Language Representation

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Dissociated language functions are largely invalidated by standard techniques such as the amobarbital test and cortical stimulation. Language studies in which magnetoencephalography (MEG) and functional magnetic resonance (fMR) imaging are used to record data while the patient performs lexicosemantic tasks have enabled researchers to perform independent brain mapping for temporal and frontal language functions (MEG is used for temporal and fMR imaging for frontal functions). In this case report, the authors describe a right-handed patient in whom a right-sided insular glioma was diagnosed. The patient had a right-lateralized receptive language area, but expressive language function was identified in the left hemisphere on fMR imaging– and MEG-based mapping. Examinations were performed in 20 right-handed patients with low-grade gliomas (control group) for careful comparison with and interpretation of this patient's results. In these tests, all patients were asked to generate verbs related to acoustically presented nouns (verb generation) for fMR imaging, and to categorize as abstract or concrete a set of visually presented words consisting of three Japanese letters for fMR imaging and MEG.

The most prominent display of fMR imaging activation by the verb-generation task was observed in the left inferior and middle frontal gyri in all participants, including the patient presented here. Estimated dipoles identified with the abstract/concrete categorization task were concentrated in the superior temporal and supra-marginal gyri in the left hemisphere in all control patients. In this patient, however, the right superior temporal region demonstrated significantly stronger activations on MEG and fMR imaging with the abstract/concrete categorization task. Suspected dissociation of the language functions was successfully mapped with these two imaging modalities and was validated by the modified amobarbital test and the postoperative neurological status. The authors describe detailed functional profiles obtained in this patient and review the cases of four previously described patients in whom dissociated language functions were found.

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1

Benson RRFitzGerald DBLeSueur LLKennedy DNKwong KKBuchbinder BR: Language dominance determined by whole brain functional MRI in patients with brain lesions. Neurology 52:7988091999

2

Binder JRSwanson SJHammeke TAMorris GLMueller WMFischer M: Determination of language dominance using functional MRI: a comparison with the Wada test. Neurology 46:9789841996

3

Gaillard WDBalsamo LXu BMcKinney CPapero PHWeinstein S: fMRI language task panel improves determination of language dominance. Neurology 63:140314082004

4

Hunter KEBlaxton TABookheimer SYFiglozzi CGaillard WDGrandin C: (15)O water positron emission tomography in language localization: a study comparing positron emission tomography visual and computerized region of interest analysis with the Wada test. Ann Neurol 45:6626651999

5

Kho KHLeijten FSRutten GJVermeulen JVan Rijen PRamsey NF: Discrepant findings for Wada test and functional magnetic resonance imaging with regard to language function: use of electrocortical stimulation to confirm results. Case report. J Neurosurg 102:1691732005

6

Nathoo NNair DPhillips MVogelbaum MA: Mapping prosody: correlation of functional magnetic resonance imaging with intraoperative electrocorticography recordings in a patient with a right-sided temporooccipital glioma. Case illustration. J Neurosurg 103:9302005

7

Ross EDAffective prosody and the aprosodias. Mesulam MM: Principles of Behavioral and Cognitive Neurology ed 2New YorkOxford University Press2000. 316331

8

Rutten GJRamsey NFvan Rijen PCAlpherts WCvan Veelen CW: fMRI-determined language lateralization in patients with unilateral or bilateral language dominance according to the Wada test. Neuroimage 17:4474602002

9

Rutten GJRamsey NFvan Rijen PCNoordmans HJvan Veelen CW: Development of a functional MRI protocol for intraoperative localization of critical temporoparietal language areas. Ann Neurol 51:3503602002

10

Sabsevitz DSSwanson SJHammeke TASpanaki MVPossing ETMorris GL III: Use of preoperative functional neuroimaging to predict language deficits from epilepsy surgery. Neurology 60:178817922003

11

Spreer JArnold SQuiske AWohlfarth RZiyeh SAltenmuller D: Determination of hemisphere dominance for language: comparison of frontal and temporal fMRI activation with intra-carotid amytal testing. Neuroradiology 44:4674742002

12

Springer JABinder JRHammeke TASwanson SJFrost JABellgowan PS: Language dominance in neurologically normal and epilepsy subjects: a functional MRI study. Brain 122:Pt 11203320461999

13

Wyllie ELuders HMurphy DMorris H IIIDinner DLesser R: Intracarotid amobarbital (Wada) test for language dominance: correlation with results of cortical stimulation. Epilepsia 31:1561611990

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