Neuropsychology Review

, Volume 17, Issue 2, pp 145–155

Pre-Surgical Language Mapping with Functional Magnetic Resonance Imaging

Original Paper

DOI: 10.1007/s11065-007-9026-x

Cite this article as:
Bookheimer, S. Neuropsychol Rev (2007) 17: 145. doi:10.1007/s11065-007-9026-x

Abstract

Patients with lesions in or near eloquent cortex typically undergo one of several invasive techniques to prevent loss of function following surgery. One of the most promising potential clinical applications of functional magnetic resonance imaging (fMRI) is to map these functions as part of the pre-surgical work-up to identify patients at-risk, guide the surgical entry, or tailor the surgical procedure to prevent deficits. While motor and sensory mapping are relatively straightforward, language mapping is far more complex. The language system is variable in location across individuals and in many cases may reorganize partially or completely to the contralateral hemisphere. In addition, multiple regions of the brain contribute to language functioning including essential regions that must not be removed in surgery, and contributory regions that may result in transient or insignificant impairments post-surgery. Despite these challenges, an increasing number of studies have supported the use of fMRI for pre-surgical language mapping in a variety of disorders. This article reviews the literature from three disorders for which patients benefit from preoperative language mapping: epilepsy, brain tumors, and arteriovenous malformations. Each disorder presents unique challenges to language mapping. Specific case studies are presented highlighting the both the potential benefits of preclinical fMRI for language mapping as well as the potential risks and pitfalls.

Keywords

Functional MRI (FMRI) Epilepsy Tumors Surgical planning 

Copyright information

© Springer Science+Business Media, LLC 2007

Authors and Affiliations

  1. 1.Center for Cognitive Neurosciences, Semel InstituteDepartment of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, UCLALos AngelesUSA

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