Language dominance in partial epilepsy patients identified with an fMRI reading task
Language dominance in partial epilepsy patients identified with an fMRI reading task
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DOI：
10.1212/wnl.59.2.256
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发表时间：
2002-07-23
期刊：
影响因子：
9.9
通讯作者：
Theodore, WH
中科院分区：
文献类型：
--
作者：
Gaillard, WD;Balsamo, L;Theodore, WH
背景：fMRI语言任务很容易识别额叶语言区域；时间激活一直不太一致。还没有研究将临床视觉判断与感兴趣区(ROI)定量分析进行比较。目的：利用临床和感兴趣区解读相结合的阅读范式，识别部分性癫痫患者的暂时性语言区域。方法：30例颞叶癫痫患者，年龄8~56岁，均行1.5T fMRI检查。与视觉控制相比，患者会默默地说出用句子描述的物体的名字。对数据进行t-map的ROI分析。计算区域不对称指数([L-R]/[L+R])，语言优势度定义为>；0.20。T-Maps被三位读者以三个t阈值进行视觉评分。21例行颈动脉异巴比妥钠试验(IAT)。结果：在30例ROI分析的患者中，有27例的fMRI阅读任务提供了语言偏侧化的证据。左侧占优势25例，右侧2例，双侧1例，非诊断性2例；IAT和功能磁共振成像在大多数患者中一致，3例部分一致，没有明显不一致。评价者之间的一致性介于0.77至0.82之间(Cramer V；p<；0.0001)；视觉与投资回报率与IAT之间的一致性为0.71至0.77(Cramer V；p<；0.0001)。以较低的阈值查看数据为12名患者的视觉分析和8名ROI分析的患者增加了解释。结论：fMRI阅读范式可以识别额叶和颞叶区域的语言优势。临床目测解释可与定量ROI分析相媲美。
Background: fMRI language tasks readily identify frontal language areas; temporal activation has been less consistent. No studies have compared clinical visual judgment to quantitative region of interest (ROI) analysis. Objective: To identify temporal language areas in patients with partial epilepsy using a reading paradigm with clinical and ROI interpretation. Methods: Thirty patients with temporal lobe epilepsy, aged 8 to 56 years, had 1.5-T fMRI. Patients silently named an object described by a sentence compared to a visual control. Data were analyzed with ROI analysis from t-maps. Regional asymmetry indices (AI) were calculated ([L-R]/[L+R]) and language dominance defined as >0.20. t-Maps were visually rated by three readers at three t thresholds. Twenty-one patients had intracarotid amobarbital test (IAT). Results: The fMRI reading task provided evidence of language lateralization in 27 of 30 patients with ROI analysis. Twenty-five were left dominant, two right, one bilateral, and two were nondiagnostic; IAT and fMRI agreed in most patients, three had partial agreement, none overtly disagreed. Interrater agreement ranged between 0.77 to 0.82 (Cramer V; p < 0.0001); agreement between visual and ROI reading with IAT was 0.71 to 0.77 (Cramer V; p < 0.0001). Viewing data at lower thresholds added interpretation to 12 patients on visual analysis and 8 with ROI analysis. Conclusions: An fMRI reading paradigm can identify language dominance in frontal and temporal areas. Clinical visual interpretation is comparable to quantitative ROI analysis.