Clinical neurophysiology of language: the MEG approach

Clinical evaluation of language function and basic neuroscience research into the neurophysiology of language are tied together. Whole-head MEG systems readily facilitate detailed spatiotemporal characterization of language processes. A fair amount of information is available about the cortical sequence of word perception and comprehension in the auditory and visual domain, which can be applied for clinical use. Language production remains, at present, somewhat less well charted. In clinical practice, the most obvious needs are noninvasive evaluation of the language-dominant hemisphere and mapping of areas involved in language performance to assist surgery. Multiple experimental designs and analysis approaches have been proposed for estimation of language lateralization. Some of them have been compared with the invasive Wada test and need to be tested further. Development of approaches for more comprehensive pre-surgical characterization of language cortex should build on basic neuroscience research, making use of parametric designs that allow functional mapping. Studies of the neural basis of developmental and acquired language disorders, such as dyslexia, stuttering, and aphasia can currently be regarded more as clinical or basic neuroscience research rather than as clinical routine. Such investigations may eventually provide tools for development of individually targeted training procedures and their objective evaluation.