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AJNR - American Journal of Neuroradiology

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American Journal of Neuroradiology 26:1461-1468, June-July 2005
© 2005 American Society of Neuroradiology

BRAIN

Mapping the Functional Anatomy of Sentence Comprehension and Application to Presurgical Evaluation of Patients with Brain Tumor

Manzar Ashtari^a, Kenneth Perrine^a,b,c, Rania Elbaz^a, Uzma Syed^a, Emily Thaden^d, Carolyn McIlree^d, Rima Dolgoff-Kaspar^b, Tana Clarke^a, Alan Diamond^a and Alan Ettinger^a

^a Department of Radiology and Neurology, Long Island Jewish Division of the North Shore-Long Island Jewish Health System, New Hyde Park, New York, NY
^b Department of Psychology, Queens College and the Graduate Center of the City University of New York, New York, NY
^c Department of Neurological Surgery, Cornell-Weill College of Medicine, New York, NY
^d Department of Psychiatry, Zucker Hillside Hospital, New York, NY

Address reprint request to Dr Manzar Ashtari, Department of Radiology and Neurology, Long Island Jewish Division, North Shore–Long Island Jewish Health System, 270-05 76th Avenue, New Hyde Park, NY 11040

BACKGROUND AND PURPOSE: The main clinical indication for functional MR imaging (fMRI) has been to preoperatively map the cortex. Motor paradigms to activate the cortex are simple and robust; however, language tasks show greater variability and difficulty. The aim of this study was to develop a language task with an adequate control task to engage the areas of the posterior temporal lobe responsible for sentence comprehension.

METHODS: We performed a cloze paradigm requiring silent reading of a visually presented sentence-completion task based on semantic meaning versus a letter-scanning epoch requiring the completion of nonlinguistic strings or a rest period. Before this task was clinically used in two patients epilepsy and cavernous angioma, its feasibility and accuracy were tested in 14 healthy right-handed participants.

RESULTS: Results showed significant activation of the posterior temporal cortex, including a broad area across the posterior left temporal cortex extending into the inferior parietal lobule. When the sentence completion–minus-letter string task was compared with the sentence completion–minus-rest task, increased activation was present in the posterior temporal lobe.

CONCLUSION: Decreased significant activation during the sentence completion–minus-rest contrast may be attributed to increased noise from intersubject variability in the rest period. Our results suggest that this task elucidates areas important to reading comprehension in the posterior and inferior temporal regions that verbal fluency and auditory discrimination tasks do not. Data from two cases are summarized to exemplify the input of this task for neurosurgery.