BACKGROUND: fMRI language tasks readily identify frontal language areas; temporal activation has been less consistent. No studies have compared clinical visual judgment to quantitative region of interest (ROI) analysis. OBJECTIVE: To identify temporal language areas in patients with partial epilepsy using a reading paradigm with clinical and ROI interpretation. METHODS: Thirty patients with temporal lobe epilepsy, aged 8 to 56 years, had 1.5-T fMRI. Patients silently named an object described by a sentence compared to a visual control. Data were analyzed with ROI analysis from t-maps. Regional asymmetry indices (AI) were calculated ([L-R]/[L+R]) and language dominance defined as >0.20. t-Maps were visually rated by three readers at three t thresholds. Twenty-one patients had intracarotid amobarbital test (IAT). RESULTS: The fMRI reading task provided evidence of language lateralization in 27 of 30 patients with ROI analysis. Twenty-five were left dominant, two right, one bilateral, and two were nondiagnostic; IAT and fMRI agreed in most patients, three had partial agreement, none overtly disagreed. Interrater agreement ranged between 0.77 to 0.82 (Cramer V; p < 0.0001); agreement between visual and ROI reading with IAT was 0.71 to 0.77 (Cramer V; p < 0.0001). Viewing data at lower thresholds added interpretation to 12 patients on visual analysis and 8 with ROI analysis. CONCLUSIONS: An fMRI reading paradigm can identify language dominance in frontal and temporal areas. Clinical visual interpretation is comparable to quantitative ROI analysis.
BACKGROUND: fMRI language tasks readily identify frontal language areas; temporal activation has been less consistent. No studies have compared clinical visual judgment to quantitative region of interest (ROI) analysis. OBJECTIVE: To identify temporal language areas in patients with partial epilepsy using a reading paradigm with clinical and ROI interpretation. METHODS: Thirty patients with temporal lobe epilepsy, aged 8 to 56 years, had 1.5-T fMRI. Patients silently named an object described by a sentence compared to a visual control. Data were analyzed with ROI analysis from t-maps. Regional asymmetry indices (AI) were calculated ([L-R]/[L+R]) and language dominance defined as >0.20. t-Maps were visually rated by three readers at three t thresholds. Twenty-one patients had intracarotid amobarbital test (IAT). RESULTS: The fMRI reading task provided evidence of language lateralization in 27 of 30 patients with ROI analysis. Twenty-five were left dominant, two right, one bilateral, and two were nondiagnostic; IAT and fMRI agreed in most patients, three had partial agreement, none overtly disagreed. Interrater agreement ranged between 0.77 to 0.82 (Cramer V; p < 0.0001); agreement between visual and ROI reading with IAT was 0.71 to 0.77 (Cramer V; p < 0.0001). Viewing data at lower thresholds added interpretation to 12 patients on visual analysis and 8 with ROI analysis. CONCLUSIONS: An fMRI reading paradigm can identify language dominance in frontal and temporal areas. Clinical visual interpretation is comparable to quantitative ROI analysis.
Authors: William D Gaillard; Bonnie C Sachs; Joseph R Whitnah; Zaaira Ahmad; Lyn M Balsamo; Jeffrey R Petrella; Suzanne H Braniecki; Christopher M McKinney; Kevin Hunter; Ben Xu; Cecile B Grandin Journal: Hum Brain Mapp Date: 2003-03 Impact factor: 5.038
Authors: K Deblaere; P A Boon; P Vandemaele; A Tieleman; K Vonck; G Vingerhoets; W Backes; L Defreyne; E Achten Journal: Neuroradiology Date: 2004-05-01 Impact factor: 2.804
Authors: Madison M Berl; Jessica Mayo; Erin N Parks; Lisa R Rosenberger; John VanMeter; Nan Bernstein Ratner; Chandan J Vaidya; William Davis Gaillard Journal: Hum Brain Mapp Date: 2012-10-03 Impact factor: 5.038
Authors: Yu-Hsuan A Chang; Nobuko Kemmotsu; Kelly M Leyden; N Erkut Kucukboyaci; Vicente J Iragui; Evelyn S Tecoma; Leena Kansal; Marc A Norman; Rachelle Compton; Tobin J Ehrlich; Vedang S Uttarwar; Anny Reyes; Brianna M Paul; Carrie R McDonald Journal: Brain Lang Date: 2017-04-20 Impact factor: 2.381