TY - JOUR
T1 - Language related reorganization in adult brain with slow growing glioma
T2 - FMRI prospective case-study
AU - Rosenberg, Keren
AU - Liebling, Ronit
AU - Avidan, Galia
AU - Perry, Daniella
AU - Siman-Tov, Tali
AU - Andelman, Fani
AU - Ram, Zvi
AU - Fried, Itzhak
AU - Hendler, Talma
PY - 2008
Y1 - 2008
N2 - One possible mechanism for language plasticity in cases of lesions in left dominant hemisphere is the recruitment of homologous region in the unaffected non-dominant hemisphere. The potential of the right hemisphere to carry out such plasticity is expressed by the functional outcome of patients with lesions in the left hemisphere acquired at childhood prior to language acquisition. Whether lesions in the dominant hemisphere acquired in adulthood can result in functional recovery of language by means of recruitment of the non-dominant hemisphere is undetermined. We describe a 28-year-old, right-handed male diagnosed with a left temporo-frontal glioma. It was decided to manage him expectantly due to the low level of suspicion of malignancy and the close proximity of the lesion to critical language function centers. Language functional MRI (fMRI) tests were performed twice within the ensuing 2 years before surgical intervention. Regional brain activation was measured within the temporal and frontal lobes. Laterality index (LI) was calculated based on the corresponding number of activated voxels. The main finding is that over time, prior to resection of the enlarged tumor, the inferior frontal gyrus (IFG) changed from being strongly left lateralized in the first fMRI exam to being bilateral in the second fMRI exam, mainly due to larger activation in the right hemisphere. By that time, although the patient was not aphasic, his language performance was significantly below average. These findings suggest that a slow growing tumor in an adult language-related area might result in a functional reorganization by recruiting the right hemisphere. However, the contribution of such reorganization to the preservation of language performance remains equivocal.
AB - One possible mechanism for language plasticity in cases of lesions in left dominant hemisphere is the recruitment of homologous region in the unaffected non-dominant hemisphere. The potential of the right hemisphere to carry out such plasticity is expressed by the functional outcome of patients with lesions in the left hemisphere acquired at childhood prior to language acquisition. Whether lesions in the dominant hemisphere acquired in adulthood can result in functional recovery of language by means of recruitment of the non-dominant hemisphere is undetermined. We describe a 28-year-old, right-handed male diagnosed with a left temporo-frontal glioma. It was decided to manage him expectantly due to the low level of suspicion of malignancy and the close proximity of the lesion to critical language function centers. Language functional MRI (fMRI) tests were performed twice within the ensuing 2 years before surgical intervention. Regional brain activation was measured within the temporal and frontal lobes. Laterality index (LI) was calculated based on the corresponding number of activated voxels. The main finding is that over time, prior to resection of the enlarged tumor, the inferior frontal gyrus (IFG) changed from being strongly left lateralized in the first fMRI exam to being bilateral in the second fMRI exam, mainly due to larger activation in the right hemisphere. By that time, although the patient was not aphasic, his language performance was significantly below average. These findings suggest that a slow growing tumor in an adult language-related area might result in a functional reorganization by recruiting the right hemisphere. However, the contribution of such reorganization to the preservation of language performance remains equivocal.
KW - Cerebral lesion
KW - Functional reorganization
KW - Inferior frontal gyrus
KW - Language activation
KW - Lateralization index
UR - http://www.scopus.com/inward/record.url?scp=56549101220&partnerID=8YFLogxK
U2 - 10.1080/13554790802459486
DO - 10.1080/13554790802459486
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AN - SCOPUS:56549101220
SN - 1355-4794
VL - 14
SP - 465
EP - 473
JO - Neurocase
JF - Neurocase
IS - 6
ER -