Comparison between visual half-field performance and cerebral blood flow changes as indicators of language dominance.

The determination of hemispheric language dominance (HLD) can be accomplished in two ways. One approach relies on hemispheric differences in cerebral blood flow velocity (CBFV) changes during language activity, while the other approach makes use of performance differences between the left and right visual field when verbal stimuli are presented in a tachistoscopic visual field paradigm. Since both methodologically different approaches claim to assess functional HLD, it seems plausible to expect that the respective laterality indices (LI) would correspond. To test this expectation we measured language lateralisation in 58 healthy right-handed, left-handed, and ambidextrous subjects with both approaches. CBFV changes were recorded with functional transcranial Doppler sonography (fTCD). We applied a lexical decision task with bilateral visual field presentation of abstract nouns and, in addition, a task of mental word generation. In the lexical decision task, a highly significant right visual field advantage was observed for number of correct responses and reaction times, while at the same time and contrary to expectation the increase of CBFV was significantly higher in the right than left hemisphere. During mental word generation, the acceleration of CBF was significantly higher in the left hemisphere. A comparison between individual LI derived from CBF measurement during mental word generation and from visual field performances in the lexical decision task showed a moderate correspondence in classifying the subjects' HLD. However, the correlation between the corresponding individual LI was surprisingly low and not significant. The results are discussed with regard to the issue of a limited reliability of behavioural LI on the one hand and the possibility of a fundamental difference between the behavioural and the physiological indicators of laterality on the other hand.