title: Post-Surgical Language Reorganization Occurs in Tumors of the Dominant and Non-Dominant Hemisphere.
abstract: OBJECTIVE
  Surgical resection of brain tumors may shift the location of cortical language areas. Studies of language reorganization primarily investigated left-hemispheric tumors irrespective of hemispheric language dominance. We used functional magnetic resonance imaging (fMRI) to investigate how tumors influence post-surgical language reorganization in relation to the dominant language areas.
  
  
  METHODS
  A total of, 17 patients with brain tumors (16 gliomas, one metastasis) in the frontotemporal and lower parietal lobes planned for awake surgery underwent pre-surgical and post-surgical language fMRI. Language activation post-to-pre surgery was evaluated visually and quantitatively on the statistically thresholded images on patient-by-patient basis. Results were qualitatively compared between three patient groups: temporal, with tumors in the dominant temporal lobe, frontal, with tumors in the dominant frontal lobe and remote, with tumors in the non-dominant hemisphere.
  
  
  RESULTS
  Post-to-pre-surgical distributions of activated voxels changed in all except the one patient with metastasis. Changes were more pronounced in the dominant hemisphere for all three groups, showing increased number of activated voxels and also new activation areas. Tumor resection in the dominant hemisphere (frontal and temporal) shifted the activation from frontal towards temporal, whereas tumor resection in the non-dominant hemisphere shifted the activation from temporal towards frontal dominant areas.
  
  
  CONCLUSIONS
  Resection of gliomas in the dominant and in the non-dominant hemisphere induces postsurgical shifts and increase in language activation, indicating that infiltrating gliomas have a widespread influence on the language network. The dominant hemisphere gained most of the language activation irrespective of tumor localization, possibly reflecting recovery of pre-surgical tumor-induced suppression of these activations.
authors.affiliation: Department of Neuroradiology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.
authors.forename: M
authors.initials: M
authors.lastname: Avramescu-Murphy
authors.affiliation: Department of Neuroradiology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany.
authors.forename: E
authors.initials: E
authors.lastname: Hattingen
authors.affiliation: Department of Neurosurgery, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: M-T
authors.initials: MT
authors.lastname: Forster
authors.affiliation: Department of Neurosurgery, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Oszvald
authors.affiliation: Brain Imaging Center, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Anti
authors.affiliation: Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: S
authors.initials: S
authors.lastname: Frisch
authors.affiliation: Department of Neurology, Goethe University Frankfurt, Frankfurt, Germany.
authors.forename: M O
authors.initials: MO
authors.lastname: Russ
authors.affiliation: Department of Neuroradiology, Goethe University Frankfurt, Schleusenweg 2-16, 60528, Frankfurt, Germany. jurcoane@bic.uni-frankfurt.de.|Center for Individual Development and Adaptive Education of Children at Risk, Frankfurt, Germany. jurcoane@bic.uni-frankfurt.de.
authors.forename: A
authors.initials: A
authors.lastname: Jurcoane
mesh_terms: D000328:Adult; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D007839:Functional Laterality; D005858:Germany; D005910:Glioma; D006801:Humans; D007802:Language; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged
keywords: Language dominance; Post surgery; Reorganization; Tumor; fMRI