Clinical Report: Utilization of Resting-State fMRI for Preoperative Language Area Lateralization

Overview

This study investigates language lateralization in patients with left-sided epileptogenic foci using resting-state fMRI.

Background

Understanding language lateralization is crucial for optimizing epilepsy surgery and minimizing postoperative language impairments. This study aims to clarify these differences and provide a reliable framework for preoperative assessment.

Data Highlights

Key Findings

• Non-classical language dominance was observed in 69.4% of epilepsy patients versus 45.5% of controls (P=0.024).
• Wernicke's area showed a higher rate of non-classical dominance (81.8%) compared to Broca's area (50.0%).
• The consistency of the laterality index–activation map was 83.3% (Kappa=0.586).
• Regional laterality index consistency was 75.0% (Kappa=0.40).
• SEEG stimulation confirmed that the left Broca's area retained core language function.
• Only 10.0% positive stimulation rate was observed in the left Wernicke's area, indicating significant functional impairment.

Clinical Implications

Preoperative language lateralization assessments using resting-state fMRI can identify language dominance shifts in epilepsy patients.

Conclusion

This study highlights the importance of using resting-state fMRI for preoperative language mapping in epilepsy.

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3. Brain, 2026 -- Cortical stimulation predicts language decline following SEEG radiofrequency thermocoagulation
4. Brain, 2026 -- Localization of Lesions and Associated Networks Linked to Dysnomia Following Epilepsy Surgery
5. American Academy of Neurology, 2023 -- Practice Guideline for Language Lateralization
6. Consensus recommendations for clinical functional MRI applied to language mapping, 2025
7. Frontiers, 2026 -- Application Value of Resting-State fMRI in Preoperative Lateralization of Language Areas in Epilepsy with Left-Sided Epileptogenic Foci
8. https://www.aan.com/Guidelines/home/GetGuidelineContent/840
9. Consensus recommendations for clinical functional MRI applied to language mapping
10. Frontiers | Application Value of Resting-State fMRI in Preoperative Lateralization of Language Areas in Epilepsy with Left-Sided Epileptogenic Foci