title: Role of semantic paradigms for optimization of language mapping in clinical FMRI studies.
abstract: OBJECTIVE
  The optimal paradigm choice for language mapping in clinical fMRI studies is challenging due to the variability in activation among different paradigms, the contribution to activation of cognitive processes other than language, and the difficulties in monitoring patient performance. In this study, we compared language localization and lateralization between 2 commonly used clinical language paradigms and 3 newly designed dual-choice semantic paradigms to define a streamlined and adequate language-mapping protocol.
  
  
  METHODS
  Twelve healthy volunteers performed 5 language paradigms: Silent Word Generation, Sentence Completion, Visual Antonym Pair, Auditory Antonym Pair, and Noun-Verb Association. Group analysis was performed to assess statistically significant differences in fMRI percentage signal change and lateralization index among these paradigms in 5 ROIs: inferior frontal gyrus, superior frontal gyrus, middle frontal gyrus for expressive language activation, middle temporal gyrus, and superior temporal gyrus for receptive language activation.
  
  
  RESULTS
  In the expressive ROIs, Silent Word Generation was the most robust and best lateralizing paradigm (greater percentage signal change and lateralization index than semantic paradigms at P < .01 and P < .05 levels, respectively). In the receptive region of interest, Sentence Completion and Noun-Verb Association were the most robust activators (greater percentage signal change than other paradigms, P < .01). All except Auditory Antonym Pair were good lateralizing tasks (the lateralization index was significantly lower than other paradigms, P < .05).
  
  
  CONCLUSIONS
  The combination of Silent Word Generation and ≥1 visual semantic paradigm, such as Sentence Completion and Noun-Verb Association, is adequate to determine language localization and lateralization; Noun-Verb Association has the additional advantage of objective monitoring of patient performance.
authors.affiliation: Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University School of Medicine, Baltimore, Maryland.
authors.forename: D
authors.initials: D
authors.lastname: Zacà
authors.forename: S
authors.initials: S
authors.lastname: Jarso
authors.forename: J J
authors.initials: JJ
authors.lastname: Pillai
mesh_terms: D000328:Adult; D001244:Association; D001931:Brain Mapping / Q000379:methods* / Q000592:standards; D002540:Cerebral Cortex / Q000502:physiology*; D005260:Female; D007839:Functional Laterality; D064368:Healthy Volunteers; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging / Q000379:methods* / Q000592:standards; D008297:Male; D008875:Middle Aged; D008959:Models, Neurological; D010775:Photic Stimulation / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D015203:Reproducibility of Results; D012660:Semantics; D013647:Task Performance and Analysis; D055815:Young Adult