Picture-naming in patients with left frontal lobe tumor - a functional neuroimaging study

The objective of this study was to investigate behavioral performance as well as cortical activation patterns while picture-naming, in patients with left frontal lobe tumor prior to surgery. Functional magnetic resonance imaging was used to compare behavior and brain activations while 10 patients with a tumor in the left frontal lobe and 9 controls, named aloud simple pictures presented in a block design inside a 3 T Philips Achieva scanner. Evaluations of task performance included naming accuracy and articulation time. Behaviorally, patients took significantly longer to articulate picture names but naming accuracy was preserved. Analysis of brain activations showed differences only in the frontal regions of the cortical network. In particular, while the frontal activations in the control population were focused and localized in the left inferior orbito-frontal gyrus, in patients the frontal network was distributed and included a significantly greater number of clusters that were distributed in homologous or near homologous areas of the (orbito-frontal gyrus) left and/or right hemisphere of the frontal lobe. Our results suggest that in patients with a left frontal lobe tumor the process of naming simple pictures is preserved but the cortical network of activation in the frontal region is altered and is distributed in the frontal regions of both hemispheres.