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Bishop DVM. What does lack of language lateralization signify? Evidence of fluctuating asymmetry rather than hemispheric equipoise on non-lateralized tasks. ROYAL SOCIETY OPEN SCIENCE 2024; 11:240495. [PMID: 39144494 PMCID: PMC11321854 DOI: 10.1098/rsos.240495] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/12/2024] [Accepted: 07/15/2024] [Indexed: 08/16/2024]
Abstract
In a study of patterns of language laterality in left- and right-handers, Woodhead et al. (Woodhead ZVJ, Thompson PA, Karlsson EM, Bishop DVM. 2021 R. Soc. Open Sci. 8, 200696. (doi:10.1098/rsos.200696)) noted that several tasks showed no bias to the left hemisphere in left-handed individuals. This might appear to suggest that these functions were mediated by the two hemispheres working together equally-what can be termed 'hemispheric equipoise'. Here, I consider an alternative possibility that individuals show lateral bias on these tasks, but the bias can occur to either the left or right-a form of fluctuating asymmetry. Further analysis of the distributions of data from individuals in Woodhead et al. is compared with simulated data. The pattern of results suggests that the impression of hemispheric equipoise may be an artefact of reliance on group data: even though the group mean does not differ from zero, a high proportion of individuals are biased to the left or right.
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Campbell JM, Kundu B, Lee JN, Miranda M, Arain A, Taussky P, Grandhi R, Rolston JD. Evaluating the concordance of functional MRI-based language lateralization and Wada testing in epilepsy patients: A single-center analysis. Interv Neuroradiol 2023; 29:599-604. [PMID: 35979608 PMCID: PMC10549711 DOI: 10.1177/15910199221121384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2022] [Revised: 07/20/2022] [Accepted: 08/03/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND For patients with drug-resistant epilepsy, surgery may be effective in controlling their disease. Surgical evaluation may involve localization of the language areas using functional magnetic resonance imaging (fMRI) or Wada testing. We evaluated the accuracy of task-based fMRI versus Wada-based language lateralization in a cohort of our epilepsy patients. METHODS In a single-center, retrospective analysis, we identified patients with medically intractable epilepsy who participated in presurgical language mapping (n = 35) with fMRI and Wada testing. Demographic variables and imaging metrics were obtained. We calculated the laterality index (LI) from task-evoked fMRI activation maps across language areas during auditory and reading tasks to determine lateralization. Possible scores for LI range from -1 (strongly left-hemisphere dominant) to 1 (strongly right-hemisphere dominant). Concordance between fMRI and Wada was estimated using Cohen's Kappa coefficient. Association between the LI scores from the auditory and reading tasks was tested using Spearman's rank correlation coefficient. RESULTS The fMRI-based laterality indices were concordant with results from Wada testing in 91.4% of patients during the reading task (κ = .55) and 96.9% of patients during the auditory task (κ = .79). The mean LIs for the reading and auditory tasks were -0.52 ± 0.43 and -0.68 ± 0.42, respectively. The LI scores for the language and reading tasks were strongly correlated, r(30) = 0.57 (p = 0.001). CONCLUSION Our findings suggest that fMRI is generally an accurate, low-risk alternative to Wada testing for language lateralization. However, when fMRI indicates atypical language lateralization (e.g., bilateral dominance), patients may benefit from subsequent Wada testing or intraoperative language mapping.
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Affiliation(s)
- Justin M Campbell
- School of Medicine, University of Utah, Salt Lake City, Utah, USA
- Interdepartmental Program in Neuroscience, University of Utah, Salt Lake City, Utah, USA
| | - Bornali Kundu
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - James N Lee
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Michelle Miranda
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Amir Arain
- Department of Neurology, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
| | - Philipp Taussky
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - Ramesh Grandhi
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
- Department of Radiology and Imaging Sciences, University of Utah, Salt Lake City, Utah, USA
| | - John D Rolston
- Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah, USA
- Department of Biomedical Engineering, University of Utah, Salt Lake City, Utah, USA
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Herfurth K, Harpaz Y, Roesch J, Mueller N, Walther K, Kaltenhaeuser M, Pauli E, Goldstein A, Hamer H, Buchfelder M, Doerfler A, Prell J, Rampp S. Localization of beta power decrease as measure for lateralization in pre-surgical language mapping with magnetoencephalography, compared with functional magnetic resonance imaging and validated by Wada test. Front Hum Neurosci 2022; 16:996989. [PMID: 36393988 PMCID: PMC9644652 DOI: 10.3389/fnhum.2022.996989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2023] Open
Abstract
Objective: Atypical patterns of language lateralization due to early reorganizational processes constitute a challenge in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy. There is no consensus on an optimal analysis method used for the identification of language dominance in MEG. This study examines the concordance between MEG source localization of beta power desynchronization and fMRI with regard to lateralization and localization of expressive and receptive language areas using a visual verb generation task. Methods: Twenty-five patients with pharmaco-resistant epilepsy, including six patients with atypical language lateralization, and ten right-handed controls obtained MEG and fMRI language assessment. Fourteen patients additionally underwent the Wada test. We analyzed MEG beta power desynchronization in sensor (controls) and source space (patients and controls). Beta power decrease between 13 and 35 Hz was localized applying Dynamic Imaging of Coherent Sources Beamformer technique. Statistical inferences were grounded on cluster-based permutation testing for single subjects. Results: Event-related desynchronization of beta power in MEG was seen within the language-dominant frontal and temporal lobe and within the premotor cortex. Our analysis pipeline consistently yielded left language dominance with high laterality indices in controls. Language lateralization in MEG and Wada test agreed in all 14 patients for inferior frontal, temporal and parietal language areas (Cohen's Kappa = 1, p < 0.001). fMRI agreed with Wada test in 12 out of 14 cases (85.7%) for Broca's area (Cohen's Kappa = 0.71, p = 0.024), while the agreement for temporal and temporo-parietal language areas were non-significant. Concordance between MEG and fMRI laterality indices was highest within the inferior frontal gyrus, with an agreement in 19/24 cases (79.2%), and non-significant for Wernicke's area. Spatial agreement between fMRI and MEG varied considerably between subjects and brain regions with the lowest Euclidean distances within the inferior frontal region of interest. Conclusion: Localizing the desynchronization of MEG beta power using a verb generation task is a promising tool for the identification of language dominance in the pre-surgical evaluation of epilepsy patients. The overall agreement between MEG and fMRI was lower than expected and might be attributed to differences within the baseline condition. A larger sample size and an adjustment of the experimental designs are needed to draw further conclusions.
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Affiliation(s)
- Kirsten Herfurth
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Yuval Harpaz
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Julie Roesch
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Nadine Mueller
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Katrin Walther
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | | | - Elisabeth Pauli
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Abraham Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Hajo Hamer
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Julian Prell
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
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Yazbek S, Hage S, Mallak I, Smayra T. Tractography of the arcuate fasciculus in healthy right-handed and left-handed multilingual subjects and its relation to language lateralization on functional MRI. Sci Rep 2021; 11:20936. [PMID: 34686728 PMCID: PMC8536719 DOI: 10.1038/s41598-021-00490-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
Functional MRI (fMRI) enables evaluation of language cortical organization and plays a central role in surgical planning. Diffusion Tensor Imaging (DTI) or Tractography, allows evaluation of the white matter fibers involved in language. Unlike fMRI, DTI does not rely on the patient’s cooperation. In monolinguals, there is a significant correlation between the lateralization of language on fMRI and on DTI. Our objective is to delineate the arcuate fasciculus (AF) in right- and left-handed trilinguals and determine if the AF laterality on DTI is correlated to language lateralization on fMRI. 15 right and 15 left-handed trilingual volunteers underwent fMRI and DTI. Laterality Index was determined on fMRI (fMRI-LI). Mean Diffusivity, Fractional Anisotropy (FA), Number of Fibers, Fiber Length, Fiber Volume and Laterality Index (DTI-LI) of the AF were calculated on DTI. 28 of the 30 subjects presented a bilateral AF. Most subjects (52%) were found to have a bilateral language lateralization of the AF on DTI. Only 4 subjects had bilateral lateralization of language on fMRI. The right AF demonstrated lower diffusivity than the left AF in the total participants, the right-handed, and the left-handed subjects. FA, Volume and Length of the AF were not significantly different between the two hemispheres. No correlation was found between the DTI-LI of the AF and the fMRI-LI. A prominent role of the right AF and a bilateral structural organization of the AF was present in our multilingual population regardless of their handedness. While in prior studies DTI was able to determine language lateralization in monolingual subjects, this was not possible in trilingual highly educated subjects.
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Affiliation(s)
- Sandrine Yazbek
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Stephanie Hage
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Iyad Mallak
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Tarek Smayra
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon.
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Quintiliani M, Bianchi F, Fuggetta F, Chieffo DPR, Ramaglia A, Battaglia DI, Tamburrini G. Role of high-density EEG (hdEEG) in pre-surgical epilepsy evaluation in children: case report and review of the literature. Childs Nerv Syst 2021; 37:1429-1437. [PMID: 33604716 PMCID: PMC8084826 DOI: 10.1007/s00381-021-05069-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2020] [Accepted: 02/02/2021] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Electrical source imaging (ESI) and especially hdEEG represent a noninvasive, low cost and accurate method of localizing epileptic zone (EZ). Such capability can greatly increase seizure freedom rate in surgically treated drug resistant epilepsy cases. Furthermore, ESI might be important in intracranial record planning. CASE REPORT We report the case of a 15 years old boy suffering from drug resistant epilepsy with a previous history of DNET removal. The patient suffered from heterogeneous seizure semiology characterized by anesthesia and loss of tone in the left arm, twisting of the jaw to the left and dysarthria accompanied by daze; lightheadedness sometimes associated with headache and dizziness and at a relatively short time distance negative myoclonus involving the left hand. Clinical evidence poorly match scalp and video EEG monitoring thus requiring hdEEG recording followed by SEEG to define surgical target. Surgery was also guided by ECoG and obtained seizure freedom. DISCUSSION ESI offers an excellent estimate of EZ, being hdEEG and intracranial recordings especially important in defining it. We analyzed our results together with the data from the literature showing how in children hdEEG might be even more crucial than in adults due to the heterogeneity in seizures phenomenology. The complexity of each case and the technical difficulties in dealing with children, stress even more the importance of a noninvasive tool for diagnosis. In fact, hdEEG not only guided in the presented case SEEG planning but may also in the future offer the possibility to replace it.
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Affiliation(s)
- Michela Quintiliani
- Infantile Neuropsychiatry, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Federico Bianchi
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, 00168, Rome, Italy.
| | - Filomena Fuggetta
- Infantile Neuropsychiatry, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | | | - Antonia Ramaglia
- Institute of Radiology, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
| | - Domenica Immacolata Battaglia
- Infantile Neuropsychiatry, Fondazione Policlinico Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - Gianpiero Tamburrini
- Pediatric Neurosurgery, Fondazione Policlinico Universitario A. Gemelli IRCCS, Largo F. Vito 1, 00168, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
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Han Y, Tong X, Wang X, Teng F, Deng Q, Zhou J, Guan Y, Yan Z, Chen L, Luan G, Wang M. A concordance study determining language dominance between navigated transcranial magnetic stimulation and the Wada test in patients with drug-resistant epilepsy. Epilepsy Behav 2021; 117:107711. [PMID: 33636527 DOI: 10.1016/j.yebeh.2020.107711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It remains unclear whether transcranial magnetic stimulation (TMS) can replace the Wada test to determine language hemisphere dominance (HD). Using the Wada test as the gold standard, this study aimed to investigate the accuracy of navigated TMS (nTMS) in determining language HD. METHODS This study enrolled nine right-handed patients with drug-resistant epilepsy. We hypothesized that application of nTMS to language-related areas of the language-dominant hemisphere would induce positive manifestation of language dysfunction (LD). To test our hypothesis, the patients were instructed to perform a visual object-naming task while nTMS was applied to the anterior (e.g., Broca's area) and posterior (e.g., Wernicke's area) regions, which are closely related to language processing. The Wada test result was used as the gold standard, and the diagnostic value of nTMS was assessed using the Kappa consistency test. RESULTS The nTMS-induced LD positive rate for the bilateral anterior language areas (85.7%) was higher than that for the posterior language areas (57.1%). There was high consistency between nTMS stimulation of the left anterior and posterior language areas and the Wada test results for determining language HD. In contrast, the consistency of stimulation of the right anterior and posterior transfer sites was moderate (Kappa value = 0.545, P = 0.171) and low, respectively. For the latter, no statistical calculation was performed because stimulation of the right posterior speech area was negative in all patients compared with the Wada test results. CONCLUSIONS Our findings revealed that using nTMS to stimulate language-related left anterior and posterior areas could predict language HD with high accuracy. When the stimulation performance of these areas is positive, nTMS and the Wada test are equally accurate. Observing only negative performance may indicate that language HD has been transferred to the right side.
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Affiliation(s)
- Yixian Han
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xuezhi Tong
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xiongfei Wang
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Fei Teng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Qinqin Deng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Jian Zhou
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Yuguang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Zhaofen Yan
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Lingling Chen
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Guoming Luan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China; Beijing Key Laboratory of Epilepsy, Beijing 100093, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100093, China.
| | - Mengyang Wang
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China.
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Fang S, Wang Y, Jiang T. Epilepsy enhance global efficiency of language networks in right temporal lobe gliomas. CNS Neurosci Ther 2021; 27:363-371. [PMID: 33464718 PMCID: PMC7871790 DOI: 10.1111/cns.13595] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Revised: 12/16/2020] [Accepted: 12/17/2020] [Indexed: 12/11/2022] Open
Abstract
AIMS We analyzed the resting state functional magnetic resonance images to investigate the alterations of neural networks in patients with glioma-related epilepsy (GRE). METHODS Fifty-six patients with right temporal lower-grade glioma were divided into GRE (n = 28) and non-GRE groups. Twenty-eight healthy subjects were recruited after matching age, sex, and education level. Sensorimotor, visual, language, and left executive control networks were applied to generate functional connectivity matrices, and their topological properties were investigated. RESULTS No significant alterations in functional connectivity were found. The least significant discovery test revealed differences only in the language network. The shortest path length, clustering coefficient, local efficiency, and vulnerability were greater in the non-GRE group than in the other groups. The nodal efficiencies of two nodes (mirror areas to Broca and Wernicke) were weaker in the non-GRE group than in the other groups. The node of degree centrality (Broca), nodal local efficiency (Wernicke), and nodal clustering coefficient (temporal polar) were greater in the non-GRE group than in the healthy group. CONCLUSION Different tumor locations alter different neural networks. Temporal lobe gliomas in the right hemisphere altered the language network. Glioma itself and GRE altered the network in opposing ways in patients with right temporal glioma.
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Affiliation(s)
- Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
- Department of NeurosurgeryBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Yinyan Wang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
- Department of NeurosurgeryBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
| | - Tao Jiang
- Beijing Neurosurgical Institute, Capital Medical UniversityBeijingChina
- Department of NeurosurgeryBeijing Tiantan HospitalCapital Medical UniversityBeijingChina
- Research Unit of Accurate Diagnosis, Treatment, and Translational Medicine of Brain Tumors Chinese Academy of Medical SciencesBeijingChina
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Yazbek S, Smayra T, Mallak I, Hage S, Sleilaty G, Atat C, Abdel Hay J, Moussa R. Functional MRI study of language organization in left-handed and right-handed trilingual subjects. Sci Rep 2020; 10:13165. [PMID: 32759954 PMCID: PMC7406510 DOI: 10.1038/s41598-020-70167-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Accepted: 07/24/2020] [Indexed: 11/16/2022] Open
Abstract
Functional MRI (fMRI) is gaining importance in the preoperative assessment of language. Selecting the appropriate language to test by fMRI in trilingual patients is intricate. Our objective is to compare fMRI maps for all three languages in left- and right-handed trilingual subjects. 15 right- and 15 left-handed trilingual volunteers were included in the study. We performed fMRI for each volunteer with a visual responsive naming paradigm that was repeated three times, once in each language. The activated areas and the laterality indices were calculated and correlation with the age of acquisition and proficiency of each language was determined. Strong statistical correlation was found between the Laterality Index (LI) of the three languages, in both the right and left-handed groups. Discordant lateralization of language was only observed in four left-handed subjects who demonstrated bilateral and left-lateralization. In right-handed subjects, the activation maps for the first and the second acquired language were similar. The largest activation was seen with the last acquired language. Irrespective of language proficiency and age of acquisition, the language lateralization might change for left-handed subjects. In right-handed subjects, there is no change and the last acquired language results in the largest activation. fMRI performed for a single language can accurately determine language lateralization in right-handed subjects, whereas in left-handed subjects, it is mandatory to test all languages.
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Affiliation(s)
- Sandrine Yazbek
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon.
| | - Tarek Smayra
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Iyad Mallak
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Stephanie Hage
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Ghassan Sleilaty
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Chirine Atat
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Joe Abdel Hay
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
| | - Ronald Moussa
- Hotel Dieu de France Hospital, Boulevard Alfred Naccache, Achrafieh, PO Box: 166830, Beirut, Lebanon
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Nath A, Robinson M, Magnotti J, Karas P, Curry D, Paldino M. Determination of Differences in Seed-Based Resting State Functional Magnetic Resonance Imaging Language Networks in Pediatric Patients with Left- and Right-Lateralized Language: A Pilot Study. J Epilepsy Res 2019; 9:93-102. [PMID: 32509544 PMCID: PMC7251337 DOI: 10.14581/jer.19011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 01/24/2020] [Accepted: 01/24/2020] [Indexed: 11/03/2022] Open
Abstract
Background and Purpose The current tools available for localization of expressive language, including functional magnetic resonance imaging (fMRI) and cortical stimulation mapping (CSM), require that the patient remain stationary and follow language commands with precise timing. Many pediatric epilepsy patients, however, have intact language skills but are unable to participate in these tasks due to cognitive impairments or young age. In adult subjects, there is evidence that language laterality can be determined by resting state (RS) fMRI activity, however there are few studies on the use of RS to accurately predict language laterality in children. Methods A retrospective review of pediatric patients at Texas Children's Hospital was performed to identify patients who have undergone epilepsy surgical planning over 3 years with language localization using traditional methods of Wada testing, CSM, or task-based fMRI with calculated laterality index, as well as a 7-minute RS scan available without excessive motion or noise. We found the correlation between each subject's left and right Broca's region activity and each of 68 cortical regions. Results A group of nine patients with left-lateralized language were found to have greater voxel-wise correlations than a group of six patients with right-lateralized language between a left hemispheric Broca's region seed and the following six cortical regions: left inferior temporal, left lateral orbitofrontal, left pars triangularis, right lateral orbitofrontal, right pars orbitalis and right superior frontal regions. Conclusions In a cohort of children with epilepsy, we found that patients with left- and right-hemispheric language lateralization have different RS networks.
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Affiliation(s)
- Audrey Nath
- Department of Pediatric Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Meghan Robinson
- Core for Advanced MRI, Baylor College of Medicine, Houston, TX, USA
| | - John Magnotti
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Patrick Karas
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Daniel Curry
- Division of Pediatric Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Michael Paldino
- Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
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