Probabilistic machine learning for the evaluation of presurgical language dominance

Tomer Gazit*, Fani Andelman, Yifat Glikmann-Johnston, Tal Gonen, Aliya Solski, Irit Shapira-Lichter, Moran Ovadia, Svetlana Kipervasser, Miriam Y. Neufeld, Itzhak Fried, Talma Hendler, Daniella Perry

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


OBJECTIVE: Providing a reliable assessment of language lateralization is an important task to be performed prior to neurosurgery in patients with epilepsy. Over the last decade, functional MRI (fMRI) has emerged as a useful noninvasive tool for language lateralization, supplementing or replacing traditional invasive methods. In standard practice, fMRI-based language lateralization is assessed qualitatively by visual inspection of fMRI maps at a specific chosen activation threshold. The purpose of this study was to develop and evaluate a new computational technique for providing the probability of each patient to be left, right, or bilateral dominant in language processing. METHODS: In 76 patients with epilepsy, a language lateralization index was calculated using the verb-generation fMRI task over a wide range of activation thresholds (from a permissive threshold, analyzing all brain regions, to a harsh threshold, analyzing only the strongest activations). The data were classified using a probabilistic logistic regression method. RESULTS: Concordant results between fMRI and Wada lateralization were observed in 89% of patients. Bilateral and right-dominant groups showed similar fMRI lateralization patterns differentiating them from the left-dominant group but still allowing classification in 82% of patients. CONCLUSIONS: These findings present the utility of a semi-supervised probabilistic learning approach for presurgical language-dominance mapping, which may be extended to other cognitive domains such as memory and attention.

Original languageEnglish
Pages (from-to)481-493
Number of pages13
JournalJournal of Neurosurgery
Issue number2
StatePublished - Aug 2016


  • Epilepsy
  • Functional neurosurgery
  • Language lateralization
  • Logistic regression
  • Semi-supervised
  • Wada
  • fMRI


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