Language lateralization in children using functional transcranial Doppler sonography.
OBJECTIVE
Language lateralization with functional transcranial Doppler sonography (fTCD) and lexical word generation has been shown to have high concordance with the Wada test and functional magnetic resonance imaging in adults. We evaluated a nonlexical paradigm to determine language dominance in children.


METHODS
In 23 right-handed children (12 females, 11 males; age range 6-11y; mean age 8y 4mo, SD 1y 7mo) and in 22 adolescents (14 females, 8 males; age range 12-18y; mean age 14y 8mo, SD 2y 5 mo) cerebral blood flow velocity (CBFV) was measured in both middle cerebral arteries during picture description and in adolescents additionally during lexical word generation. For each individual/paradigm a lateralization index (LI; side difference in CBFV during mental activity) and its standard error of the mean (SEM; representing variability of the LI throughout task repetition) were computed.


RESULTS
Fourteen of 23 children (mean LI=0.74, SD 4.22; SEM 1.05, SD 0.51) and 14 of 21 adolescents (LI=2.35, SD 4.65; SEM 1.09, SD 0.61) showed left hemispheric dominance during picture description compared with 20 of 21 adolescents during word generation (LI=3.72 SD 1.93; SEM 0.99, SD 0.41). Indicated by similarity in mean SEM, variability of the LI throughout task repetition did not differ between age groups or paradigms.


CONCLUSIONS
Functional TCD proved to be well tolerated in children, with similar data quality as in adolescents. However, the picture description paradigm failed to show left hemispheric dominance in a substantial number of participants. This emphasizes the need to evaluate further paradigms for fTCD language lateralization in children.
Haag
Anja
A
Department of Neurology, University of Marburg, Germany. haag@staff.uni-marburg.de <haag@staff.uni-marburg.de>
Moeller
Nicola
N
Knake
Susanne
S
Hermsen
Anke
A
Oertel
Wolfgang H
WH
Rosenow
Felix
F
Hamer
Hajo M
HM
D000293:Adolescent; D000367:Age Factors; D001921:Brain / Q000098:blood supply / Q000502:physiology*; D001931:Brain Mapping; D002560:Cerebrovascular Circulation / Q000502:physiology*; D002648:Child; D005260:Female; D007839:Functional Laterality / Q000502:physiology*; D006801:Humans; D007091:Image Processing, Computer-Assisted / Q000379:methods; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D010100:Oxygen / Q000097:blood; D017585:Ultrasonography, Doppler, Transcranial
D010100:Oxygen