Abstract

Objectives: Functional magnetic resonance imaging (fMRI) is a reliable and non-invasive method with which to localize language function in pre-surgical planning. In clinical practice, visual stimulus presentation is often difficult or impossible, due to the patient's restricted language or attention abilities. Therefore, our aim was to investigate modality-specific differences in visual and auditory stimulus presentation.Methods: Ten healthy subjects participated in an fMRI study comprising two experiments with visual and auditory stimulus presentation. In both experiments, two language paradigms (one for language comprehension and one for language production) used in clinical practice were investigated. In addition to standard data analysis by the means of the general linear model (GLM), independent component analysis (ICA) was performed to achieve more detailed information on language processing networks.Results: GLM analysis revealed modality-specific brain activation for both language paradigms for the contrast visual > auditory in the area of the intraparietal sulcus and the hippocampus, two areas related to attention and working memory. Using group ICA, a language network was detected for both paradigms independent of stimulus presentation modality. The investigation of language lateralization revealed no significant variations. Visually presented stimuli further activated an attention-shift network, which could not be identified for the auditory presented language.Conclusion: The results of this study indicate that the visually presented language stimuli additionally activate an attention-shift network. These findings will provide important information for pre-surgical planning in order to preserve reading abilities after brain surgery, significantly improving surgical outcomes. Our findings suggest that the presentation modality for language paradigms should be adapted on behalf of individual indication.

Highlights

  • Brain surgery that involves eloquent cortical areas, in brain tumor or epilepsy patients, has remained a challenging task (Spena et al, 2010)

  • general linear model (GLM) analysis revealed modality-specific brain activation for both language paradigms for the contrast visual > auditory in the area of the intraparietal sulcus and the hippocampus, two areas related to attention and working memory

  • Our findings suggest that the presentation modality for language paradigms should be adapted on behalf of individual indication

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Summary

Introduction

Brain surgery that involves eloquent cortical areas, in brain tumor or epilepsy patients, has remained a challenging task (Spena et al, 2010). An accurate mapping of eloquent cortical areas ensures a sufficiently extensive and safe resection of brain parenchyma. Functional magnetic resonance imaging (fMRI) has been established as a reliable and noninvasive tool in mapping of cognitive and executive functions prior to brain surgery [for review see Dimou et al (2013)]. The gold standard for intraoperative language localization and neuronavigation is direct electrocortical stimulation (ECS; Sunaert, 2006). This method is time-consuming during surgery and is not applicable in all cases, as compliance of the awake patient during surgery is mandatory, and not all patients are capable of this

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