Wongsripuemtet Jitsupa, Wongfukiat Oragarn, Vichianin Yudthapon, Ngamsombat Chanon, Witthiwej Theerapol, Sitthinamsuwan Bunpot, Aurboonyawat Thaweesak, Chankaew Ekawut, Chawalparit Orasa
J Med Assoc Thai. 2016 Dec;99(12):1344-54.
To evaluate the concordance of language lateralization between functional magnetic resonance imaging (fMRI) using Thai version of language paradigm and Wada test or awake surgery with direct cortical brain stimulation (DCS).
Retrospective study of thirteen patients (3 males and 10 females with mean age of 33.9 years old) with epilepsy (7 cases) or brain tumor (6 cases) was performed. Every patient underwent both fMRI (word generation, verb generation, naming picture, and sentence completion tasks) and Wada test or awake surgery with DCS (defined as the gold standard). The lateralization index (LI) of fMRI was automatically calculated by using the LI-toolbox on SPM8. The hemispheric lateralization was also evaluated visually. The concordance between fMRI and gold standard were analyzed.
The concordance between the lateralization of fMRI by visual assessment and gold standard was 92.3%. Concordance between the calculated LI by fMRI and gold standard was varied along with the task and regional calculation method. The concordance was good in all tasks (except for naming picture task) when using calculated LI from frontal or whole brain excluded cerebellum and occipital lobe (range 76.92 to 88.98% and 76.92 to 92.31%, respectively).
There was good concordance between fMRI and gold standard. Regional calculation from frontal lobes and whole brain excluded cerebellum and occipital lobes gave the best results. The results supported feasibility to use the fMRI with Thai language paradigm as an alternative way to determine the language dominant hemisphere in Thai patients. In case of language dominant hemisphere is unclear, further invasive investigation of language mapping such as Wada test or DCS is crucial.
评估使用泰语版语言范式的功能磁共振成像（fMRI）与Wada测试或清醒手术中直接皮质脑刺激（DCS）之间语言侧化的一致性。
对13例患者（3例男性和10例女性，平均年龄33.9岁）进行回顾性研究，这些患者患有癫痫（7例）或脑肿瘤（6例）。每位患者均接受了fMRI（单词生成、动词生成、图片命名和句子完成任务）以及Wada测试或清醒手术中的DCS（定义为金标准）。fMRI的侧化指数（LI）通过使用SPM8上的LI工具箱自动计算得出。还通过视觉评估半球侧化情况。分析fMRI与金标准之间 的一致性。
通过视觉评估的fMRI侧化与金标准之间的一致性为92.3%。fMRI计算得出的LI与金标准之间的一致性随任务和区域计算方法而有所不同。当使用额叶或排除小脑和枕叶的全脑计算得出的LI时，所有任务（图片命名任务除外）的一致性都很好（分别为76.92%至88.98%和76.92%至92.31%）。
fMRI与金标准之间具有良好的一致性。额叶和排除小脑及枕叶的全脑区域计算得出的结果最佳。这些结果支持使用泰语版语言范式的fMRI作为确定泰国患者语言优势半球的替代方法的可行性。在语言优势半球不明确的情况下，进一步进行侵入性语言映射研究，如Wada测试或DCS至关重要。
