Determination of language dominance using functional MRI

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Abstract
We performed functional MRI (FMRI) in 22 consecutive epilepsy patients undergoing intracarotid amobarbital (Wada) testing and compared language lateralization measures obtained with the two procedures.FMRI used a single-word semantic decision task previously shown to activate lateralized language areas in normal adults. Correlation between the two tests was highly significant (r equals 0.96; 95% CIs 0.90 to 0.98; p less than 0.0001). These results validate the FMRI technique and suggest that ``active99 areas observed with this semantic processing task correspond to those underlying hemispheric dominance for language. The strong correlation observed supports the view that language lateralization is a continuous rather than a dichotomous variable. In addition to lateralization information, FMRI consistently demonstrated focal regions of activity in lateral frontal and temporo-parieto-occipital cortex. These functional maps may be helpful in defining the boundaries of surgical excisions. NEUROLOGY 1996;46: 978-984.