Language dominance in patients with early childhood tumors near left hemisphere language areas

Objective. Conduct a comparative analysis of clinical and neurosonographic indicators of intracranial hemorrhage in infants.Materials and methods. In the clinical part of the study, 68 patients took part in the acute / acute periods of intracranial hemorrhage, which we took for the study on the basis of the Tashkent City Children's Clinical Hospital No1. Gender ratios of which were 69.1% boys (47 children) and 30.9% girls (21 children), from birth to 2 months of life (average age at the time of hemorrhage is 36.28 ± 9.85 days). Diagnostic examination included neurosonography (NSG) of all children in the first 24 hours of the implementation of intracranial hemorrhages on admission to the clinic.Results. According to our study of 68 children with intracranial hemorrhage, it turned out that the average age of morbidity was 36.28 ± 9.85 days (p < 0.001) Neurosonographic indicators stated the presence of parenchymal hemorrhage (right and left hemisphere), SAH (subarachnoid hemorrhage), hemorrhage into the trunk, IVH (intraventricular hemorrhage) II, IVH III. According to neurosonography, parenchymal hemorrhage (right-16 or left hemisphere-21) was observed in 37 patients, SAH and IVH-II 21 (30.9%) patients, IVH III – in 17 (25%) patients, hemorrhage in 3 (4.4%) brain stem of patientsConclusion. Analysis of the implementation of hemorrhage showed that not always small gestational age is the risk of hemorrhage. Cases of less severe changes (27%) on NSG with a coarser clinical picture and vice versa (15%), necessitate (taking into account the severity of the neurological state), a more detailed examination, including visualization (CT, MRI).

Download Full-text

Faculty Opinions recommendation of Meta-analyzing left hemisphere language areas: phonology, semantics, and sentence processing.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.1089616.544883 ◽

2007 ◽

Author(s):

Yves Joanette

Keyword(s):

Left Hemisphere ◽

Sentence Processing ◽

Language Areas

Download Full-text

Right-Hemisphere Language Dominance in a Case of Left-Hemisphere Arteriovenous Malformation

Journal of Speech and Hearing Disorders ◽

10.1044/jshd.4201.106 ◽

1977 ◽

Vol 42 (1) ◽

pp. 106-112 ◽

Cited By ~ 9

Author(s):

Robert T. Wertz ◽

Bernard Messert ◽

Michael Collins ◽

Jay C. Rosenbek ◽

Chun C. Kao

Keyword(s):

Arteriovenous Malformation ◽

Left Hemisphere ◽

Right Hemisphere ◽

Surgical Removal ◽

Language Dominance ◽

Language Deficit ◽

Left Handed ◽

Motor Areas

This paper reports a case of surgical removal of a left-hemisphere arteriovenous malformation (AVM) in a left-handed adult without subsequent speech or language deficit. Preoperative intracarotid amobarbital testing indicated right-hemisphere language dominance. Our patient demonstrated no language involvement prior to or following surgery. We speculate the congenital nature of a left-hemisphere AVM may dictate right-hemisphere language dominance, thereby explaining the lack of residuals following removal of AVMs in left-hemisphere speech and motor areas.

Download Full-text

Language Dominance with Left Hemisphere Tumors

Pediatric Neurology Briefs ◽

10.15844/pedneurbriefs-9-2-8 ◽

1995 ◽

Vol 9 (2) ◽

pp. 14

Author(s):

J Gordon Millichap

Keyword(s):

Left Hemisphere ◽

Language Dominance

Download Full-text

Language Functional Magnetic Resonance Imaging in Preoperative Assessment of Language Areas: Correlation with Direct Cortical Stimulation

Neurosurgery ◽

10.1227/01.neu.0000064803.05077.40 ◽

2003 ◽

Vol 52 (6) ◽

pp. 1335-1347 ◽

Cited By ~ 287

Author(s):

Franck-Emmanuel Roux ◽

Kader Boulanouar ◽

Jean-Albert Lotterie ◽

Mehdi Mejdoubi ◽

James P. LeSage ◽

...

Keyword(s):

Magnetic Resonance Imaging ◽

Magnetic Resonance ◽

Functional Magnetic Resonance Imaging ◽

Left Hemisphere ◽

Brain Mapping ◽

Fmri Data ◽

Functional Magnetic Resonance ◽

Resonance Imaging ◽

Verb Generation ◽

Language Areas

Abstract OBJECTIVE The aim of this study was to analyze the usefulness of preoperative language functional magnetic resonance imaging (fMRI), by correlating fMRI data with intraoperative cortical stimulation results for patients with brain tumors. METHODS Naming and verb generation tasks were used, separately or in combination, for 14 right-handed patients with tumors in the left hemisphere. fMRI data obtained were analyzed with SPM software, with two standard analysis thresholds (P < 0.005 and then P < 0.05). The fMRI data were then registered in a frameless stereotactic neuronavigational device and correlated with direct brain mapping results. We used a statistical model with the fMRI information as a predictor, spatially correlating each intraoperatively mapped cortical site with fMRI data integrated in the neuronavigational system (site-by-site correlation). Eight patients were also studied with language fMRI postoperatively, with the same acquisition protocol. RESULTS We observed high variability in signal extents and locations among patients with both tasks. The activated areas were located mainly in the left hemisphere in the middle and inferior frontal gyri (F2 and F3), the superior and middle temporal gyri (T1 and T2), and the supramarginal and angular gyri. A total of 426 cortical sites were tested for each task among the 14 patients. In frontal and temporoparietal areas, poor sensitivity of the fMRI technique was observed for the naming and verb generation tasks (22 and 36%, respectively) with P < 0.005 as the analysis threshold. Although not perfect, the specificity of the fMRI technique was good in all conditions (97% for the naming task and 98% for the verb generation task). Better correlation (sensitivity, 59%; specificity, 97%) was achieved by combining the two fMRI tasks. Variation of the analysis threshold to P < 0.05 increased the sensitivity to 66% while decreasing the specificity to 91%. Postoperative fMRI data (for the cortical brain areas studied intraoperatively) were in accordance with brain mapping results for six of eight patients. Complete agreement between pre- and postoperative fMRI studies and direct brain mapping results was observed for only three of eight patients. CONCLUSION With the paradigms and analysis thresholds used in this study, language fMRI data obtained with naming or verb generation tasks, before and after surgery, were imperfectly correlated with intraoperative brain mapping results. A better correlation could be obtained by combining the fMRI tasks. The overall results of this study demonstrated that language fMRI could not be used to make critical surgical decisions in the absence of direct brain mapping. Other acquisition protocols are required for evaluation of the potential role of language fMRI in the accurate detection of essential cortical language areas.

Download Full-text

Tumor location and reduction in functional MRI estimates of language laterality

Journal of Neurosurgery ◽

10.3171/2020.9.jns202036 ◽

2021 ◽

pp. 1-11

Author(s):

Monika M. Połczyńska ◽

Lilian Beck ◽

Taylor Kuhn ◽

Christopher F. Benjamin ◽

Timothy K. Ly ◽

...

Keyword(s):

Functional Mri ◽

Left Hemisphere ◽

Right Hemisphere ◽

Tumor Location ◽

Broca’S Area ◽

Broca's Area ◽

Whole Brain ◽

Language Dominance ◽

Left Posterior ◽

Language Laterality

OBJECTIVE Brain tumors located close to the language cortex may distort functional MRI (fMRI)–based estimates of language dominance. The nature of this distortion, and whether this is an artifact of numerous confounders, remains unknown. The authors hypothesized tumor bias based on laterality estimates independent of confounders and that the effects are the greatest for tumors proximal to Broca's area. METHODS To answer this question, the authors reviewed more than 1113 patients who underwent preoperative fMRI to match samples on 11 known confounders (tumor location, size, type, and grade; seizure history; prior neurosurgery; aphasia presence and severity; and patient age, sex, and handedness). The samples included 30 patients with left hemisphere tumors (15 anterior and 15 posterior) and 30 with right hemisphere tumors (15 anterior and 15 posterior), thus totaling 60 patients (25 women; 18 left-handed and 4 ambidextrous; mean age 47 [SD 14.1] years). Importantly, the authors matched not only patients with left and right hemisphere tumors but also those with anterior and posterior tumors. Standard fMRI laterality indices (LIs) were calculated using whole-brain and region of interest (ROI) approaches (Broca's and Wernicke's areas). RESULTS Tumors close to Broca's area in the left hemisphere decreased LIs independently of known confounders. At the whole-brain level, this appeared to reflect a decrease in LI values in patients with left anterior tumors compared with patients with right anterior tumors. ROI analysis replicated these findings. Broca's area LIs were significantly lower (p = 0.02) in patients with left anterior tumors (mean LI 0.28) when compared with patients with right anterior tumors (mean LI 0.70). Changes in Wernicke's area–based LIs did not differ as a function of the tumor hemisphere. Therefore, in patients with left anterior tumors, it is essential to assess language laterality using left posterior ROIs. In all remaining tumor groups (left posterior tumors and right hemisphere tumors), language laterality derived from the anterior language ROI was the most robust measure of language dominance. CONCLUSIONS Patients with tumors close to Broca's area showed more bilateral fMRI language maps independent of known confounders. The authors caution against the assumption that this reduced language laterality suggests no or little risk to language function following tumor resection in the left inferior frontal gyrus. Their results address how to interpret fMRI data for neurosurgical purposes, along with theoretical questions of contralesional functional compensation and disinhibition.

Download Full-text

Homotopic organization of essential language sites in right and bilateral cerebral hemispheric dominance

Journal of Neurosurgery ◽

10.3171/2010.11.jns10888 ◽

2011 ◽

Vol 114 (4) ◽

pp. 893-902 ◽

Cited By ~ 38

Author(s):

Edward F. Chang ◽

Doris D. Wang ◽

David W. Perry ◽

Nicholas M. Barbaro ◽

Mitchel S. Berger

Keyword(s):

San Francisco ◽

Left Hemisphere ◽

Language Production ◽

Right Hemisphere ◽

General Pattern ◽

Hemispheric Dominance ◽

Precentral Gyrus ◽

Language Dominance ◽

Speech Mapping ◽

Hemisphere Dominance

Object Language dominance in the right hemisphere is rare. Therefore, the organization of essential language sites in the dominant right hemisphere is unclear, especially compared with cases involving the more prevalent left dominant hemisphere. Methods The authors reviewed the medical records of 15 patients who underwent awake craniotomy for tumor or epilepsy surgery and speech mapping of right hemisphere perisylvian language areas at the University of California, San Francisco. All patients were determined to have either complete right-sided or bilateral language dominance by preoperative Wada testing. Results All patients but one were left-handed. Of more than 331 total stimulation sites, 27 total sites were identified as essential for language function (14 sites for speech arrest/anarthria; 12 for anomia; and 1 for alexia). While significant interindividual variability was observed, the general pattern of language organization was similar to classic descriptions of frontal language production and posterior temporal language integration for the left hemisphere. Speech arrest sites were clustered in the ventral precentral gyrus and pars opercularis. Anomia sites were more widely distributed, but were focused in the posterior superior and middle temporal gyri as well as the inferior parietal gyrus. One alexia site was found over the superior temporal gyrus. Face sensory and motor cortical sites were also identified along the ventral sensorimotor strip. The prevalence and specificity of essential language sites were greater in unilateral right hemisphere–dominant patients, compared with those with bilateral dominance by Wada testing. Conclusions The authors' results suggest that the organization of language in right hemisphere dominance mirrors that of left hemisphere dominance. Awake speech mapping is a safe and reliable surgical adjunct in these rare clinical cases and should be done in the setting of right hemisphere dominance to avoid preventable postoperative aphasia.

Download Full-text

Factors predicting language lateralization in patients with perisylvian vascular malformations

Journal of Neurosurgery ◽

10.3171/2010.2.jns091595 ◽

2010 ◽

Vol 113 (4) ◽

pp. 723-730 ◽

Cited By ~ 13

Author(s):

Darrin J. Lee ◽

Nader Pouratian ◽

Susan Y. Bookheimer ◽

Neil A. Martin

Keyword(s):

Vascular Malformations ◽

Lesion Size ◽

Anatomical Landmarks ◽

Cavernous Malformations ◽

Language Dominance ◽

3.0 T ◽

Martin Grade ◽

Eloquent Cortex ◽

Language Area ◽

Language Areas

Object The authors conducted a study to determine the factors associated with right-sided language dominance in patients with cerebrovascular malformations. Methods Twenty-two patients with either arteriovenous malformations (AVMs [15 cases]) or cavernous malformations (7 cases) underwent functional MR (fMR) imaging studies of language function; a 3.0-T head-only unit was used. Lateralization indices were calculated separately for Broca and Wernicke areas. Lesion size, Spetzler-Martin grade, and the distance between the lesion and anatomically defined language cortex were calculated for each patient. Results Right-sided language dominance occurred in 5 patients, all of whom had AVMs within 10 mm of canonical language areas. Three patients had right-sided language dominance in the Wernicke area alone whereas 2 had right-sided language dominance in both Broca and Wernicke areas. Wada testing and intraoperative electrocortical stimulation were performed as clinically indicated to corroborate fMR imaging findings. Conclusions The primary factor associated with right-sided language dominance was the AVM being within 10 mm of anatomically defined language areas. The lesion size and the Spetzler-Martin grade were not significant factors. Anomalous fMR imaging laterality was typically confined to the language area proximate to the lesion, with the distal language area remaining in the left hemisphere dominant. This study emphasizes the need to map each case individually in patients with left perisylvian AVMs. Assumptions about eloquent cortex based on anatomical landmarks (a key component of Spetzler-Martin grading) may have to be reconsidered.

Download Full-text