Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

• Published in: Journal of neuroimaging Vol. 30; no. 2; pp. 175 - 183
• Main Authors: Leung, Lok Wa Laura, Unadkat, Prashin, Bertotti, Melina More, Bi, Wenya Linda, Essayed, Walid Ibn, Bunevicius, Adomas, Chavakula, Vamsidhar, Rigolo, Laura, Fumagalli, Luca, Tie, Ziyun, Golby, Alexandra J., Tie, Yanmei
• Format: Journal Article
• Language: English
• Published: United States Wiley Subscription Services, Inc 01-03-2020
• Subjects: Activation; Adult; Bilingual language; Bilingualism; Brain; Brain cancer; Brain mapping; Brain Mapping - methods; Brain Neoplasms - diagnostic imaging; Brain Neoplasms - surgery; brain tumor; Brain tumors; Decision analysis; Decision making; English language; Evaluation; Female; Functional Laterality - physiology; Functional magnetic resonance imaging; functional magnetic resonance imaging (fMRI); Humans; Language; language mapping; Languages; Localization; Magnetic Resonance Imaging - methods; Male; Mapping; Middle Aged; Multilingualism; Neuroimaging; Neurosurgery; Patients; Polls & surveys; preoperative planning; Quantitative analysis; Retrospective Studies; Surgery; Tumors; Wakefulness; Young Adult; functional magnetic resonance imaging (fMRI); language mapping; brain tumor; Bilingual language; preoperative planning
• ISSN: 1051-2284; 1552-6569
• DOI: 10.1111/jon.12690

ABSTRACT
BACKGROUND AND PURPOSE
Previous literature has demonstrated disparity in the postoperative recovery of first and second language function of bilingual neurosurgical patients. However, it is unclear to whether preoperative brain mapping of both languages is needed. In this study, we aimed to evaluate the clinical utility of language task functional MRI (fMRI) implemented in both languages in bilingual patients.
METHODS
We retrospectively examined fMRI data of 13 bilingual brain tumor patients (age: 23 to 59 years) who performed antonym generation task‐based fMRIs in English and non‐English language. The usefulness of bilingual language mapping was evaluated using a structured survey administered to 5 neurosurgeons. Additionally, quantitative comparison between the brain activation maps of both languages was performed.
RESULTS
Survey responses revealed differences in raters’ surgical approach, including asleep versus awake surgery and extent of resection, after viewing the language fMRI maps. Additional non‐English fMRI led to changes in surgical decision‐making and bettered localization of language areas. Quantitative analysis revealed an increase in laterality index (LI) in non‐English fMRI compared to English fMRI. The Dice coefficient demonstrated fair overlap (.458 ± .160) between the activation maps.
CONCLUSION
Bilingual fMRI mapping of bilingual patients allows to better appreciate functionally active language areas that may be neglected in single language mapping. Utility of bilingual mapping was supported by changes in both surgical approach and LI measurements, suggesting its benefit on preoperative language mapping.