Threshold-independent functional MRI determination of language dominance: a validation study against clinical gold standards.
Threshold-independent functional MRI determination of language dominance: a validation study against clinical gold standards.
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DOI：
10.1016/j.yebeh.2009.07.034
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发表时间：
2009-10
期刊：
影响因子：
--
通讯作者：
Golby AJ
中科院分区：
文献类型：
--
作者：
Suarez RO;Whalen S;Nelson AP;Tie Y;Meadows ME;Radmanesh A;Golby AJ
Functional MRI (fMRI) is often used for presurgical language lateralization. The most common approach calculates a laterality index (LI) based on suprathreshold voxels. However, strong dependencies between LI and threshold can diminish the effectiveness of this technique; in this study we investigated an original methodology that is independent of threshold. We compared this threshold-independent method against the common threshold-dependent method in 14 epilepsy patients who underwent Wada testing. In addition, clinical results from eletrocortical language mapping and post-operative language findings were used to assess the validity of the fMRI laterality method. The threshold-dependent methodology yielded ambiguous or incongruent lateralization outcomes in 4 of 14 patients in the inferior frontal gyrus (IFG), and in 6 of 14 patients in the supramarginal gyrus (SMG). Conversely, the threshold-independent method yielded unambiguous lateralization in all the patients tested, and demonstrated lateralization outcomes incongruent with clinical standards in 2 of 14 patients in IFG, and in 1 of 14 patients in SMG. This validation study demonstrates that the threshold-dependent LI calculation is prone to significant within-patient variability that could render results unreliable; the threshold-independent method can generate distinct LIs that are more concordant with gold-standard clinical findings.
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