Clinical fMRI of language function in aphasic patients: reading paradigm successful, while word generation paradigm fails.
BACKGROUND
In fMRI examinations, it is very important to select appropriate paradigms assessing the brain function of interest. In addition, the patients' ability to perform the required cognitive tasks during fMRI must be taken into account.


OBJECTIVE
To evaluate two language paradigms, word generation and sentence reading for their usefulness in examinations of aphasic patients and to make suggestions for improvements of clinical fMRI.


METHODS
Five patients with aphasia after stroke or trauma sequelae were examined by fMRI. The patients' language ability was screened by neurolinguistic tests and elementary pre-fMRI language tests.


RESULTS
The sentence-reading paradigm succeeded to elicit adequate language-related activation in perilesional areas whereas the word generation paradigm failed. These findings were consistent with results on the behavioral tests in that all patients showed very poor performance in phonemic fluency, but scored well above mean at a reading comprehension task.


CONCLUSIONS
The sentence-reading paradigm is appropriate to assess language function in this patient group, while the word-generation paradigm seems to be inadequate. In addition, it is crucial to use elementary pre-fMRI language tests to guide the fMRI paradigm decision.
Engström
Maria
M
Center for Medical Image Science and Visualization, Department of Medicine and Health Sciences/Radiology, Linköping University, Linköping, Sweden. maria.engstrom@liu.se
Karlsson
Marie
M
Croné
Marie
M
Ragnehed
Mattias
M
Antepohl
Wolfram
W
Landtblom
Anne-Marie
AM
Lundberg
Peter
P
D000328:Adult; D001037:Aphasia / Q000175:diagnosis*; D001921:Brain / Q000473:pathology*; D005260:Female; D006801:Humans; D007802:Language; D007807:Language Tests; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011932:Reading; D013060:Speech