Mapping anterior temporal lobe language areas with fMRI: a multicenter normative study.
Removal of the anterior temporal lobe (ATL) is an effective surgical treatment for intractable temporal lobe epilepsy but carries a risk of language and verbal memory deficits. Preoperative localization of functional zones in the ATL might help reduce these risks, yet fMRI protocols in current widespread use produce very little activation in this region. Based on recent evidence suggesting a role for the ATL in semantic integration, we designed an fMRI protocol comparing comprehension of brief narratives (Story task) with a semantically shallow control task involving serial arithmetic (Math task). The Story > Math contrast elicited strong activation throughout the ATL, lateral temporal lobe, and medial temporal lobe bilaterally in an initial cohort of 18 healthy participants. The task protocol was then implemented at 6 other imaging centers using identical methods. Data from a second cohort of participants scanned at these centers closely replicated the results from the initial cohort. The Story-Math protocol provides a reliable method for activation of surgical regions of interest in the ATL. The bilateral activation supports previous claims that conceptual processing involves both temporal lobes. Used in combination with language lateralization measures, reliable ATL activation maps may be useful for predicting cognitive outcome in ATL surgery, though the validity of this approach needs to be established in a prospective surgical series.
Binder
Jeffrey R
JR
Department of Neurology, Medical College of Wisconsin, Milwaukee, WI 53226, USA. jbinder@mcw.edu
Gross
William L
WL
Allendorfer
Jane B
JB
Bonilha
Leonardo
L
Chapin
Jessica
J
Edwards
Jonathan C
JC
Grabowski
Thomas J
TJ
Langfitt
John T
JT
Loring
David W
DW
Lowe
Mark J
MJ
Koenig
Katherine
K
Morgan
Paul S
PS
Ojemann
Jeffrey G
JG
Rorden
Christopher
C
Szaflarski
Jerzy P
JP
Tivarus
Madalina E
ME
Weaver
Kurt E
KE
D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D032882:Comprehension / Q000502:physiology; D005260:Female; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D013702:Temporal Lobe / Q000502:physiology*; D055815:Young Adult