title: Association between lesion location and language function in adult glioma using voxel-based lesion-symptom mapping.
abstract: BACKGROUND
  Management of language difficulties is an important aspect of clinical care for glioma patients, and accurately identifying the possible language deficits in patients based on lesion location would be beneficial to clinicians. To that end, we examined the relationship between lesion presence and language performance on tests of receptive language and expressive language using a highly specific voxel-based lesion-symptom mapping (VLSM) approach in glioma patients.
  
  
  METHODS
  98 adults with primary glioma, who were pre-surgical candidates, were administered seven neurocognitive tests within the domains of receptive language and expressive language. The association between language performance and lesion presence was examined using VLSM. Statistical parametric maps were created for each test, and composite maps for both receptive language and expressive language were created to display the significant voxels common to all tests within these language domains.
  
  
  RESULTS
  We identified clusters of voxels with a significant relationship between lesion presence and language performance. All tasks were associated with several white matter pathways. The receptive language tasks were additionally all associated with regions primarily within the lateral temporal lobe and medial temporal lobe. In contrast, the expressive language tasks shared little overlap, despite each task being independently associated with large anatomic areas.
  
  
  CONCLUSIONS
  Our findings identify the key anatomic structures involved in language functioning in adult glioma patients using an innovative lesion analysis technique and suggest that expressive language abilities may be more task-dependent and distributed than receptive language abilities.
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 760 Westwood Plaza, C8-746, Los Angeles, CA 90095, USA.
authors.forename: Pia
authors.initials: P
authors.lastname: Banerjee
authors.affiliation: UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers (CVIB), David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Leu
authors.affiliation: UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers (CVIB), David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Harris
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA.
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Cloughesy
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA.
authors.forename: Albert
authors.initials: A
authors.lastname: Lai
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, 710 Westwood Plaza, Los Angeles, CA 90095, USA.
authors.forename: Phioanh L
authors.initials: PL
authors.lastname: Nghiemphu
authors.affiliation: Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA.
authors.forename: Whitney B
authors.initials: WB
authors.lastname: Pope
authors.affiliation: Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, 760 Westwood Plaza, C8-746, Los Angeles, CA 90095, USA.
authors.forename: Susan Y
authors.initials: SY
authors.lastname: Bookheimer
authors.affiliation: UCLA Neuro-Oncology Program, University of California, Los Angeles, 710 Westwood Plaza, Reed Building 1-230, Los Angeles, CA 90095, USA; UCLA Brain Tumor Imaging Laboratory (BTIL), Center for Computer Vision and Imaging Biomarkers (CVIB), David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Radiological Sciences, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Bioengineering, Henry Samueli School of Engineering and Applied Science, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA; Department of Biomedical Physics, David Geffen School of Medicine, University of California, Los Angeles, 924 Westwood Blvd, Suite 615, Los Angeles, CA 90024, USA.
authors.forename: Benjamin M
authors.initials: BM
authors.lastname: Ellingson
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001932:Brain Neoplasms / Q000473:pathology* / Q000523:psychology*; D016000:Cluster Analysis; D007839:Functional Laterality; D005910:Glioma / Q000473:pathology* / Q000523:psychology*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D007802:Language; D008279:Magnetic Resonance Imaging / Q000379:methods; D008875:Middle Aged; D009483:Neuropsychological Tests; D055815:Young Adult
keywords: Glioma; Language; Lesion–symptom mapping; MRI; Neurocognitive functioning