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Improving language mapping in clinical fMRI through assessment of grammar.
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Improving language mapping in clinical fMRI through assessment of grammar.
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Połczyńska, Monika; Japardi, Kevin; Curtiss, Susan; Moody, Teena; Benjamin, Christopher; Cho, Andrew; Vigil, Celia; Kuhn, Taylor; Jones, Michael; Bookheimer, Susan. - : eScholarship, University of California, 2017
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Abstract:
IntroductionBrain surgery in the language dominant hemisphere remains challenging due to unintended post-surgical language deficits, despite using pre-surgical functional magnetic resonance (fMRI) and intraoperative cortical stimulation. Moreover, patients are often recommended not to undergo surgery if the accompanying risk to language appears to be too high. While standard fMRI language mapping protocols may have relatively good predictive value at the group level, they remain sub-optimal on an individual level. The standard tests used typically assess lexico-semantic aspects of language, and they do not accurately reflect the complexity of language either in comprehension or production at the sentence level. Among patients who had left hemisphere language dominance we assessed which tests are best at activating language areas in the brain.MethodWe compared grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking) with standard tests (object naming, auditory and visual responsive naming), using pre-operative fMRI. Twenty-five surgical candidates (13 females) participated in this study. Sixteen patients presented with a brain tumor, and nine with epilepsy. All participants underwent two pre-operative fMRI protocols: one including CYCLE-N grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking); and a second one with standard fMRI tests (object naming, auditory and visual responsive naming). fMRI activations during performance in both protocols were compared at the group level, as well as in individual candidates.ResultsThe grammar tests generated more volume of activation in the left hemisphere (left/right angular gyrus, right anterior/posterior superior temporal gyrus) and identified additional language regions not shown by the standard tests (e.g., left anterior/posterior supramarginal gyrus). The standard tests produced more activation in left BA 47. Ten participants had more robust activations in the left hemisphere in the grammar tests and two in the standard tests. The grammar tests also elicited substantial activations in the right hemisphere and thus turned out to be superior at identifying both right and left hemisphere contribution to language processing.ConclusionThe grammar tests may be an important addition to the standard pre-operative fMRI testing.
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Keyword:
Adult; Brain Mapping; Brain Neoplasms; Cerebral Cortex; Curtiss-Yamada Comprehensive Language Evaluation: Neurological Measures; CYCLE-N; Epilepsy; Female; fMRI; functional magnetic resonance imaging; Grammar; Humans; Language; Language Disorders; left hemisphere; LH; Linguistics; Magnetic Resonance Imaging; Male; Middle Aged; Neurosciences; Neurosurgical Procedures; Postoperative Complications; RH; right hemisphere; Surgery; Tumor; Young Adult
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URL: https://escholarship.org/uc/item/08b6b0ht
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Exploring Neuronal Plasticity: Language Development in Pediatric Hemispherectomies
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In: de Bode, Stella; & Curtiss, Susan. (2001). Exploring Neuronal Plasticity: Language Development in Pediatric Hemispherectomies. Proceedings of the Cognitive Science Society, 23(23). Retrieved from: http://www.escholarship.org/uc/item/1kv4v9r7 (2001)
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