| Threshold-independent functional MRI determination of language dominance: a validation study against clinical gold standards. | |
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MedLine Citation:
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PMID: 19733509 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Functional MRI (fMRI) is often used for presurgical language lateralization. In the most common approach, a laterality index (LI) is calculated on the basis of suprathreshold voxels. However, strong dependencies between LI and threshold can diminish the effectiveness of this technique; in this study we investigated an original methodology that is independent of threshold. We compared this threshold-independent method against the common threshold-dependent method in 14 patients with epilepsy who underwent Wada testing. In addition, clinical results from electrocortical language mapping and postoperative language findings were used to assess the validity of the fMRI lateralization method. The threshold-dependent methodology yielded ambiguous or incongruent lateralization outcomes in 4 of 14 patients in the inferior frontal gyrus (IFG) and in 6 of 14 patients in the supramarginal gyrus (SMG). Conversely, the threshold-independent method yielded unambiguous lateralization in all the patients tested, and demonstrated lateralization outcomes incongruent with clinical standards in 2 of 14 patients in IFG and in 1 of 14 patients in SMG. This validation study demonstrates that the threshold-dependent LI calculation is prone to significant within-patient variability that could render results unreliable; the threshold-independent method can generate distinct LIs that are more concordant with gold standard clinical findings. |
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Authors:
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Ralph O Suarez; Stephen Whalen; Aaron P Nelson; Yanmei Tie; Mary-Ellen Meadows; Alireza Radmanesh; Alexandra J Golby |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Validation Studies Date: 2009-09-04 |
Journal Detail:
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Title: Epilepsy & behavior : E&B Volume: 16 ISSN: 1525-5069 ISO Abbreviation: Epilepsy Behav Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2009-10-06 Completed Date: 2009-12-07 Revised Date: 2011-05-09 |
Medline Journal Info:
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Nlm Unique ID: 100892858 Medline TA: Epilepsy Behav Country: United States |
Other Details:
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Languages: eng Pagination: 288-97 Citation Subset: IM |
Affiliation:
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Department of Radiology, Brigham and Women's Hospital and Harvard Medical School, Boston, MA 02115, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Amobarbital / administration & dosage, diagnostic use, pharmacology Analysis of Variance Brain / blood supply*, pathology, physiopathology Brain Mapping* Epilepsy, Temporal Lobe / pathology*, physiopathology Female Functional Laterality / physiology* Humans Image Processing, Computer-Assisted / methods Language* Language Tests Magnetic Resonance Imaging / methods*, standards Male Middle Aged Neuropsychological Tests Oxygen / blood Photic Stimulation Preoperative Care Reproducibility of Results Young Adult |
| Grant Support | |
ID/Acronym/Agency:
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3U41RR019703-03S1/RR/NCRR NIH HHS; K08 NS048063-04/NS/NINDS NIH HHS; K08 NS048063-05/NS/NINDS NIH HHS; K08-NS048063-02/NS/NINDS NIH HHS; U41 RR019703-01A29003/RR/NCRR NIH HHS; U41 RR019703-028713/RR/NCRR NIH HHS; U41 RR019703-037948/RR/NCRR NIH HHS; U41 RR019703-045853/RR/NCRR NIH HHS; U41-RR019703/RR/NCRR NIH HHS |
| Chemical | |
Reg. No./Substance:
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57-43-2/Amobarbital; 7782-44-7/Oxygen |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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