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fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca’s area

  • Functional Neuroradiology
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Abstract

Introduction

Functional MRI (fMRI) can assess language lateralization in brain tumor patients; however, this can be limited if the primary language area—Broca’s area (BA)—is affected by the tumor. We hypothesized that the middle frontal gyrus (MFG) can be used as a clinical indicator of hemispheric dominance for language during presurgical workup.

Methods

Fifty-two right-handed subjects with solitary left-hemispheric primary brain tumors were retrospectively studied. Subjects performed a verbal fluency task during fMRI. The MFG was compared to BA for fMRI voxel activation, language laterality index (LI), and the effect of tumor grade on the LI.

Results

Language fMRI (verbal fluency) activated more voxels in MFG than in BA (MFG = 315, BA = 216, p < 0.001). Voxel activations in the left-hemispheric MFG and BA were positively correlated (r = 0.69, p < 0.001). Mean LI in the MFG was comparable to that in BA (MFG = 0.48, BA = 0.39, p = 0.06). LIs in MFG and BA were positively correlated (r = 0.62, p < 0.001). Subjects with high-grade tumors demonstrate lower language lateralization than those with low-grade tumors in both BA and MFG (p = 0.02, p = 0.02, respectively).

Conclusion

MFG is comparable to BA in its ability to indicate hemispheric dominance for language using a measure of verbal fluency and may be an adjunct measure in the clinical determination of language laterality for presurgical planning.

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Abbreviations

BA:

Broca’s area

LI:

Laterality index

MFG:

Middle frontal gyrus

ROI:

Region of interest

DCS:

Direct cortical stimulation

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Authors and Affiliations

  1. Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA

    Jian W. Dong, Nicole M. Petrovich Brennan, Giana Izzo, Kyung K. Peck & Andrei I. Holodny

  2. New York University School of Medicine, New York, NY, USA

    Jian W. Dong

  3. Department of Bioimaging and Radiological Sciences, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy

    Giana Izzo

  4. Department of Medical Physics and the Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA

    Kyung K. Peck & Andrei I. Holodny

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  1. Jian W. Dong
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Corresponding author

Correspondence to Andrei I. Holodny.

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We declare that all human and animal studies have been approved by the Institutional Review Board and have therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments. We declare that all patients gave informed consent prior to inclusion in this study.

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We declare that we have no conflict of interest.

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Dong, J.W., Brennan, N.M.P., Izzo, G. et al. fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca’s area. Neuroradiology 58, 513–520 (2016). https://doi.org/10.1007/s00234-016-1655-4

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