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Functional MRI Localization of Language in a 9-Year-Old Child

Published online by Cambridge University Press:  18 September 2015

R.R. Benson ,
W.J. Logan ,
G.R. Cosgrove ,
A.J. Cole ,
H. Jiang ,
L.L. LeSueur ,
B.R. Buchbinder ,
B.R. Rosen  and
V.S. Caviness Jr
R.R. Benson*
Affiliation:
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto
W.J. Logan
Affiliation:
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto
G.R. Cosgrove
Affiliation:
Department of Neurology, Massachusetts General Hospital. Boston
A.J. Cole
Affiliation:
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto
H. Jiang
Affiliation:
Department of Neurology, Massachusetts General Hospital. Boston
L.L. LeSueur
Affiliation:
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto
B.R. Buchbinder
Affiliation:
Department of Neurosurgery, Massachusetts General Hospital, Boston
B.R. Rosen
Affiliation:
Department of Neurosurgery, Massachusetts General Hospital, Boston
V.S. Caviness Jr
Affiliation:
Division of Neurology, The Hospital for Sick Children, University of Toronto, Toronto
*
Massachusetts General Hospital, Harvard Medical School. Bldg. 149. 13th Street, Charlestown. MA USA 02129-2060
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Abstract

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Background: Localizing critical brain functions such as language in children is difficult and generally requires invasive techniques. Recently sensory, motor and language functions in adults have been mapped to specific brain locations using functional imaging techniques. Of these techniques, functional MRI (fMRI) is the least invasive and has the highest spatial and temporal resolution. Its use in adults is well documented but application to children has not been as well described. In the present study lateralization and localization of language was evaluated with fMRI prior to epilepsy surgery in a nine-year-old male with complex partial seizures, attentional difficulty and decreased verbal proficiency. Methods: Two language paradigms well studied in adults (read, verb generation) and two additional language paradigms (antonym generation, letter fluency) were studied using whole brain fMRI after stimulus items and timing were adjusted to achieve the desired performance level during imaging. The patient was also conditioned to the magnet environment prior to imaging. Results: Word reading and letter fluency tasks produced lateralized and localized activation similar to that seen in adults. The patient had no language deficits following an anterior 2/3 dominant temporal lobe resection. Conclusions: With modifications of protocols such as those detailed in this report, this non-invasive method for localizing language function is feasible for the presurgical evaluation of children as well being applicable for a variety of developmental language issues.

Résumé

Résumé

Localisation fonctionnelle du langage par RMN chez un enfant de 9 ans. Introduction: Il est difficile de localiser des fonctions critiques du cerveau comme le langage chez les enfants et une telle tâche requiert généralement des techniques invasives. Dernièrement, on a localisé à certaines régions spécifiques du cerveau des fonctions sensorielles, motrices et linguistiques chez des adultes au moyen de techniques d’imagerie fonctionnelle. Parmi ces techniques, la RMN fonctionnelle (RMNf) est la moins invasive et possède la meilleure résolution spatiale et temporale. Son utilisation chez les adultes est bien documentée, mais son application chez les enfants n’a pas été bien décrite. Dans cette étude, la latéralisation et la localisation du langage ont été évaluées par RMNf avant une chirurgie pour épilepsie chez un enfant de neuf ans qui avait des crises partielles complexes, des difficultés d’attention et une habileté verbale limitée. Méthodes: Deux paradigmes du langage qui ont été bien étudiés chez les adultes (la lecture, la génération des verbes) et deux paradigmes additionnels du langage (la génération des antonymes, la maîtrise des lettres) ont été étudiés au moyen de la RMNf du cerveau entier après avoir ajusté les items servant au stimulus et le chronométrage pour obtenir le niveau de performance désiré pendant l’imagerie. Le patient avait aussi été conditionné à l’environnement avant l’imagerie. Résultats: Les tâches impliquant lecture de mots et la maîtrise des lettres ont produit une activation latéralisée et localisée semblable à celle observée chez les adultes. Le patient n’avait pas de déficit du langage suite à une résection des deux tiers antérieurs du lobe temporal dominant. Conclusions: Avec des modifications du protocole comme celles qui sont décrites dans cet article, cette méthode non invasive pour localiser la fonction linguistique est utilisable pour l’évaluation préopératoire des enfants ainsi que pour certaines questions relatives au développement du langage.

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 23 , Issue 3 , August 1996 , pp. 213 - 219
Copyright
Copyright © Canadian Neurological Sciences Federation 1996

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