title: Presurgical language fMRI and postsurgical deficits: a single centre experience.
abstract: BACKGROUND
  In this study, we conducted a retrospective investigation of our initial single-centre experience with the clinical use of functional magnetic resonance imaging (fMRI) of hemisphere dominance for language processing (i.e., language lateralization). We demonstrated its association with surgical outcome and its potential impact on surgical planning and patient management.
  
  
  METHODS
  Fifty-two cases were reviewed, covering the period from July 2007 to July 2010. Clinical fMRI reports were examined to determine the hemisphere dominance for language processing. Neurological reports were examined to determine if new language deficits were present post-surgery. Neurosurgeon notes were also reviewed to determine if fMRI had an impact on surgical planning.
  
  
  RESULTS
  Of the cases reviewed, 49 (94%) generated conclusive fMRI. Eleven (22%) patients exhibited fMRI language lateralization contralateral to pathology; zero of nine of these patients that had surgery experienced post-surgical deficits. Twenty-two (44%) patients exhibited fMRI language lateralization ipsilateral to pathology; three of 13 of these patients that had surgery experienced post-surgical deficits. Sixteen (34%) patients exhibited bilateral lateralization of language; five of 13 of these patients that had surgery experienced post-surgery deficits. Several post-fMRI reports indicated that fMRI results had an impact on surgical planning.
  
  
  CONCLUSIONS
  Our results suggest that fMRI demonstrations of language processing within the hemisphere ipsilateral to pathology (either ipsilateral alone or bilateral) is associated with a greater risk for post-surgical language deficits, and in these cases, fMRI results should be taken into consideration for pre-surgical planning.
  
  
  
  IRMf du langage avant la chirurgie et déficits après la chirurgie : expérience d'un centre.
authors.forename: Charmaine
authors.initials: C
authors.lastname: Wiens
authors.forename: Bradley G
authors.initials: BG
authors.lastname: Goodyear
authors.forename: Ankur
authors.initials: A
authors.lastname: Goel
authors.forename: Paolo
authors.initials: P
authors.lastname: Federico
authors.forename: Walter
authors.initials: W
authors.lastname: Hader
authors.forename: Mayank
authors.initials: M
authors.lastname: Goyal
mesh_terms: D001931:Brain Mapping; D007839:Functional Laterality; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D012189:Retrospective Studies