Cerebellar language mapping and cerebral language dominance in pediatric epilepsy surgery patients.
OBJECTIVE
Children with epilepsy often have reorganization of language networks and abnormal brain anatomy, making determination of language lateralization difficult. We characterized the proportion and distribution of language task activation in the cerebellum to determine the relationship to cerebral language lateralization.


METHODS
Forty-six pediatric epilepsy surgery candidates (aged 7-19 years) completed an fMRI auditory semantic decision language task. Distribution of activated voxels and language laterality indices were computed using: (a) Broca's and Wernicke's areas and their right cerebral homologues; and (b) left and right cerebellar hemispheres. Language task activation was anatomically localized in the cerebellum.


RESULTS
Lateralized language task activation in either cerebral hemisphere was highly correlated with lateralized language task activation in the contralateral cerebellar hemisphere (Broca vs. cerebellar: ρ = -0.54, p < 0.01). Cerebellar language activation was located within Crus I/II, areas previously implicated in non-motor functional networks.


CONCLUSIONS
Cerebellar language activation occurs in homologous regions of Crus I/II contralateral to cerebral language activation in patients with both right and left cerebral language dominance. Cerebellar language laterality could contribute to comprehensive pre-operative evaluation of language lateralization in pediatric epilepsy surgery patients. Our data suggest that patients with atypical cerebellar language activation are at risk for having atypical cerebral language organization.
Neurosciences and Physiology, New York University Langone Medical Center, 450 East 29th St, New York, NY 10016, USA.
Jennifer N
JN
Gelinas
Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada.
Kevin P V
KP
Fitzpatrick
Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada.
Hong Cheol
HC
Kim
Division of Neurology, Department of Pediatrics, University of British Columbia, 4480 Oak Street, Vancouver V6H 3V4, Canada ; Child and Family Research Institute, University of British Columbia, 950 W. 28th Ave, Vancouver V6H 3V4, Canada.
Bruce H
BH
Bjornson
D000293:Adolescent; D002531:Cerebellum / Q000503:physiopathology*; D002540:Cerebral Cortex / Q000503:physiopathology*; D002648:Child; D004827:Epilepsy / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D012660:Semantics
Aphasia; Broca's area; Cerebellum; Child; Functional Connectivity; Functional MRI; Laterality index; Wernicke's area