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Language dominance in partial epilepsy patients identified with an fMRI reading task.

W D Gaillard1, L Balsamo, B Xu

  • 1Department of Neurosciences, Children's National Medical Center, George Washington University School of Medicine, Washington, DC, USA. gaillardw@ninds.nih.gov

Neurology
|July 24, 2002
PubMed
Summary
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Functional MRI (fMRI) reading tasks effectively identify language dominance in temporal lobe epilepsy patients. Visual interpretation of fMRI data is as reliable as quantitative region of interest (ROI) analysis for determining language areas.

Area of Science:

  • Neuroimaging
  • Neurology
  • Epilepsy

Background:

  • Functional MRI (fMRI) reliably detects frontal language areas but shows inconsistent temporal lobe activation.
  • Previous studies have not compared clinical visual judgment with quantitative region of interest (ROI) analysis for temporal language areas.

Purpose of the Study:

  • To identify temporal language areas in patients with partial epilepsy using a reading paradigm.
  • To compare clinical visual interpretation with quantitative ROI analysis of fMRI data.

Main Methods:

  • Thirty temporal lobe epilepsy patients (aged 8-56) underwent 1.5-T fMRI using a silent object naming task versus a visual control.
  • Data were analyzed using ROI analysis of t-maps, calculating asymmetry indices (AI) for language dominance (>0.20).
  • t-Maps were visually rated by three readers, and results compared with intracarotid amobarbital test (IAT) in 21 patients.

Related Experiment Videos

Main Results:

  • The fMRI reading task successfully lateralized language in 27 of 30 patients (ROI analysis).
  • Twenty-five patients showed left dominance, two right, one bilateral; IAT and fMRI results showed high agreement.
  • Interrater reliability for visual and ROI analysis was high (Cramer V 0.77-0.82), with comparable agreement to IAT (Cramer V 0.71-0.77).

Conclusions:

  • An fMRI reading paradigm effectively identifies language dominance in both frontal and temporal regions.
  • Clinical visual interpretation of fMRI data is a reliable method, comparable to quantitative ROI analysis.