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Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients

Institution:
1Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
2Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
3Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Publisher:
Wiley
Publication Date:
May-2019
Journal:
J Neuroimaging
Volume Number:
29
Issue Number:
3
Pages:
348-56
Citation:
J Neuroimaging. 2019 May;29(3):348-56.
PubMed ID:
30648771
PMCID:
PMC6506353
Keywords:
BOLD fMRI, brain lesions, brain tumors, language mapping, presurgical planning
Appears in Collections:
NCIGT
Sponsors:
P41 RR019703//National Institutes of Health
P41 EB015898//National Institutes of Health
R21 CA198740//National Institutes of Health
R21 NS075728//National Institutes of Health
R25 CA089017//National Institutes of Health
Generated Citation:
Unadkat P., Fumagalli L., Rigolo L., Vangel M.G., Young G.S., Huang R., Mukundan S., Golby A., Tie Y. Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients. J Neuroimaging. 2019 May;29(3):348-56. PMID: 30648771. PMCID: PMC6506353.
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BACKGROUND AND PURPOSE: Language task-based functional MRI (fMRI) is increasingly used for presurgical planning in patients with brain lesions. Different paradigms elicit activations of different components of the language network. The aim of this study is to optimize fMRI clinical usage by comparing the effectiveness of three language tasks for language lateralization and localization in a large group of patients with brain lesions. METHODS: We analyzed fMRI data from a sequential retrospective cohort of 51 patients with brain lesions who underwent presurgical fMRI language mapping. We compared the effectiveness of three language tasks (Antonym Generation, Sentence Completion (SC), and Auditory Naming) for lateralizing language function and for activating cortex within patient-specific regions-of-interest representing eloquent language areas, and assessed the degree of spatial overlap of the areas of activation elicited by each task. RESULTS: The tasks were similarly effective for lateralizing language within the anterior language areas. The SC task produced higher laterality indices within the posterior language areas and had a significantly higher agreement with the clinical report. Dice coefficients between the task pairs were in the range of .351-.458, confirming substantial variation in the components of the language network activated by each task. CONCLUSIONS: SC task consistently produced large activations within the dominant hemisphere and was more effective for lateralizing language within the posterior language areas. The low degree of spatial overlap among the tasks strongly supports the practice of using a battery of tasks to help the surgeon to avoid eloquent language areas.