PT - JOURNAL ARTICLE AU - Partovi, S. AU - Jacobi, B. AU - Rapps, N. AU - Zipp, L. AU - Karimi, S. AU - Rengier, F. AU - Lyo, J.K. AU - Stippich, C. TI - Clinical Standardized fMRI Reveals Altered Language Lateralization in Patients with Brain Tumor AID - 10.3174/ajnr.A3137 DP - 2012 Dec 01 TA - American Journal of Neuroradiology PG - 2151--2157 VI - 33 IP - 11 4099 - http://www.ajnr.org/content/33/11/2151.short 4100 - http://www.ajnr.org/content/33/11/2151.full SO - Am. J. Neuroradiol.2012 Dec 01; 33 AB - BACKGROUND AND PURPOSE: Brain tumors affecting language-relevant areas may influence language lateralization. The purpose of this study was to systematically investigate language lateralization in brain tumor patients using clinical language fMRI, comparing the results with a group of healthy volunteers. MATERIALS AND METHODS: Fifty-seven strictly right-handed patients with left-hemispheric-space intracranial masses (mainly neoplastic) affecting either the Broca area (n = 19) or Wernicke area (n = 38) were prospectively enrolled in this study. Fourteen healthy volunteers served as a control group. Standardized clinical language fMRI, using visually triggered sentence- and word-generation paradigms, was performed on a 1.5T MR scanner. Semiautomated analyses of all functional data were conducted on an individual basis using BrainVoyager. A regional lateralization index was calculated for Broca and Wernicke areas separately versus their corresponding right-hemisphere homologs. RESULTS: In masses affecting the Broca area, a significant decrease in the lateralization index was found when performing word generation (P = .0017), whereas when applying sentence generation, the decrease did not reach statistical significance (P = .851). Masses affecting the Wernicke area induced a significant decrease of the lateralization index when performing sentence generation (P = .0007), whereas when applying word generation, the decrease was not statistically significant (P = .310). CONCLUSIONS: Clinical language fMRI was feasible for patients with brain tumors and provided relevant presurgical information by localizing essential language areas and determining language dominance. A significant effect of the brain masses on language lateralization was observed, with a shift toward the contralesional, nondominant hemisphere. This may reflect compensatory mechanisms of the brain to maintain communicative abilities. BOLDblood oxygen level–dependentBRBroca rightHRFhemodynamic response functionLIlateralization indexSGsentence generationWGword generationWHOWorld Health OrganizationWRWernicke right