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DOI: 10.1148/rg.26si065507
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Right arrow Magnetic Resonance Imaging
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Functional MR Imaging of Language Processing: An Overview of Easy-to-Implement Paradigms for Patient Care and Clinical Research1

Marion Smits, MD, Evy Visch-Brink, PhD, Caroline K. Schraa-Tam, MScm MEng, Peter J. Koudstaal, MD, PhD and Aad van der Lugt, MD, PhD

1 From the Departments of Radiology (M.S., C.K.S.T., A.v.d.L.) and Neurology (E.V.B., P.J.K.), Erasmus MC–University Medical Center Rotterdam, Dr Molewaterplein 40, 3015 GD Rotterdam, the Netherlands. Presented as an education exhibit at the 2005 RSNA Annual Meeting. Received February 3, 2006; revision requested April 12 and received May 1; accepted May 17. All authors have no financial relationships to disclose.

Figure 1
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  		Figure 1.  Image shows language processing areas of the brain, including Broca area (blue), located in Brodmann areas (BAs) 44 and 45; and Wernicke area (yellow), located in BAs 22, 37, 39, and 40. a.g. = angular gyrus, m.t.g. = middle temporal gyrus, p.o. = pars opercularis, p.t. = pars triangularis, s.g. = supramarginal gyrus, s.t.g. = superior temporal gyrus. Not shown is the planum temporale, which is located on the dorsal surface of the posterior part of the superior temporal gyrus, inside the sylvian fissure.

 

Figure 2
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  		Figure 2a.  Areas of activation for the semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster >10 voxels). (a) Silent gap acquisition. On high-resolution T1-weighted MR images, superimposed activation is seen only in the posterior language areas, predominantly in the left hemisphere. (b) Continuous acquisition. High-resolution T1-weighted MR images show much more widespread (superimposed) activation, with additional activation in the frontal language areas. Although activation is still predominantly left hemispheric, a substantial amount is also seen in the right hemisphere. Presumably, since the words are more difficult to hear with continuous acquisition, the subject will need to concentrate more on the words themselves, not just on the meaning of the words (ie, additional phonologic processing areas of the brain are recruited).

 

Figure 2
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  		Figure 2b.  Areas of activation for the semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster >10 voxels). (a) Silent gap acquisition. On high-resolution T1-weighted MR images, superimposed activation is seen only in the posterior language areas, predominantly in the left hemisphere. (b) Continuous acquisition. High-resolution T1-weighted MR images show much more widespread (superimposed) activation, with additional activation in the frontal language areas. Although activation is still predominantly left hemispheric, a substantial amount is also seen in the right hemisphere. Presumably, since the words are more difficult to hear with continuous acquisition, the subject will need to concentrate more on the words themselves, not just on the meaning of the words (ie, additional phonologic processing areas of the brain are recruited).

 

Figure 3
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  		Figure 3.  Schematic illustrates the verbal fluency–verb generation paradigm, with suggested responses to the presented nouns shown in text bubbles.

 

Figure 4
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  		Figure 4a.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 42-year-old man with a right hemispheric temporal lobe lesion who presented with headache and speech disorders. T1-weighted MR images show a lesion in the right temporal lobe (arrow in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; no relationship between the areas of activation and the lesion.

 

Figure 4
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  		Figure 4b.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 42-year-old man with a right hemispheric temporal lobe lesion who presented with headache and speech disorders. T1-weighted MR images show a lesion in the right temporal lobe (arrow in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; no relationship between the areas of activation and the lesion.

 

Figure 4
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  		Figure 4c.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 42-year-old man with a right hemispheric temporal lobe lesion who presented with headache and speech disorders. T1-weighted MR images show a lesion in the right temporal lobe (arrow in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; no relationship between the areas of activation and the lesion.

 

Figure 5
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  		Figure 5a.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 34-year-old man with a left hemispheric temporal lobe lesion who presented with speech disorders and seizures. T1-weighted MR images show a very large lesion in the left temporal lobe (arrows in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; classic Wernicke area activation adjacent to lesion.

 

Figure 5
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  		Figure 5b.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 34-year-old man with a left hemispheric temporal lobe lesion who presented with speech disorders and seizures. T1-weighted MR images show a very large lesion in the left temporal lobe (arrows in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; classic Wernicke area activation adjacent to lesion.

 

Figure 5
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  		Figure 5c.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 34-year-old man with a left hemispheric temporal lobe lesion who presented with speech disorders and seizures. T1-weighted MR images show a very large lesion in the left temporal lobe (arrows in a), an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b), and areas of equal activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c). Conclusions: left hemispheric dominance for language; classic Wernicke area activation adjacent to lesion.

 

Figure 6
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  		Figure 6a.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 49-year-old man with a left hemispheric temporal lobe lesion. T1-weighted MR images show a lesion in the left frontal lobe (arrows in a); an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b); and areas of activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c), with greater activation on the left side than on the right. Conclusions: left hemispheric dominance for language; classic Broca area activation adjacent to lesion.

 

Figure 6
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  		Figure 6b.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 49-year-old man with a left hemispheric temporal lobe lesion. T1-weighted MR images show a lesion in the left frontal lobe (arrows in a); an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b); and areas of activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c), with greater activation on the left side than on the right. Conclusions: left hemispheric dominance for language; classic Broca area activation adjacent to lesion.

 

Figure 6
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  		Figure 6c.  Areas of activation for the verbal fluency–verb generation paradigm. The subject was a left-handed 49-year-old man with a left hemispheric temporal lobe lesion. T1-weighted MR images show a lesion in the left frontal lobe (arrows in a); an area of superimposed activation in the left inferior frontal gyrus (classic Broca area) (arrows in b); and areas of activation bilaterally in the medial temporal gyri (classic Wernicke area) (arrows in c), with greater activation on the left side than on the right. Conclusions: left hemispheric dominance for language; classic Broca area activation adjacent to lesion.

 

Figure 7
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  		Figure 7.  Schematic illustrates the lexical decision paradigm, with the correct responses indicated by the button-press symbol.

 

Figure 8
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  		Figure 8a.  Areas of activation for the phonologic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster >10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal (a) and posterior parietotemporal (b) language areas, predominantly in the left hemisphere.

 

Figure 8
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  		Figure 8b.  Areas of activation for the phonologic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster >10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal (a) and posterior parietotemporal (b) language areas, predominantly in the left hemisphere.

 

Figure 9
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  		Figure 9.  Schematic illustrates the semantic paradigm, with the correct responses indicated by the button-press symbol.

 

Figure 10
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  		Figure 10a.  Areas of activation for the semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the posterior parietotemporal language area in the left hemisphere (b). No activation is seen in the frontal language area (a).

 

Figure 10
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  		Figure 10b.  Areas of activation for the semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the posterior parietotemporal language area in the left hemisphere (b). No activation is seen in the frontal language area (a).

 

Figure 11
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  		Figure 11.  Schematic illustrates the combined phonologic-semantic paradigm, with the correct responses indicated by the button-press symbol.

 

Figure 12
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  		Figure 12a.  Areas of activation for the combined phonologic-semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal (a) and posterior parietotemporal (b) language areas, predominantly in the left hemisphere.

 

Figure 12
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  		Figure 12b.  Areas of activation for the combined phonologic-semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal (a) and posterior parietotemporal (b) language areas, predominantly in the left hemisphere.

 

Figure 13
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  		Figure 13a.  Areas of activation for the combined phonologic-semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas (arrows in a) for phonologically incorrect sentences and in the posterior parietotemporal language areas only (arrows in b) for semantically incorrect sentences.

 

Figure 13
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  		Figure 13b.  Areas of activation for the combined phonologic-semantic paradigm as determined with a fixed-effects group analysis of six right-handed volunteers (T > 5, cluster > 10 voxels). High-resolution T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas (arrows in a) for phonologically incorrect sentences and in the posterior parietotemporal language areas only (arrows in b) for semantically incorrect sentences.

 

Figure 14
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  		Figure 14a.  Areas of activation for the semantic, phonologic, and combined phonologic-semantic paradigms. The patient was a right-handed 59-year-old man with primary progressive aphasia. (a) T1-weighted MR images show cerebral atrophy, including atrophy of the temporal lobes. (b–d) T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas for both the semantic (b) and phonologic (c) tasks, as well as widespread bilateral activation in these areas for the combined task (d).

 

Figure 14
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  		Figure 14b.  Areas of activation for the semantic, phonologic, and combined phonologic-semantic paradigms. The patient was a right-handed 59-year-old man with primary progressive aphasia. (a) T1-weighted MR images show cerebral atrophy, including atrophy of the temporal lobes. (b–d) T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas for both the semantic (b) and phonologic (c) tasks, as well as widespread bilateral activation in these areas for the combined task (d).

 

Figure 14
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  		Figure 14c.  Areas of activation for the semantic, phonologic, and combined phonologic-semantic paradigms. The patient was a right-handed 59-year-old man with primary progressive aphasia. (a) T1-weighted MR images show cerebral atrophy, including atrophy of the temporal lobes. (b–d) T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas for both the semantic (b) and phonologic (c) tasks, as well as widespread bilateral activation in these areas for the combined task (d).

 

Figure 14
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  		Figure 14d.  Areas of activation for the semantic, phonologic, and combined phonologic-semantic paradigms. The patient was a right-handed 59-year-old man with primary progressive aphasia. (a) T1-weighted MR images show cerebral atrophy, including atrophy of the temporal lobes. (b–d) T1-weighted MR images show superimposed activation in the frontal and posterior parietotemporal language areas for both the semantic (b) and phonologic (c) tasks, as well as widespread bilateral activation in these areas for the combined task (d).

 




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