Evaluating functional MRI procedures for assessing hemispheric language dominance in neurosurgical patients


Two methods of quantifying hemispheric language dominance (HLD) in neurosurgical patients are compared: (1) an average magnitudes (AM) method, which is a calculation of the average signal intensity variation in regions of interest for each patient that were predefined in a group analysis for each task, and (2) a lateralization indices (LI) method, which is based on the number of activated pixels in regions of interest predefined in each individual patient. Four language tasks [a living/nonliving (LNL) judgment, word stem completion (WSC), semantic associate (SA) and a phonological associate (PA) task] were compared with “gold standard” measures such as the Wada test or electrocortical stimulation. Results showed that the LI method was more accurate (73% agreement with gold standard methods) than the AM method (only 40% agreement) across tasks and subjects. Furthermore, by varying the threshold used for determining laterality, the ability of functional magnetic resonance imaging (fMRI) to predict HLD was influenced for the AM method, whereas the LI method was relatively unaffected by changing the threshold. Using the LI method, the SA task was the most accurate for quantifying HLD (100% agreement with gold standard methods) with respect to the other three language tasks (80% accuracy for WSC, 65% for the LNL and 63% for phonological task). Depending on the method and the task, fMRI may be a promising tool for assessing HLD in neurosurgical patients.

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We thank Steve Petersen and Brad Schlaggar for helpful discussion throughout this project, Kristina Visscher and Christine Kang for help with the analyses and for comments on an earlier version of this manuscript, and Kate O’Brien and Margaret Sheridan for help with data collection. We also thank Abraham Snyder and Mark McAvoy for help with data processing and analysis. Support for this research project was provided by the McDonnell Center for Higher Brain Function and NIH/NINDS Grant NS41272.

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Correspondence to M. V. Baciu.

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Baciu, M.V., Watson, J.M., Maccotta, L. et al. Evaluating functional MRI procedures for assessing hemispheric language dominance in neurosurgical patients. Neuroradiology 47, 835–844 (2005). https://doi.org/10.1007/s00234-005-1431-3

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  • Functional MRI
  • Hemispheric language dominance
  • lateralization
  • Epilepsy
  • Wada test
  • Electrocortical stimulation