From the Department of Health Informatics (S.G.), Rutgers University School of Health Professions, Newark, New Jersey.
Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.).
AJNR Am J Neuroradiol. 2019 Feb;40(2):319-325. doi: 10.3174/ajnr.A5932. Epub 2019 Jan 10.
A recent study using task-based fMRI demonstrated that the middle frontal gyrus is comparable with Broca's area in its ability to determine language laterality using a measure of verbal fluency. This study investigated whether the middle frontal gyrus can be used as an indicator for language-hemispheric dominance in patients with brain tumors using task-free resting-state fMRI. We hypothesized that no significant difference in language lateralization would occur between the middle frontal gyrus and Broca area and that the middle frontal gyrus can serve as a simple and reliable means of measuring language laterality.
Using resting-state fMRI, we compared the middle frontal gyrus with the Broca area in 51 patients with glial neoplasms for voxel activation, the language laterality index, and the effect of tumor grade on the laterality index. The laterality index derived by resting-state fMRI and task-based fMRI was compared in a subset of 40 patients.
Voxel activations in the left middle frontal gyrus and left Broca area were positively correlated ( = 0.47, < .001). Positive correlations were seen between the laterality index of the Broca area and middle frontal gyrus regions ( = 0.56, < .0005). Twenty-seven of 40 patients (67.5%) showed concordance of the laterality index based on the Broca area using resting-state fMRI and the laterality index based on a language task. Thirty of 40 patients (75%) showed concordance of the laterality index based on the middle frontal gyrus using resting-state fMRI and the laterality index based on a language task.
The middle frontal gyrus is comparable with the Broca area in its ability to determine hemispheric dominance for language using resting-state fMRI. Our results suggest the addition of resting-state fMRI of the middle frontal gyrus to the list of noninvasive modalities that could be used in patients with gliomas to evaluate hemispheric dominance of language before tumor resection. In patients who cannot participate in traditional task-based fMRI, resting-state fMRI offers a task-free alternate to presurgically map the eloquent cortex.
最近一项基于任务的 fMRI 研究表明，在使用语言流畅性指标确定语言侧化方面，额中回与布罗卡区具有相当的能力。本研究使用静息态 fMRI 探讨在脑肿瘤患者中，额中回是否可以作为语言优势半球的指标。我们假设额中回和布罗卡区在语言侧化方面没有显著差异，并且额中回可以作为一种简单可靠的测量语言侧化的方法。
使用静息态 fMRI，我们比较了 51 例胶质肿瘤患者的额中回和 Broca 区的体素激活、语言侧化指数以及肿瘤分级对侧化指数的影响。在 40 例患者的亚组中比较了静息态 fMRI 和任务态 fMRI 得出的侧化指数。
左额中回和左 Broca 区的体素激活呈正相关（r = 0.47，P <.001）。Broca 区和额中回区域的侧化指数之间也存在正相关（r = 0.56，P <.0005）。40 例患者中有 27 例（67.5%）静息态 fMRI 基于 Broca 区的侧化指数与语言任务基于的侧化指数一致。40 例患者中有 30 例（75%）静息态 fMRI 基于额中回的侧化指数与语言任务基于的侧化指数一致。
额中回在使用静息态 fMRI 确定语言优势半球方面与 Broca 区具有相当的能力。我们的结果表明，在胶质瘤患者中，除了传统的任务态 fMRI 外，还可以将额中回的静息态 fMRI 添加到非侵入性评估语言优势半球的方法列表中，以便在肿瘤切除前评估语言优势半球。对于无法参与传统任务态 fMRI 的患者，静息态 fMRI 提供了一种无任务的替代方案，可以在术前映射语言功能区。
