Sasan Partovi BS, Presenter: Nothing to Disclose

Sasan Karimi MD, Abstract Co-Author: Nothing to Disclose

Lisa Zipp BS, Abstract Co-Author: Nothing to Disclose

John Lyo MD, Abstract Co-Author: Nothing to Disclose

Christoph Stippich MD, Abstract Co-Author: Nothing to Disclose

The purpose of this study was to systematically analyze presurgical language lateralization using fMRI in brain tumor patients including a comparison with heathy volunteers.

57 strictly right-handed patients with brain tumors (32 males, mean age 44.3 years) localized in the left hemisphere affecting either Broca’s area (B, n=19) or Wernicke’s area (W, n=38) were enroled in this prospective trial and compared to 14 strictly right handed healthy volunteers (7 males, mean age 27 years). Each participant underwent standardized whole head BOLD fMRI of language function at 1.5 Tesla using visually triggered sentence generation (SG) for determining W/WR and word generation (WG) for determining B/BR. Semi-automated analysis of all functional data was performed on an individual basis according to a protocol previously published (Stippich C et al. Radiology 2007). Regional lateralization indexes (LI) were calculated for B/BR and for W/WR separately and were compared between both groups performing Mann-Whitney-U-Test, p<0.05 was considered significant.

WG revealed a median LI value of -0.215 in the patient group (standard deviation 0.768, mean value 0.010) for B/BR (healthy volunteers: median value 0.970, standard deviation 0.367, mean value 0.825) and a significant difference between the two groups (p=0.017). (Figure 1 A). SG revealed a median LI value of 0.500 in the patient group (standard deviation 0.644, mean value 0.232) for W/WR (volunteers: median value 0.960, standard deviation 0.717, mean value 0.653) and a significant difference between both groups (p=0.007). (Figure 1 B).  

Significant alterations in fMRI language lateralization were demonstrated in patients with brain tumors. The data support the hypothesis that brain tumors affecting language relevant areas lead to cortical reorganization in terms of a shift of the dominant hemisphere to the contralateral side. This effect also impacts the diagnostic capabilities of the technique. Further validation studies are needed to give extent to this statement.

In clinical language fMRI brain tumors affecting language relevant areas have an impact on language lateralization.

Partovi, S, Karimi, S, Zipp, L, Lyo, J, Stippich, C, FMRI Reveals Altered Language Lateralization in Brain Tumor Patients.  Radiological Society of North America 2011 Scientific Assembly and Annual Meeting, November 26 - December 2, 2011 ,Chicago IL. http://archive.rsna.org/2011/11004955.html