Do women really have more bilateral language representation than men? A meta-analysis of functional imaging studies

Sex differences in cognition are consistently reported, men excelling in most visuospatial tasks and women in certain verbal tasks. It has been hypothesized that these sex differences in cognition results from a more bilateral pattern of language representation in women than in men. This bilateral pattern of language representation in women is thought to interfere with visuospatial functions in the right hemisphere. To test whether language representation is indeed more bilateral in the female than in the male brain, a meta-analysis was performed on studies that assessed language activity with functional imaging in healthy men and women. Effect sizes were weighted for sample size and the meta-analytic method was applied to obtain a combined effect size. Fourteen studies were included, providing data on 377 men and 442 women. Meta-analysis yielded a mean weighted effect d of 0.21 with a 95% confidence interval of -0.05 to 0.48, indicating no significant difference in language lateralization between men and women. This implies that the putative sex difference in language lateralization may be absent at the population level, or may be observed only with some, as yet not defined, language tasks. It is therefore not likely that differences in language lateralization underlie the general sex differences in cognitive performance, and the neuronal basis for these cognitive sex differences remains elusive.