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Research ArticleFunctional

Clinical Standardized fMRI Reveals Altered Language Lateralization in Patients with Brain Tumor

S. Partovi, B. Jacobi, N. Rapps, L. Zipp, S. Karimi, F. Rengier, J.K. Lyo and C. Stippich
American Journal of Neuroradiology December 2012, 33 (11) 2151-2157; DOI: https://doi.org/10.3174/ajnr.A3137
S. Partovi
aFrom the Department of Neuroradiology (S.P., L.Z., F.R., C.S.), University Hospital of Basel, Basel, Switzerland
bDepartment of Radiology, Section of Neuroradiology (S.P., S.K., J.K.L.), Memorial Sloan-Kettering Cancer Center, New York, New York
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B. Jacobi
cClinical Cooperation Unit Molecular Hematology/Oncology (B.J.), German Cancer Research Center, Heidelberg, Germany
eDepartments of Internal Medicine V (B.J.), Neuroradiology (N.R., C.S.), and Diagnostic and Interventional Radiology (F.R.), University Hospital of Heidelberg, Heidelberg, Germany.
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N. Rapps
dDepartment of Psychosomatic Medicine and Psychotherapy (N.R.), University Hospital of Tuebingen, Tuebingen, Germany
eDepartments of Internal Medicine V (B.J.), Neuroradiology (N.R., C.S.), and Diagnostic and Interventional Radiology (F.R.), University Hospital of Heidelberg, Heidelberg, Germany.
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L. Zipp
aFrom the Department of Neuroradiology (S.P., L.Z., F.R., C.S.), University Hospital of Basel, Basel, Switzerland
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S. Karimi
bDepartment of Radiology, Section of Neuroradiology (S.P., S.K., J.K.L.), Memorial Sloan-Kettering Cancer Center, New York, New York
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F. Rengier
aFrom the Department of Neuroradiology (S.P., L.Z., F.R., C.S.), University Hospital of Basel, Basel, Switzerland
eDepartments of Internal Medicine V (B.J.), Neuroradiology (N.R., C.S.), and Diagnostic and Interventional Radiology (F.R.), University Hospital of Heidelberg, Heidelberg, Germany.
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J.K. Lyo
bDepartment of Radiology, Section of Neuroradiology (S.P., S.K., J.K.L.), Memorial Sloan-Kettering Cancer Center, New York, New York
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C. Stippich
aFrom the Department of Neuroradiology (S.P., L.Z., F.R., C.S.), University Hospital of Basel, Basel, Switzerland
eDepartments of Internal Medicine V (B.J.), Neuroradiology (N.R., C.S.), and Diagnostic and Interventional Radiology (F.R.), University Hospital of Heidelberg, Heidelberg, Germany.
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  • Fig 1.
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    Fig 1.

    Applied visually triggered paradigms in clinical language fMRI. A, Two examples of the sentence generation paradigm are shown. Comic-like pictures such as the lion or the elephant are shown and the subject has to verbalize a standard simple sentence, such as “The lion is dangerous” or “The elephant is heavy.” Altogether, this paradigm consists of a set of 12 visual comic-like stimuli, with 12 corresponding standard simple sentences. B, Two examples of the word-generation paradigm are shown. Generic terms like “cars” or “countries” are shown and the subject is asked to generate as many words as possible, such as, “Ford, Porsche, Mercedes,” or “United States, Switzerland, Canada.” Altogether, this paradigm consists of a set of 12 generic terms.

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    Fig 2.

    Representative instances of the patient group are demonstrated. A, A right-handed 62-year-old patient with left hemispheric frontal astrocytoma (WHO II) is depicted. The word-generation paradigm was applied and a lateralization index of Broca area versus its right hemisphere homolog of −0.85 was calculated (lateralization toward right hemisphere). B, A right-handed 49-year-old patient with left hemispheric parietal astrocytoma (WHO II) is depicted. A sentence-generation paradigm was applied and a lateralization index of Wernicke area versus its right hemisphere homolog of −0.84 was calculated (lateralization toward right hemisphere).

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    Fig 3.

    Local lateralization indexes in the patient group compared with healthy volunteers are depicted as box-and-whisker plots. A, A significant decrease of the lateralization index in Broca area versus its right hemisphere homolog, when performing the word generation paradigm for brain tumors affecting Broca area, is shown (P = .017). B, A significant reduction of lateralization index in Wernicke area versus its right hemisphere homolog, when performing sentence generation paradigm for brain tumors affecting Wernicke area, is shown (P = .007).

Tables

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  • Baseline characteristics of the control (healthy volunteers) and patient groups

    Healthy volunteers (n = 14)
        Age, years (± SD)26 ± 5
        Male sex (n [%])7 (50%)
    Patient population (n = 57)
        Age, years (± SD)44 ± 16
        Male sex (n [%])32 (56%)
    Tumor localization (n [%])
        Affecting Broca area19 (33%)
        Affecting Wernicke area38 (67%)
    WHO tumor grade (n [%])
        I9 (16%)
        II12 (21%)
        III4 (4%)
        IV12 (21%)
        No WHO grade16 (28%)
        No histology available4 (7%)
    • Note:—For tumor data, n = 57.

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American Journal of Neuroradiology: 33 (11)
American Journal of Neuroradiology
Vol. 33, Issue 11
1 Dec 2012
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Cite this article
S. Partovi, B. Jacobi, N. Rapps, L. Zipp, S. Karimi, F. Rengier, J.K. Lyo, C. Stippich
Clinical Standardized fMRI Reveals Altered Language Lateralization in Patients with Brain Tumor
American Journal of Neuroradiology Dec 2012, 33 (11) 2151-2157; DOI: 10.3174/ajnr.A3137

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Clinical Standardized fMRI Reveals Altered Language Lateralization in Patients with Brain Tumor
S. Partovi, B. Jacobi, N. Rapps, L. Zipp, S. Karimi, F. Rengier, J.K. Lyo, C. Stippich
American Journal of Neuroradiology Dec 2012, 33 (11) 2151-2157; DOI: 10.3174/ajnr.A3137
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