title: Noninvasive language mapping in patients with epilepsy or brain tumors.
abstract: BACKGROUND
  Functional magnetic resonance imaging (fMRI) has become part of routine brain mapping in patients with epilepsy or tumor undergoing resective surgery. However, robust localization of crucial functional areas is required.
  
  
  OBJECTIVE
  To establish a simple, short fMRI task that reliably localizes crucial language areas in individual patients who undergo respective surgery.
  
  
  METHODS
  fMRI was measured during an 8-minute auditory semantic decision task in 28 healthy controls and 35 consecutive patients who had focal epilepsy or a brain tumor. Nineteen underwent resective surgery. Group and individual analyses were performed. Results in patients were compared with postsurgical language outcome and electrocortical stimulation when available.
  
  
  RESULTS
  fMRI activations concordant with the anterior and posterior language areas were found in 96% and 89% of the controls, respectively. The anterior and posterior language areas were both activated in 93% of the patients. These results were concordant with electrocortical stimulation results in 5 patients. Transient postsurgical language deficits were found in 2 patients in whom surgery was performed in the vicinity of the fMRI activations or who had postsurgical complications implicating areas of fMRI activations.
  
  
  CONCLUSIONS
  The proposed fast fMRI language protocol reliably localized the most relevant language areas in individual subjects. It appears to be a valuable complementary tool for surgical planning of epileptogenic foci and of brain tumors.
authors.affiliation: Department of Neurology and Fundamental Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
authors.forename: Melanie
authors.initials: M
authors.lastname: Genetti
authors.forename: Frederic
authors.initials: F
authors.lastname: Grouiller
authors.forename: Serge
authors.initials: S
authors.lastname: Vulliemoz
authors.forename: Laurent
authors.initials: L
authors.lastname: Spinelli
authors.forename: Margitta
authors.initials: M
authors.lastname: Seeck
authors.forename: Christoph Martin
authors.initials: CM
authors.lastname: Michel
authors.forename: Karl
authors.initials: K
authors.lastname: Schaller
mesh_terms: D000161:Acoustic Stimulation / Q000379:methods*; D000293:Adolescent; D000328:Adult; D001931:Brain Mapping / Q000379:methods*; D001932:Brain Neoplasms / Q000175:diagnosis* / Q000503:physiopathology; D002648:Child; D015331:Cohort Studies; D004827:Epilepsy / Q000175:diagnosis* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012660:Semantics; D055815:Young Adult