gms | German Medical Science

67th Annual Meeting of the German Society of Neurosurgery (DGNC)
Joint Meeting with the Korean Neurosurgical Society (KNS)

German Society of Neurosurgery (DGNC)

12 - 15 June 2016, Frankfurt am Main

Mapping the language network using passive fMRI

Meeting Abstract

  • Miriam H. A. Bauer - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg, Germany; LMN Marburg, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Marburg, Marburg, Germany; International Clinical Research Center, St. Anne‘s University Hospital, Brno, Czech Republic
  • Peer Herholz - LMN Marburg, Klinik für Psychiatrie und Psychotherapie, Universitätsklinikum Marburg, Marburg, Germany
  • Mirza Pojskic - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg, Germany
  • Barbara Carl - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg, Germany
  • Christopher Nimsky - Klinik für Neurochirurgie, Universitätsklinikum Marburg, Marburg, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocMI.15.03

doi: 10.3205/16dgnc321, urn:nbn:de:0183-16dgnc3213

Published: June 8, 2016

© 2016 Bauer et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at



Objective: To preoperatively localize and intraoperatively visualize components of the language network, such as Broca’s and Wernicke’s area, typically functional MRI (fMRI) is performed using word generation tasks or semantic decision tasks. These active fMRI tasks are heavily dependent on the patient’s compliance and ability to perform the task in an adequate manner, which is often complicated due to cognitive impairment, language deficits or stress related to following surgery. Inadequate task performance thereby often leads to insufficient identification of language areas and adaption of surgical strategies to ensure neurological functions postoperatively.

Method: To overcome this drawback we developed a passive fMRI paradigm for language network activation. The paradigm consists of a pseudo-randomized blocked design of auditory stimuli (sentences) and white noise. Patients only had to listen to the presented stimuli. To evaluate its ability to outline the language network in the clinical setting 3 patients (1: male, age 45, left handed; 2: female, age 53, right handed, 3: male, age 40, right handed) with gliomas close to the language areas within the left hemisphere underwent this 10 minute passive fMRI task at a 3T Trio MRI System (Siemens, Erlangen, Germany) using a T2* weighted echo planar imaging sequence. Analysis was performed using SPM12 including realignment, smoothing and analysis applying a general linear model. P<0.05 (family wise error corrected) was used as statistical threshold.

Results: Using the passive fMRI paradigm we were able to outline language network components such as Broca’s and Wernicke’s area besides further components such as Broca’s homologue in all 3 patients with cluster sizes of more than 200 voxels. Patient 1 revealed a right, patient 2 a left lateralized language network. Patient 3 (tumor recurrence) revealed right lateralized language components with less activation in the left hemisphere in comparison to the other patients. Word generation tasks thereby only outlined a plausible activation pattern in patient 3 with cluster size of 40 voxels visualizing Broca’s area.

Conclusions: Passive fMRI shows promising results for outlining language network components in patients with gliomas close to language areas. Further work will focus on optimization (efficiency and reliability) of the paradigm for integration in clinical practice.