Language area localization with three-dimensional functional magnetic resonance imaging matches intrasulcal electrostimulation in Broca's area

• Published in: Annals of neurology Vol. 46; no. 3; pp. 405 - 408
• Main Authors: Rutten, G. J. M., Van Rijen, P. C., Van Veelen, C. W. M., Ramsey, N. F.
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York John Wiley & Sons, Inc 01.09.1999; Willey-Liss
• Subjects: Adolescent; Biological and medical sciences; Brain Mapping - methods; Brain Neoplasms - complications; Brain Neoplasms - pathology; Electric Stimulation; Epilepsy - complications; Epilepsy - pathology; Female; Frontal Lobe - pathology; Frontal Lobe - physiopathology; Ganglioglioma - complications; Ganglioglioma - pathology; Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy; Humans; Language; Magnetic Resonance Imaging; Medical sciences; Nervous system (semeiology, syndromes); Neurology; Human; Nervous system diseases; Epilepsy; Exploration; Intraoperative; Anticonvulsant; Nuclear magnetic resonance imaging; Cerebral disorder; Case study; Ganglioglioma; Three dimensional representation; Central nervous system disease; Adolescent; Medical imagery; Negative therapeutic reaction; Comparative study; Electrocorticography
• ISSN: 0364-5134; 1531-8249
• DOI: 10.1002/1531-8249(199909)46:3<405::AID-ANA17>3.0.CO;2-G

In this study, intraoperative electrocortical stimulation mapping (ioESM), the current gold standard for the localization of critical language areas, is compared with functional magnetic resonance imaging (fMRI) in a 14‐year‐old girl with medically intractable epilepsy caused by a tumor in the region of Broca's area. Prior to the operation, four different fMRI tasks that target inferior frontal language areas were applied. Prior to the resection, ioESM as well as fMRI detected no language areas at the exposed cortical area. After removal of the tumor, a unique opportunity presented itself, where ioESM could be performed in the depth of a now exposed and intact gyrus. One specific locus that was indicated to be a critical language area by multiple‐task fMRI was targeted. IoESM selectively confirmed the location of this language area to within an estimated 3 mm. We propose that the combined use of different fMRI tasks increases the sensitivity and specificity for the detection of essential language areas.