title: Probabilistic machine learning for the evaluation of presurgical language dominance.
abstract: OBJECTIVE Providing a reliable assessment of language lateralization is an important task to be performed prior to neurosurgery in patients with epilepsy. Over the last decade, functional MRI (fMRI) has emerged as a useful noninvasive tool for language lateralization, supplementing or replacing traditional invasive methods. In standard practice, fMRI-based language lateralization is assessed qualitatively by visual inspection of fMRI maps at a specific chosen activation threshold. The purpose of this study was to develop and evaluate a new computational technique for providing the probability of each patient to be left, right, or bilateral dominant in language processing. METHODS In 76 patients with epilepsy, a language lateralization index was calculated using the verb-generation fMRI task over a wide range of activation thresholds (from a permissive threshold, analyzing all brain regions, to a harsh threshold, analyzing only the strongest activations). The data were classified using a probabilistic logistic regression method. RESULTS Concordant results between fMRI and Wada lateralization were observed in 89% of patients. Bilateral and right-dominant groups showed similar fMRI lateralization patterns differentiating them from the left-dominant group but still allowing classification in 82% of patients. CONCLUSIONS These findings present the utility of a semi-supervised probabilistic learning approach for presurgical language-dominance mapping, which may be extended to other cognitive domains such as memory and attention.
authors.affiliation: Functional Brain Center.
authors.forename: Tomer
authors.initials: T
authors.lastname: Gazit
authors.affiliation: Functional Neurosurgery Unit, Department of Neurosurgery and.
authors.forename: Fani
authors.initials: F
authors.lastname: Andelman
authors.affiliation: Functional Brain Center.
authors.forename: Yifat
authors.initials: Y
authors.lastname: Glikmann-Johnston
authors.affiliation: Functional Brain Center.|School of Psychological Sciences and.
authors.forename: Tal
authors.initials: T
authors.lastname: Gonen
authors.affiliation: Functional Brain Center.
authors.forename: Aliya
authors.initials: A
authors.lastname: Solski
authors.affiliation: Functional Brain Center.|Department of Neurology, Tel Aviv Souraksy Medical Center;
authors.forename: Irit
authors.initials: I
authors.lastname: Shapira-Lichter
authors.affiliation: Functional Brain Center.
authors.forename: Moran
authors.initials: M
authors.lastname: Ovadia
authors.affiliation: Functional Neurosurgery Unit, Department of Neurosurgery and.|Department of Neurology, Tel Aviv Souraksy Medical Center;|Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Svetlana
authors.initials: S
authors.lastname: Kipervasser
authors.affiliation: Department of Neurology, Tel Aviv Souraksy Medical Center;|Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Miriam Y
authors.initials: MY
authors.lastname: Neufeld
authors.affiliation: Functional Neurosurgery Unit, Department of Neurosurgery and.|Sagol School of Neuroscience.|Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.|Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California.
authors.forename: Itzhak
authors.initials: I
authors.lastname: Fried
authors.affiliation: Functional Brain Center.|School of Psychological Sciences and.|Sagol School of Neuroscience.|Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and.
authors.forename: Talma
authors.initials: T
authors.lastname: Hendler
authors.affiliation: Functional Brain Center.
authors.forename: Daniella
authors.initials: D
authors.lastname: Perry
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D000069279:Drug Resistant Epilepsy / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D007839:Functional Laterality; D006801:Humans; D007802:Language; D000069550:Machine Learning; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D055815:Young Adult
keywords: EPI = echo-planar imaging; LDP = language dominance probability; LI = lateralization index; SPGR = spoiled gradient; TASMC = Tel Aviv Sourasky Medical Center; Wada; epilepsy; fMRI; fMRI = functional MRI; functional neurosurgery; language lateralization; logistic regression; semi-supervised