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<meta name="DC.Title" content="Assessment of the Language Laterality Index in Patients with Brain Tumor Using Functional MR Imaging: Effects of Thresholding, Task Selection, and Prior Surgery" />
<meta name="DC.Identifier" content="10.3174/ajnr.A0841" />
<meta name="DC.Date" content="2008-03-01" />
<meta name="DC.Publisher" content="American Journal of Neuroradiology" />
<meta name="DC.Rights" content="Copyright © American Society of Neuroradiology" />
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<meta name="DC.Description" content="BACKGROUND AND PURPOSE: Functional MR imaging (fMRI) is used to determine preoperatively the laterality of cortical language representation along with the relationship of language areas to adjacent brain tumors. The purpose of this study was to determine whether changing the statistical threshold for different language tasks influences the language laterality index (LI) for a group of controls, patients with tumor without prior surgery, and patients with tumor and prior surgery.

MATERIALS AND METHODS: Seven controls, 9 patients with tumor without prior surgery, and 4 patients with tumor and prior surgery performed verb-generation, phonemic fluency, and semantic fluency language tasks during fMRI. Interhemispheric activation differences between the left and right Broca regions of interest were determined by calculating language LIs. LIs were compared within each group, between groups, and between language tasks. Intraoperative electrocortical mapping or the presence of aphasia during postoperative neurology examinations or both were used as ground truth.

RESULTS: The language LI varied as a result of statistical thresholding, presence of tumor, prior surgery, and language task. Although patients and controls followed a similar shape in the LI curve, there was no optimal P value for determining the LI. Three patients demonstrated a shift in the LI between hemispheres as a function of statistical threshold. Verb generation was the least variable task both between tasks and across groups.

CONCLUSION: For preoperative patients with tumor, the LI should be examined across a spectrum of P values and a range of tasks to ensure reliability. Our data suggest that the LI may be threshold- and task-dependent, particularly in the presence of adjacent tumor." />
<meta name="DC.Contributor" content="I.M. Ruff" />
<meta name="DC.Contributor" content="N.M. Petrovich Brennan" />
<meta name="DC.Contributor" content="K.K. Peck" />
<meta name="DC.Contributor" content="B.L. Hou" />
<meta name="DC.Contributor" content="V. Tabar" />
<meta name="DC.Contributor" content="C.W. Brennan" />
<meta name="DC.Contributor" content="A.I. Holodny" />
<meta name="article:published_time" content="2008-03-01" />
<meta name="article:section" content="FUNCTIONAL" />
<meta name="citation_title" content="Assessment of the Language Laterality Index in Patients with Brain Tumor Using Functional MR Imaging: Effects of Thresholding, Task Selection, and Prior Surgery" />
<meta name="citation_abstract" lang="en" content="&lt;p&gt;&lt;b&gt;BACKGROUND AND PURPOSE:&lt;/b&gt; Functional MR imaging (fMRI) is used to determine preoperatively the laterality of cortical language representation along with the relationship of language areas to adjacent brain tumors. The purpose of this study was to determine whether changing the statistical threshold for different language tasks influences the language laterality index (LI) for a group of controls, patients with tumor without prior surgery, and patients with tumor and prior surgery.&lt;/p&gt;&lt;p&gt;&lt;b&gt;MATERIALS AND METHODS:&lt;/b&gt; Seven controls, 9 patients with tumor without prior surgery, and 4 patients with tumor and prior surgery performed verb-generation, phonemic fluency, and semantic fluency language tasks during fMRI. Interhemispheric activation differences between the left and right Broca regions of interest were determined by calculating language LIs. LIs were compared within each group, between groups, and between language tasks. Intraoperative electrocortical mapping or the presence of aphasia during postoperative neurology examinations or both were used as ground truth.&lt;/p&gt;&lt;p&gt;&lt;b&gt;RESULTS:&lt;/b&gt; The language LI varied as a result of statistical thresholding, presence of tumor, prior surgery, and language task. Although patients and controls followed a similar shape in the LI curve, there was no optimal &lt;i&gt;P&lt;/i&gt; value for determining the LI. Three patients demonstrated a shift in the LI between hemispheres as a function of statistical threshold. Verb generation was the least variable task both between tasks and across groups.&lt;/p&gt;&lt;p&gt;&lt;b&gt;CONCLUSION:&lt;/b&gt; For preoperative patients with tumor, the LI should be examined across a spectrum of &lt;i&gt;P&lt;/i&gt; values and a range of tasks to ensure reliability. Our data suggest that the LI may be threshold- and task-dependent, particularly in the presence of adjacent tumor.&lt;/p&gt;" />
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<meta name="citation_publication_date" content="2008/03/01" />
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<meta name="twitter:description" content="BACKGROUND AND PURPOSE: Functional MR imaging (fMRI) is used to determine preoperatively the laterality of cortical language representation along with the relationship of language areas to adjacent brain tumors. The purpose of this study was to determine whether changing the statistical threshold for different language tasks influences the language laterality index (LI) for a group of controls, patients with tumor without prior surgery, and patients with tumor and prior surgery.

MATERIALS AND METHODS: Seven controls, 9 patients with tumor without prior surgery, and 4 patients with tumor and prior surgery performed verb-generation, phonemic fluency, and semantic fluency language tasks during fMRI. Interhemispheric activation differences between the left and right Broca regions of interest were determined by calculating language LIs. LIs were compared within each group, between groups, and between language tasks. Intraoperative electrocortical mapping or the presence of aphasia during postoperative neurology examinations or both were used as ground truth.

RESULTS: The language LI varied as a result of statistical thresholding, presence of tumor, prior surgery, and language task. Although patients and controls followed a similar shape in the LI curve, there was no optimal P value for determining the LI. Three patients demonstrated a shift in the LI between hemispheres as a function of statistical threshold. Verb generation was the least variable task both between tasks and across groups.

CONCLUSION: For preoperative patients with tumor, the LI should be examined across a spectrum of P values and a range of tasks to ensure reliability. Our data suggest that the LI may be threshold- and task-dependent, particularly in the presence of adjacent tumor." />
<meta name="og-title" property="og:title" content="Assessment of the Language Laterality Index in Patients with Brain Tumor Using Functional MR Imaging: Effects of Thresholding, Task Selection, and Prior Surgery" />
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<meta name="og-description" property="og:description" content="BACKGROUND AND PURPOSE: Functional MR imaging (fMRI) is used to determine preoperatively the laterality of cortical language representation along with the relationship of language areas to adjacent brain tumors. The purpose of this study was to determine whether changing the statistical threshold for different language tasks influences the language laterality index (LI) for a group of controls, patients with tumor without prior surgery, and patients with tumor and prior surgery.

MATERIALS AND METHODS: Seven controls, 9 patients with tumor without prior surgery, and 4 patients with tumor and prior surgery performed verb-generation, phonemic fluency, and semantic fluency language tasks during fMRI. Interhemispheric activation differences between the left and right Broca regions of interest were determined by calculating language LIs. LIs were compared within each group, between groups, and between language tasks. Intraoperative electrocortical mapping or the presence of aphasia during postoperative neurology examinations or both were used as ground truth.

RESULTS: The language LI varied as a result of statistical thresholding, presence of tumor, prior surgery, and language task. Although patients and controls followed a similar shape in the LI curve, there was no optimal P value for determining the LI. Three patients demonstrated a shift in the LI between hemispheres as a function of statistical threshold. Verb generation was the least variable task both between tasks and across groups.

CONCLUSION: For preoperative patients with tumor, the LI should be examined across a spectrum of P values and a range of tasks to ensure reliability. Our data suggest that the LI may be threshold- and task-dependent, particularly in the presence of adjacent tumor." />
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    <div class="highwire-article-citation highwire-citation-type-highwire-article node7922--5" data-node-nid="7922" id="top-node-7922--61917875000" data-pisa="ajnr;29/3/528" data-pisa-master="ajnr;ajnr.A0841" data-apath="/ajnr/29/3/528.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Research Article</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">FUNCTIONAL</span></span></div>
  
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      <h1 class="highwire-cite-title" id="page-title">Assessment of the Language Laterality Index in Patients with Brain Tumor Using Functional MR Imaging: Effects of Thresholding, Task Selection, and Prior Surgery</h1>  
    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">I.M. Ruff</span>, <span class="highwire-citation-author" data-delta="1">N.M. Petrovich Brennan</span>, <span class="highwire-citation-author" data-delta="2">K.K. Peck</span>, <span class="highwire-citation-author" data-delta="3">B.L. Hou</span>, <span class="highwire-citation-author" data-delta="4">V. Tabar</span>, <span class="highwire-citation-author" data-delta="5">C.W. Brennan</span> and <span class="highwire-citation-author" data-delta="6">A.I. Holodny</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">March 2008,  </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">528-535; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A0841 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-7922--61917875000" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">I.M. Ruff </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=I.M.%2BRuff%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Ruff%20I&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AI.M.%2BRuff%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">N.M. 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Peck </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=K.K.%2BPeck%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Peck%20K&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AK.K.%2BPeck%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">B.L. Hou </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=B.L.%2BHou%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Hou%20B&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AB.L.%2BHou%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">V. Tabar </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=V.%2BTabar%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Tabar%20V&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AV.%2BTabar%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-5"><div class="author-tooltip-name">C.W. Brennan </div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.W.%2BBrennan%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Brennan%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link last"><a href="/search/author1%3AC.W.%2BBrennan%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li></ul></div><div class="author-tooltip-6"><div class="author-tooltip-name">A.I. 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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" xmlns:xhtml="http://www.w3.org/1999/xhtml" class="section ref-list" id="ref-list-1"><h2>References</h2><ol class="cit-list"><li><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1 in text" id="ref-1">↵</a><div class="cit ref-cit ref-other" id="cit-29.3.528.1" data-doi="10.1097/00004728-199711000-00013"><div class="cit-metadata"><cite>Maldjian JA, Schulder M, Liu WC, et al. <strong>Intraoperative functional MRI using a real-time neurosurgical navigation system.</strong> <span class="cit-source">J Comput Assist Tomogr</span> <span class="cit-pub-date">1997</span>;<span class="cit-vol">21</span>:<span class="cit-fpage">910</span>–12</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/00004728-199711000-00013&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=9386283&amp;link_type=MED&amp;atom=%2Fajnr%2F29%2F3%2F528.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=A1997YF69400014&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-29.3.528.2" data-doi="10.1159/000099909"><div class="cit-metadata"><cite>Schulder M, Maldjian JA, Liu WC, et al. <strong>Functional MRI-guided surgery of intracranial tumors.</strong> <span class="cit-source">Stereotact Funct Neurosurg</span> <span class="cit-pub-date">1997</span>;<span class="cit-vol">68</span>:<span class="cit-fpage">98</span>–105</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1159/000099909&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=9711702&amp;link_type=MED&amp;atom=%2Fajnr%2F29%2F3%2F528.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><div class="cit ref-cit ref-other no-rev-xref" id="cit-29.3.528.3" data-doi="10.1097/00006123-200009000-00037"><div class="cit-metadata"><cite>Hirsch J, Ruge MI, Kim KH, et al. <strong>An integrated functional magnetic resonance imaging procedure for preoperative mapping of cortical areas associated with tactile, motor, language, and visual functions.</strong> <span class="cit-source">Neurosurgery</span> <span class="cit-pub-date">2000</span>;<span class="cit-vol">47</span>:<span class="cit-fpage">711</span>–21</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1097/00006123-200009000-00037&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi 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class="cit-fpage">266</span>–96</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=10.1006/brln.2001.2485&amp;link_type=DOI" class="cit-ref-sprinkles cit-ref-sprinkles-doi cit-ref-sprinkles-crossref"><span>CrossRef</span></a><a href="/lookup/external-ref?access_num=11712847&amp;link_type=MED&amp;atom=%2Fajnr%2F29%2F3%2F528.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a><a href="/lookup/external-ref?access_num=000172424500005&amp;link_type=ISI" class="cit-ref-sprinkles cit-ref-sprinkles-newisilink cit-ref-sprinkles-webofscience"><span>Web of Science</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-41-1" title="View reference 41 in text" id="ref-41">↵</a><div class="cit ref-cit ref-other" id="cit-29.3.528.41"><div class="cit-metadata"><cite>Pouratian N, Bookheimer SY, Rubino G, et al. <strong>Category-specific naming deficit identified by intraoperative stimulation mapping and postoperative neuropsychological testing: case report.</strong> <span class="cit-source">J Neurosurg</span> <span class="cit-pub-date">2003</span>;<span class="cit-vol">99</span>:<span class="cit-fpage">170</span>–76</cite></div><div class="cit-extra"><a href="/lookup/external-ref?access_num=12854762&amp;link_type=MED&amp;atom=%2Fajnr%2F29%2F3%2F528.atom" class="cit-ref-sprinkles cit-ref-sprinkles-medline"><span>PubMed</span></a></div></div></li><li><a class="rev-xref-ref" href="#xref-ref-42-1" title="View reference 42 in text" id="ref-42">↵</a><div class="cit ref-cit ref-other" id="cit-29.3.528.42"><div class="cit-metadata"><cite>Ramsey NF, Sommer IE, Rutten GJ, et al. <strong>Combined analysis of language tasks in fMRI improves assessment of hemispheric dominance for language functions in individual subjects.</strong> <span class="cit-source">Neuroimage</span> <span class="cit-pub-date">2001</span>;<span class="cit-vol">13</span>:<span class="cit-fpage">719</span>–33</cite></div><div 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    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">528-535; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0841 </span></div>
  
  
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0"><span class="nlm-given-names">I.M.</span> <span class="nlm-surname">Ruff</span></span>, <span class="highwire-citation-author" data-delta="1"><span class="nlm-given-names">N.M.</span> <span class="nlm-surname">Petrovich Brennan</span></span>, <span class="highwire-citation-author" data-delta="2"><span class="nlm-given-names">K.K.</span> <span class="nlm-surname">Peck</span></span>, <span class="highwire-citation-author" data-delta="3"><span class="nlm-given-names">B.L.</span> <span class="nlm-surname">Hou</span></span>, <span class="highwire-citation-author" data-delta="4"><span class="nlm-given-names">V.</span> <span class="nlm-surname">Tabar</span></span>, <span class="highwire-citation-author" data-delta="5"><span class="nlm-given-names">C.W.</span> <span class="nlm-surname">Brennan</span></span>, <span class="highwire-citation-author" data-delta="6"><span class="nlm-given-names">A.I.</span> <span class="nlm-surname">Holodny</span></span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">Mar 2008, </span><span  class="highwire-cite-metadata-volume highwire-cite-metadata">29 </span><span  class="highwire-cite-metadata-issue highwire-cite-metadata">(3) </span><span  class="highwire-cite-metadata-pages highwire-cite-metadata">528-535; </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata"><span class="label">DOI:</span> 10.3174/ajnr.A0841 </span></div>
  
  
  
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