RT Journal Article
SR Electronic
T1 Crossed Cerebrocerebellar Language Lateralization: An Additional Diagnostic Feature for Assessing Atypical Language Representation in Presurgical Functional MR Imaging
JF American Journal of Neuroradiology
JO Am. J. Neuroradiol.
FD American Society of Neuroradiology
SP 518
OP 524
DO 10.3174/ajnr.A4147
VO 36
IS 3
A1 C. Méndez Orellana
A1 E. Visch-Brink
A1 M. Vernooij
A1 S. Kalloe
A1 D. Satoer
A1 A. Vincent
A1 A. van der Lugt
A1 M. Smits
YR 2015
UL http://www.ajnr.org/content/36/3/518.abstract
AB BACKGROUND AND PURPOSE: Determining language dominance with fMRI is challenging in patients with brain tumor, particularly in cases of suspected atypical language representation. Supratentorial activation patterns must be interpreted with great care when the tumor is in or near the presumed language areas, where tumor tissue or mass effect can lead to false-negative fMRI results. In this study, we assessed cerebrocerebellar language fMRI lateralization in healthy participants and in patients with brain tumors with a focus on atypical language representation. MATERIALS AND METHODS: Twenty healthy participants and 38 patients with a brain tumor underwent fMRI with a verb-generation task. Cerebral and cerebellar language lateralizations were separately classified as left-sided, right-sided, or symmetric. Electrocortical stimulation was performed in 19 patients. With the McNemar test, we evaluated the dependency between language lateralization in the cerebrum and cerebellum, and with Pearson correlation analysis, the relationship between the cerebral and cerebellar lateralization indices. RESULTS: There was a significant dependency between cerebral and cerebellar language activation, with moderate negative correlation (Pearson r = −0.69). Crossed cerebrocerebellar language activation was present in both healthy participants and patients, irrespective of handedness or typical or atypical language representation. There were no discordant findings between fMRI and electrocortical stimulation. CONCLUSIONS: Language lateralization in the cerebellum can be considered an additional diagnostic feature to determine language dominance in patients with brain tumor. This is particularly useful in cases of uncertainty, such as the interference of a brain tumor with cerebral language activation on fMRI and atypical language representation. ECSelectrocortical stimulationHPhealthy participantLIlateralization index