Thiel A, Herholz K, von Stockhausen H M, van Leyen-Pilgram K, Pietrzyk U, Kessler J, Wienhard K, Klug N, Heiss W D
Max-Planck-Institut für neurologische Forschung, Universitätsklinik, Cologne, Germany.
Neuroimage. 1998 May;7(4 Pt 1):284-95. doi: 10.1006/nimg.1998.0334.
Measurement of relative cerebral blood flow (CBF) with 15O-labeled water PET has been widely used for brain mapping experiments on language functions in normal volunteers and patients with epilepsy. We focused on the question of whether PET during speech activation is an appropriate method for noninvasive determination of language-related cortex in patients with brain tumors. Furthermore, the suitability of the method for determination of hemispheric language dominance was examined and compared to the results of the Edinburgh Handedness Inventory. Ten right-handed and six left-handed patients with gliomas were examined prior to surgery while repeatedly performing word repetition and verb generation tasks. A set of volumes of interest (VOIs) was drawn on coregistered MRI in order to account for anatomic variability as well as anatomical alterations due to tumor mass effect. Repetition of nouns did not produce significant hemispheric differences. During stimulation by verb generation, reliable lateralized activations of Broca's area and supplementary motor area were detected in all right-handed patients. Of the left-handed patients, two showed clear right lateralization, two activated Broca's area bilaterally, and two had a pattern similar to that of right-handers. Patients with bilateral activations showed the strongest tendency toward bihandedness according to the handedness inventory. Lateralization of supplementary motor area in left-handers corresponded to lateralized activity in Broca's area. Tumors in the vicinity of language-related regions did not alter activation responses. In conclusion, measurement of CBF changes during verb generation permits identification of language-related areas in patients with gliomas with strong lateralization related to hemispheric dominance. These findings may be of particular clinical interest for left-handed patients.
用15O标记水PET测量相对脑血流量（CBF）已广泛用于正常志愿者和癫痫患者语言功能的脑图谱实验。我们关注的问题是，言语激活期间的PET是否是一种用于无创确定脑肿瘤患者语言相关皮层的合适方法。此外，还检查了该方法用于确定半球语言优势的适用性，并与爱丁堡利手量表的结果进行了比较。对10名右利手和6名左利手的胶质瘤患者在手术前进行了检查，同时让他们反复执行单词重复和动词生成任务。在配准的MRI上绘制了一组感兴趣区（VOI），以考虑解剖学变异性以及肿瘤占位效应引起的解剖学改变。名词重复未产生明显的半球差异。在动词生成刺激期间，在所有右利手患者中均检测到了布洛卡区和辅助运动区可靠的偏侧激活。在左利手患者中，两名表现出明显的右侧偏侧化，两名双侧激活了布洛卡区，两名具有与右利手患者相似的模式。根据利手量表，双侧激活的患者表现出最强的双手并用倾向。左利手患者辅助运动区的偏侧化与布洛卡区的偏侧化活动相对应。语言相关区域附近的肿瘤并未改变激活反应。总之，在动词生成期间测量CBF变化可以识别胶质瘤患者中与语言相关的区域，这些区域具有与半球优势相关的强烈偏侧化。这些发现可能对左利手患者具有特别的临床意义。
