A Four Task Based fMRI Paradigm for pre-surgical Language Localisation - A Feasibility Study
Presented During: Poster Session 3
Friday, June 27, 2025: 01:45 PM - 03:45 PM
Friday, June 27, 2025: 01:45 PM - 03:45 PM
Presented During: Poster Session 4
Saturday, June 28, 2025: 01:45 PM - 03:45 PM
Saturday, June 28, 2025: 01:45 PM - 03:45 PM
Poster No:
1881
Submission Type:
Abstract Submission
Authors:
Swati Jain1, Emmanuel Stamatakis2, Stephen Price2
Institutions:
1University Of Cambridge, Cambridge, Cambridgeshire, 2University of Cambridge, Cambridge, Cambridgeshire
First Author:
Co-Author(s):
Introduction:
Awake craniotomy with intra-operative direct cortical stimulation is now considered the gold standard for patients with brain tumours affecting the eloquent areas of the brain. Functional magnetic resonance imaging (fMRI) provides a non-invasive method for localisation of language dominant areas using task-specific brain activation maps. The maps are generated from changes in blood oxygen level dependent (BOLD) signal in response to a task. In this study, we evaluated a proposed 4 task-based fMRI paradigm to provide maximal pre-operative information for language localisation.
Methods:
15 healthy participants were recruited prospectively for this study. After completion of anatomical and resting state fMRI, the participants were asked to perform 4 tasks in the following sequence.
a. Covert naming
b. Overt naming
c. Sentence completion
d. Pyramids and Palm Trees Test (PPTT)
Pre-processed functional images for each participant were entered within a first-level general linear model (GLM) framework. The GLM model was generated for each paradigm by modelling the trial stimulus onset times, time to next event in the paradigms 1, 2, and 3, or response times in paradigm 4 (PPTT), convolved with the haemodynamic response function. A high-pass filter with a period of 128 seconds was used to remove low-frequency scanner noise. A design matrix was generated for all 4 tasks. To understand areas of activation involved in each task, a subtractive analysis was carried out between the event and the control block for each of the tasks. Resulting contrast images were entered into a second level group analysis to obtain within group activations for each task. For each participant, voxel defining threshold to identify potential clusters for activation was set at p<0.001. Cluster size threshold was defined using False Discovery Rate (FDR) at p<0.05.
a. Covert naming
b. Overt naming
c. Sentence completion
d. Pyramids and Palm Trees Test (PPTT)
Pre-processed functional images for each participant were entered within a first-level general linear model (GLM) framework. The GLM model was generated for each paradigm by modelling the trial stimulus onset times, time to next event in the paradigms 1, 2, and 3, or response times in paradigm 4 (PPTT), convolved with the haemodynamic response function. A high-pass filter with a period of 128 seconds was used to remove low-frequency scanner noise. A design matrix was generated for all 4 tasks. To understand areas of activation involved in each task, a subtractive analysis was carried out between the event and the control block for each of the tasks. Resulting contrast images were entered into a second level group analysis to obtain within group activations for each task. For each participant, voxel defining threshold to identify potential clusters for activation was set at p<0.001. Cluster size threshold was defined using False Discovery Rate (FDR) at p<0.05.
Results:
The average time duration for the whole MRI scan session was 61.8 ± 5.7 minutes, with maximal time taken by a participant being 80 minutes due to issues with the running of the task paradigm. The average time taken for all 4 tasks was 25.9 ± 1.8 minutes (23-31 minutes). This is reassuring as we can expect a patient to complete the pre-operative MRI in a reasonable time, thus reducing the chances of discomfort from prolonged lie, movements resulting in significant motion artefacts, or poor cooperation with the tasks.
There is no significant activation noted in either left or right inferior frontal gyrus or superior temporal gyrus across all 15 subjects in the covert naming task. During the overt naming task, activations were noted in the pre-central and post-central gyrus along with temporal gyrus. PPTT showed bilateral representations across 15 subjects, often involving the right parietal lobule and supramarginal gyrus. A combined language map was generated for each subject (Figure 1 for Subject 8).
As some patients are likely to have word finding difficulties or dysphasia, assessment of both covert and overt naming allows added accuracy in forming the overall language map. Intra-operatively, it is not possible to assess patient's functional areas using covert naming. During sentence completion, activations beyond the classical language areas were seen including the middle frontal gyrus, cuneus, and parietal lobule, consistent with the language network being more diffuse than localised to specific cortical areas. During PPTT involvement of the supramarginal gyrus and superior parietal lobule was consistent, in keeping with the association areas involvement to complete the task.
There is no significant activation noted in either left or right inferior frontal gyrus or superior temporal gyrus across all 15 subjects in the covert naming task. During the overt naming task, activations were noted in the pre-central and post-central gyrus along with temporal gyrus. PPTT showed bilateral representations across 15 subjects, often involving the right parietal lobule and supramarginal gyrus. A combined language map was generated for each subject (Figure 1 for Subject 8).
As some patients are likely to have word finding difficulties or dysphasia, assessment of both covert and overt naming allows added accuracy in forming the overall language map. Intra-operatively, it is not possible to assess patient's functional areas using covert naming. During sentence completion, activations beyond the classical language areas were seen including the middle frontal gyrus, cuneus, and parietal lobule, consistent with the language network being more diffuse than localised to specific cortical areas. During PPTT involvement of the supramarginal gyrus and superior parietal lobule was consistent, in keeping with the association areas involvement to complete the task.
·Combined Language Network for Subject 8
Conclusions:
The study assesses the feasibility of 4 task-based fMRI paradigm evaluating the language network in healthy volunteers. With the tasks being completed in a reasonable duration, they provide maximal information that can be translated into intra-operative testing during awake surgeries.
Language:
Language Other 2
Novel Imaging Acquisition Methods:
BOLD fMRI 1
Keywords:
fMRI CONTRAST MECHANISMS
FUNCTIONAL MRI
Language
Other - Gliomas
1|2Indicates the priority used for review
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Provide references using APA citation style.
Hickok, G. (2012). The cortical organization of speech processing: feedback control and predictive coding the context of a dual-stream model. J Commun Disord, 45(6), 393-402. https://doi.org/10.1016/j.jcomdis.2012.06.004