Functional Magnetic Resonance Imaging of Language in Epilepsy

Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, USA.
Neuropsychology Review (Impact Factor: 4.59). 01/2008; 17(4):491-504. DOI: 10.1007/s11065-007-9050-x
Source: PubMed


Functional magnetic resonance imaging (fMRI) has revolutionized our understanding of functional networks and cerebral organization in both normal and pathological brains. In the present review, we describe the use of fMRI for mapping language in epilepsy patients prior to surgical intervention including a discussion of methodological issues and task design, comparisons between fMRI and the intracarotid sodium amobarbital test, fMRI studies of language reorganization, and the use of fMRI laterality indexes to predict outcome after anterior temporal lobectomy.

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    • "In the present study both groups of children with BECTS showed increased ReHo in left inferior frontal gyrus (IFG; Broca's area) and middle frontal gyrus (MFG) when compared to controls, areas that are established regions in the language network in both healthy children and adults as well as in patients with epilepsy (Friederici and Gierhan, 2013; Scharff et al., 2013; Swanson et al., 2007). The increased ReHo value in these language regions might indicate abnormal enhanced coherence patterns which might serve to interrupt normal language network and function. "
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    ABSTRACT: Objective: The purpose of this study was to investigate regional homogeneity (ReHo) in children with new-onset drug-naïve Benign Epilepsy with Centrotemporal Spikes (BECTS), chronic BECTS and healthy controls (HC) using the Regional Homogeneity (ReHo) method applied to resting state fMRI data. Methods: Resting state fMRI data was collected from three groups of children aged 6-13, including new onset drug naïve BECTS, chronic BECTS with medication, and HC; the data analyzed by ReHo method. Mandarin school exams scores were acquired and compared across groups. Results: There were three main findings. Firstly, compared with HC, abnormally increased ReHo was observed in bilateral sensorimotor regions in new onset BECTS which normalized or even reversed in the chronic BECTS group. Secondly, enhanced ReHo was found in the left frontal language region in the two BECTS groups, with even higher ReHo value in the chronic group. Lastly, decreased ReHo was found in regions of the default mode network (DMN), bilateral occipital lobes and cerebellum in both the new onset and chronic BECTS groups, lower in chronic BECTS. Behavioral analyses of school scores showed the chronic BECTS group presented significantly lower scores compared to HC (p<.05). Significance: The coherence of low frequency fluctuations is disrupted in sensorimotor, language and DMN-related regions in new-onset BECTS. Some of these effects seem to be selectively normalized in chronic BECTS, thus allowing us to explore possible chronicity and AED-induced effects on BECTS. Abnormal ReHo in left language and DMN regions could be responsible for impairments of cognitive function.
    Epilepsy research 09/2015; 116:79-85. DOI:10.1016/j.eplepsyres.2015.06.017 · 2.02 Impact Factor
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    • "However, it is quite possible that the epileptic brains have abnormal functional organization, particularly regarding laterality of language processing (e.g. Swanson et al., 2002, 2007; Hertz-Pannier et al., 2002) and any findings resulting from this population should be interpreted carefully. Note that the present results do not change if this patient group is excluded, but their inclusion allows us to examine (albeit cautiously) the possible involvement of the anterior temporal lobe in speech processing. "
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    ABSTRACT: For more than a century, speech repetition has been used as an assay for gauging the integrity of the auditory-motor pathway in aphasia, thought classically to involve a linkage between Wernicke's area and Broca's area via the arcuate fasciculus. During the last decade, evidence primarily from functional imaging in healthy individuals has refined this picture both computationally and anatomically, suggesting the existence of a cortical hub located at the parietal-temporal boundary (area Spt) that functions to integrate auditory and motor speech networks for both repetition and spontaneous speech production. While functional imaging research can pinpoint the regions activated in repetition/auditory-motor integration, lesion-based studies are needed to infer causal involvement. Previous lesion studies of repetition have yielded mixed results with respect to Spt's critical involvement in speech repetition. The present study used voxel-based lesion symptom mapping (VLSM) to investigate the neuroanatomy of repetition of both real words and non-words in a sample of 47 patients with focal left hemisphere brain damage. VLSMs identified a large voxel cluster spanning gray and white matter in the left temporal-parietal junction, including area Spt, where damage was significantly related to poor non-word repetition. Repetition of real words implicated a very similar dorsal network including area Spt. Cortical regions including Spt were implicated in repetition performance even when white matter damage was factored out. In addition, removing variance associated with speech perception abilities did not alter the overall lesion pattern for either task. Together with past functional imaging work, our results suggest that area Spt is integral in both word and non-word repetition, that its contribution is above and beyond that made by white matter pathways, and is not driven by perceptual processes alone. These findings are highly consistent with the claim that Spt is an area of sensory-motor translation in speech processing. Copyright © 2015. Published by Elsevier Ltd.
    Neuropsychologia 03/2015; 71. DOI:10.1016/j.neuropsychologia.2015.03.012 · 3.30 Impact Factor
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    • "The validity and reliability of language fMRI data profoundly depends on the language task used as well as on the control/baseline condition employed. Ideally, an fMRI paradigm should employ a control condition that contains the same subcomponents as the task condition but exclude the cognitive process to be examined (Swanson et al., 2007). Other basic requirements of language fMRI assessments are that the patient has a good understanding of the tasks in the MR-scanner, sufficient motivation to perform the tasks and a good compliance — since fMRI is sensitive to motion. "
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    ABSTRACT: Objective The aim of this study was to evaluate the clinical use of a method to assess hemispheric language dominance in pediatric candidates for epilepsy surgery. The method is designed for patients but has previously been evaluated with healthy children. Methods Nineteen patients, 8–18 years old, with intractable epilepsy and candidates for epilepsy surgery were assessed. The assessment consisted of two functional MRI protocols (fMRI) intended to target frontal and posterior language networks respectively, and a behavioral dichotic listening task (DL). Regional left/right indices for each fMRI task from the frontal, temporal and parietal lobe were calculated, and left/right indices of the DL task were calculated from responses of consonants and vowels, separately. A quantitative analysis of each patient's data set was done in two steps based on clearly specified criteria. First, fMRI data and DL data were analyzed separately to determine whether the result from each of these assessments were conclusive or not. Thereafter, the results from the individual assessments were combined to reach a final conclusion regarding hemispheric language dominance. Results For 14 of the 19 subjects (74%) a conclusion was reached about their hemispheric language dominance. Nine subjects had a left-sided and five subjects had a right-sided hemispheric dominance. In three cases (16%) DL provided critical data to reach a conclusive result. Conclusions The success rate of conclusive language lateralization assessments in this study is comparable to reported rates on similar challenged pediatric populations. The results are promising but data from more patients than in the present study will be required to conclude on the clinical applicability of the method.
    Clinical neuroimaging 12/2014; 48. DOI:10.1016/j.nicl.2014.12.011 · 2.53 Impact Factor
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