Functional MR imaging of language processing: an overview of easy-to-implement paradigms for patient care and clinical research

Functional magnetic resonance (MR) imaging is one of the most commonly used functional neuroimaging techniques for studying the cerebral representation of language processing and is increasingly being used for both patient care and clinical research. In patient care, functional MR imaging is primarily used in the preoperative evaluation of (a) the relationship of a lesion to critical language areas and (b) hemispheric dominance. In clinical research, this modality is used to study language disorders due to neurologic disease and is generally aimed at language function recovery. A variety of language paradigms (verbal fluency, passive listening, comprehension) have been developed for the study of language processing and its separate components. All of the tasks are easy to implement, analyze, and perform. Silent gap acquisition is preferable for the imaging of specific language processing components because auditory stimuli are not degraded by imager noise. On the other hand, continuous acquisition allows more data to be acquired in less time, thereby increasing statistical power and decreasing the effects of motion artifacts. Although functional MR imaging cannot yet replace intraoperative electrocortical stimulation in patients undergoing neurosurgery, it may be useful for guiding surgical planning and mapping, thereby reducing the extent and duration of craniotomy.

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