• Melanie Genetti, Frederic Grouiller, Serge Vulliemoz, Laurent Spinelli, Margitta Seeck, Christoph Martin Michel, and Karl Schaller.
• Department of Neurology and Fundamental Neurosciences, Geneva University Hospitals, Geneva, Switzerland.
• Neurosurgery. 2013 Apr 1;72(4):555-65; discussion 565.

BackgroundFunctional magnetic resonance imaging (fMRI) has become part of routine brain mapping in patients with epilepsy or tumor undergoing resective surgery. However, robust localization of crucial functional areas is required.ObjectiveTo establish a simple, short fMRI task that reliably localizes crucial language areas in individual patients who undergo respective surgery.MethodsfMRI was measured during an 8-minute auditory semantic decision task in 28 healthy controls and 35 consecutive patients who had focal epilepsy or a brain tumor. Nineteen underwent resective surgery. Group and individual analyses were performed. Results in patients were compared with postsurgical language outcome and electrocortical stimulation when available.ResultsfMRI activations concordant with the anterior and posterior language areas were found in 96% and 89% of the controls, respectively. The anterior and posterior language areas were both activated in 93% of the patients. These results were concordant with electrocortical stimulation results in 5 patients. Transient postsurgical language deficits were found in 2 patients in whom surgery was performed in the vicinity of the fMRI activations or who had postsurgical complications implicating areas of fMRI activations.ConclusionThe proposed fast fMRI language protocol reliably localized the most relevant language areas in individual subjects. It appears to be a valuable complementary tool for surgical planning of epileptogenic foci and of brain tumors.

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