From the Neurosciences and Mental Health Program (N.L.P., A.S.S., A.R., E.W.), The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, Toronto, Ontario, Canada.
Department of Psychology (N.L.P.).
AJNR Am J Neuroradiol. 2021 Jul;42(7):1299-1304. doi: 10.3174/ajnr.A7110. Epub 2021 Apr 8.
Task-based fMRI is a noninvasive method of determining language dominance; however, not all children can complete language tasks due to age, cognitive/intellectual, or language barriers. Task-free approaches such as resting-state fMRI offer an alternative method. This study evaluated resting-state fMRI for predicting language laterality in children with drug-resistant epilepsy.
A retrospective review of 43 children with drug-resistant epilepsy who had undergone resting-state fMRI and task-based fMRI during presurgical evaluation was conducted. Independent component analysis of resting-state fMRI was used to identify language networks by comparing the independent components with a language network template. Concordance rates in language laterality between resting-state fMRI and each of the 4 task-based fMRI language paradigms (auditory description decision, auditory category, verbal fluency, and silent word generation tasks) were calculated.
Concordance ranged from 0.64 (95% CI, 0.48-0.65) to 0.73 (95% CI, 0.58-0.87), depending on the language paradigm, with the highest concordance found for the auditory description decision task. Most (78%-83%) patients identified as left-lateralized on task-based fMRI were correctly classified as left-lateralized on resting-state fMRI. No patients classified as right-lateralized or bilateral on task-based fMRI were correctly classified by resting-state fMRI.
While resting-state fMRI correctly classified most patients who had typical (left) language dominance, its ability to correctly classify patients with atypical (right or bilateral) language dominance was poor. Further study is required before resting-state fMRI can be used clinically for language mapping in the context of epilepsy surgery evaluation in children with drug-resistant epilepsy.
任务态 fMRI 是一种用于确定语言优势的非侵入性方法；然而，由于年龄、认知/智力或语言障碍，并非所有儿童都能完成语言任务。无任务的方法，如静息态 fMRI，提供了一种替代方法。本研究评估了静息态 fMRI 在预测耐药性癫痫儿童语言优势侧的应用。
对 43 例接受手术评估时进行静息态 fMRI 和任务态 fMRI 的耐药性癫痫儿童进行回顾性研究。通过比较独立成分与语言网络模板，对静息态 fMRI 进行独立成分分析，以识别语言网络。计算静息态 fMRI 与 4 种任务态 fMRI 语言范式（听觉描述决策、听觉类别、言语流畅性和静默单词生成任务）之间语言侧化的一致性率。
一致性率范围为 0.64（95%CI，0.48-0.65）至 0.73（95%CI，0.58-0.87），取决于语言范式，其中听觉描述决策任务的一致性率最高。在任务态 fMRI 上被确定为左侧优势的大多数（78%-83%）患者在静息态 fMRI 上被正确分类为左侧优势。在任务态 fMRI 上被分类为右侧或双侧优势的患者中，没有患者被静息态 fMRI 正确分类。
虽然静息态 fMRI 正确分类了大多数具有典型（左侧）语言优势的患者，但它正确分类具有非典型（右侧或双侧）语言优势的患者的能力较差。在静息态 fMRI 可用于耐药性癫痫儿童癫痫手术评估中的语言映射之前，还需要进一步研究。
