Utilization of functional MRI language paradigms for pre-operative mapping: a systematic review

  • Hanani Abdul MananEmail author
  • Elizabeth A. Franz
  • Noorazrul Yahya
Functional Neuroradiology



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.


Brain tumour fMRI Language Broca’s and Wernicke’s area Word Generation Task 


WADA test

The intracarotid sodium amobarbital


Functional magnetic resonance imaging


Intraoperative stimulation


Language network


Low grade glioma


High grade glioma


Superior temporal sulcus


Inferior frontal gyrus


Superior temporal gyrus


Middle frontal gyrus


Superior frontal gyrus


Pre-central gyrus


Post-central gyrus


Posterior cingulate cortex


Temporal parietal junction


Primary motor cortex


Healthy controls


Regional homogeneity


Laterality Index


Neuropsychological assessment


Word Generation Task


Funding information

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.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Makmal Pemprosesan Imej Kefungsian (Functional Image Processing Laboratory), Department of RadiologyUniversiti Kebangsaan Malaysia Medical CentreKuala LumpurMalaysia
  2. 2.Department of Psychology and fMRIotagoUniversity of OtagoDunedinNew Zealand
  3. 3.Diagnostic Imaging & Radiotherapy Program, Faculty of Health SciencesUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia

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