas during pre-operative mapping. Fifty-seven percent of the studies that used language-based paradigms in conjunction with fMRI as a pre-operative mapping tool were in agreement with intra-operative results of language localization.
WGT was most commonly utilised and is proposed as a suitable and useful technique for a language-based paradigm fMRI for pre-operative mapping. However, based on available evidence, WGT alone is not sufficient. We propose a combination and convergence paradigms for a more sensitive and specific map of language function for pre-operative mapping. A standard guideline for clinical applications should be established.
KeywordsBrain tumour fMRI Language Broca’s and Wernicke’s area Word Generation Task
- WADA test
The intracarotid sodium amobarbital
Functional magnetic resonance imaging
Low grade glioma
High grade glioma
Superior temporal sulcus
Inferior frontal gyrus
Superior temporal gyrus
Middle frontal gyrus
Superior frontal gyrus
Posterior cingulate cortex
Temporal parietal junction
Primary motor cortex
Word Generation Task
This work was supported by the Geran Galakan Penyelidik Muda (Incentive Grant for Young Researchers) Universiti Kebangsaan Malaysia GGPM-2017-016.
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
This article does not contain any studies with human participants or animals performed by any of the authors.
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