Comparison of fMRI data from passive listening and active-response story processing tasks in children

Success rates for functional MR imaging in children

BACKGROUND AND PURPOSE

Functional MR imaging is widely used for research in functional brain development in healthy children. However, obtaining high-quality brain imaging data from pediatric research participants requires cooperation that is challenging for young children. In this study, we examined success rates for fMRI in typically developing children in both longitudinal and cross-sectional research study designs to inform the recruitment needs of future pediatric brain imaging studies.

MATERIALS AND METHODS

In the cross-sectional study, 459 healthy children (5-18 years of age, 215 girls) were recruited. A subset of 30 healthy children 5-7 years of age from the cross-sectional cohort were selected and scanned for 10 consecutive years in the longitudinal arm of the study. Following anatomic scans, each participant attempted 4 functional MR imaging tasks. Success rate was defined as the proportion of fMRI tasks completed. Differences in success rates across sexes and in cross-sectional-versus-longitudinal cohorts were evaluated by using the Fischer exact test.

RESULTS

In the cross-sectional study, 74% of the children completed all tasks. Success rates for individual tasks ranged from 34% to 67% for children 5-7 years of age and 76%-100% for those 8-18 years of age. In the longitudinal study, 89% of children completed all tasks in all 10 years. We established significance (P < .0001) between the cross-sectional and longitudinal cohorts for both 0% and 100% task completion rates. There was no significance between sexes.

CONCLUSIONS

When designing pediatric fMRI studies in children, the sample sizes indicated by power analysis should be scaled up according to age (ie, 33% for ages 8-18 years, 50% for ages 5-7 years).

Greater Utilization of Neural-Circuits Related to Executive Functions is Associated with Better Reading: A Longitudinal fMRI Study Using the Verb Generation Task

INTRODUCTION

Reading is an acquired-developmental ability that relies on intact language and executive function skills. Verbal fluency tasks (such as verb generation) also engage language and executive function skills. Performance of such tasks matures with normal language development, and is independent of reading proficiency. In this longitudinal fMRI study, we aim to examine the association between maturation of neural-circuits supporting both executive functions and language (assessed using verb generation) with reading proficiency achieved in adolescence with a focus on left-lateralization typical for language proficiency.

METHODS

Normalized fMRI data from the verb generation task was collected from 16 healthy children at ages 7, 11, and 17 years and was correlated with reading scores at 17 years of age. Lateralization indices were calculated in key language, reading, and executive function-related regions in all age groups.

RESULTS

Typical development was associated with (i) increasingly left-lateralized patterns in language regions (ii) more profound left-lateralized activation for reading and executive function-related regions when correlating with reading scores, (iii) greater involvement of frontal and parietal regions (in older children), and of the anterior frontal cortex (in younger children).

CONCLUSION

We suggest that reading and verb generation share mutual neural-circuits during development with major reliance on regions related to executive functions and reading. The results are discussed in the context of the dual-networks architecture model.

Involvement of the right hemisphere in reading comprehension: a DTI study

The Simple View of reading emphasizes the critical role of two factors in normal reading skills: word recognition and reading comprehension. The current study aims to identify the anatomical support for aspects of reading performance that fall within these two components. Fractional anisotropy (FA) values were obtained from diffusion tensor images in twenty-one typical adolescents and young adults using the tract based spatial statistics (TBSS) method. We focused on the arcuate fasciculus (AF) and inferior longitudinal fasciculus (ILF) as fiber tracts that connect regions already implicated in the distributed cortical network for reading. Our results demonstrate dissociation between word-level and narrative-level reading skills: the FA values for both left and right ILF were correlated with measures of word reading, while only the left ILF correlated with reading comprehension scores. FA in the AF, however, correlated only with reading comprehension scores, bilaterally. Correlations with the right AF were particularly robust, emphasizing the contribution of the right hemisphere, especially the frontal lobe, to reading comprehension performance on the particular passage comprehension test used in this study. The anatomical dissociation between these reading skills is supported by the Simple View theory and may shed light on why these two skills dissociate in those with reading disorders.

Atypical language organization in temporal lobe epilepsy revealed by a passive semantic paradigm

Background

Mesial temporal lobe epilepsy (MTLE) is the most common type of focal epilepsy in adults and can be successfully cured by surgery. One of the main complications of this surgery however is a decline in language abilities. The magnitude of this decline is related to the degree of language lateralization to the left hemisphere. Most fMRI paradigms used to determine language dominance in epileptic populations have used active language tasks. Sometimes, these paradigms are too complex and may result in patient underperformance. Only a few studies have used purely passive tasks, such as listening to standard speech.

Methods

In the present study we characterized language lateralization in patients with MTLE using a rapid and passive semantic language task. We used functional magnetic resonance imaging (fMRI) to study 23 patients [12 with Left (LMTLE), 11 with Right mesial temporal lobe epilepsy (RMTLE)] and 19 healthy right-handed controls using a 6 minute long semantic task in which subjects passively listened to groups of sentences (SEN) and pseudo sentences (PSEN). A lateralization index (LI) was computed using a priori regions of interest of the temporal lobe.

Results

The LI for the significant contrasts produced activations for all participants in both temporal lobes. 81.8% of RMTLE patients and 79% of healthy individuals had a bilateral language representation for this particular task. However, 50% of LMTLE patients presented an atypical right hemispheric dominance in the LI. More importantly, the degree of right lateralization in LMTLE patients was correlated with the age of epilepsy onset.

Conclusions

The simple, rapid, non-collaboration dependent, passive task described in this study, produces a robust activation in the temporal lobe in both patients and controls and is capable of illustrating a pattern of atypical language organization for LMTLE patients. Furthermore, we observed that the atypical right-lateralization patterns in LMTLE patients was associated to earlier age at epilepsy onset. These results are in line with the idea that early onset of epileptic activity is associated to larger neuroplastic changes.

Comparison of functional network connectivity for passive-listening and active-response narrative comprehension in adolescents

Comprehension of narrative stories plays an important role in the development of language skills. In this study, we compared brain activity elicited by a passive-listening version and an active-response (AR) version of a narrative comprehension task by using independent component (IC) analysis on functional magnetic resonance imaging data from 21 adolescents (ages 14-18 years). Furthermore, we explored differences in functional network connectivity engaged by two versions of the task and investigated the relationship between the online response time and the strength of connectivity between each pair of ICs. Despite similar brain region involvements in auditory, temporoparietal, and frontoparietal language networks for both versions, the AR version engages some additional network elements including the left dorsolateral prefrontal, anterior cingulate, and sensorimotor networks. These additional involvements are likely associated with working memory and maintenance of attention, which can be attributed to the differences in cognitive strategic aspects of the two versions. We found significant positive correlation between the online response time and the strength of connectivity between an IC in left inferior frontal region and an IC in sensorimotor region. An explanation for this finding is that longer reaction time indicates stronger connection between the frontal and sensorimotor networks caused by increased activation in adolescents who require more effort to complete the task.

Compensated dyslexics have a more efficient error detection system than noncompensated dyslexics

Error/correct-related negativities, response-locked components of the evoked response potential, and N100, a stimulus-locked component, were used to compare error detection monitoring in skilled readers and in compensated and noncompensated dyslexic adolescent readers during a lexical decision task. Results showed a general increase in N100 amplitudes prior to error commission in all groups; a significant decrease in error/correct-related negativity amplitudes in the noncompensated dyslexics compared with the other 2 groups; and smaller error-related negativity correlated with a higher number of decoding errors, lower working memory scores, and lower speed of processing in the neuropsychological battery. Based on the hypothesis in previous studies that the error detection mechanism is a subcomponent of executive functions, the possibility that poor executive ability underlies poor reading skills in the noncompensated dyslexic readers is discussed. These findings can be used as a platform for executive-based diagnosis and training for individuals with reading disabilities.

Optimized simultaneous ASL and BOLD functional imaging of the whole brain

PURPOSE

To compare a double-excitation combined arterial-spin labeling/blood-oxygenation level dependent (ASL/BOLD) functional imaging method to a double-echo method. ASL provides a useful complement to standard BOLD functional imaging, to map effects of cerebral hemodynamics. Whole-brain imaging is necessary to properly characterize large functional networks. A challenge of whole-brain ASL/BOLD is that images for ASL functional contrast must be acquired before significant longitudinal relaxation of the inverted spins occurs; however, a longer echo time (TE) is required for optimal BOLD functional contrast, lengthening the acquisition time. Thus, existing combined ASL/BOLD studies have only partial-brain coverage.

MATERIALS AND METHODS

The proposed method allows acquisition of images for ASL contrast within a short period after the ASL labeling pulse and postinversion delay, then subsequent acquisition of images with longer TE for BOLD contrast. The technique is demonstrated using a narrative comprehension task in 35 normal children, and the double-excitation method is empirically compared with the double-echo method in 7 normal adults.

RESULTS

Compared with a double-echo sequence, simulations show the double-excitation method improves ASL contrast-to-noise ratio (CNR) (∼50%) in later-acquired slices with minimal (<1%) reduction in BOLD CNR in earlier-acquired slices if reduced excitation flip angles for the ASL acquisitions are used. Empirical results from adult data are in agreement with the simulations. Group analyses from the narrative comprehension task also show greater intersubject sensitivity in BOLD versus ASL.

CONCLUSION

Our method simultaneously optimizes ASL and BOLD acquisitions for CNR while economizing acquisition time.

Overlapping neural circuitry for narrative comprehension and proficient reading in children and adolescents

Narrative comprehension is a perinatal linguistic ability which is more intuitive than reading activity. Whether there are specific shared brain regions for narrative comprehension and reading that are tuned to reading proficiency, even before reading is acquired, is the question of the current study. We acquired fMRI data during a narrative comprehension task at two age points, when children are age 5-7 (K-2nd grade) and later when the same children were age 11 (5th-7th grade). We then examined correlations between this fMRI data and reading and reading comprehension scores from the same children at age 11. We found that greater frontal and supramarginal gyrus (BA 40) activation in narrative comprehension at the age of 5-7 years old was associated with better word reading and reading comprehension scores at the age of 11. A shift towards temporal and occipital activation was found when correlating their narrative comprehension functional data at age 11, with reading scores at the same age point. We suggest that increased reliance on executive functions and auditory-visual networks when listening to stories before reading is acquired, facilitates reading proficiency in older age and may be a biomarker for future reading ability. Children, who rely on use of imagination/visualization as well as auditory processing for narrative comprehension when they reach age 11, also show greater reading abilities. Understanding concordant neural pathways supporting auditory narrative and reading comprehension might be guide for development of effective tools for reading intervention programs.

Age-related functional reorganization, structural changes, and preserved cognition

Although healthy aging is associated with general cognitive decline, there is considerable variability in the extent to which cognitive functions decline or are preserved. Preserved cognitive function in the context of age-related neuroanatomical and functional changes, has been attributed to compensatory mechanisms. However, the existing sparse evidence is largely focused on functions associated with the frontal cortex, leaving open the question of how wider age-related brain changes relate to compensation. We evaluated relationships between age-related neural and functional changes in the context of preserved cognitive function by combining measures of structure, function, and cognitive performance during spoken language comprehension using a paradigm that does not involve an explicit task. We used a graph theoretical approach to derive cognitive activation-related functional magnetic resonance imaging networks. Correlating network properties with age, neuroanatomical variations, and behavioral data, we found that decreased gray matter integrity was associated with decreased connectivity within key language regions but increased overall functional connectivity. However, this network reorganization was less efficient, suggesting that engagement of a more distributed network in aging might be triggered by reduced connectivity within specialized networks.

Left ear advantage in speech-related dichotic listening is not specific to auditory processing disorder in children: A machine-learning fMRI and DTI study

Dichotic listening (DL) tests are among the most frequently included in batteries for the diagnosis of auditory processing disorders (APD) in children. A finding of atypical left ear advantage (LEA) for speech-related stimuli is often taken by clinical audiologists as an indicator for APD. However, the precise etiology of ear advantage in DL tests has been a source of debate for decades. It is uncertain whether a finding of LEA is truly indicative of a sensory processing deficit such as APD, or whether attentional or other supramodal factors may also influence ear advantage. Multivariate machine learning was used on diffusion tensor imaging (DTI) and functional MRI (fMRI) data from a cohort of children ages 7–14 referred for APD testing with LEA, and typical controls with right-ear advantage (REA). LEA was predicted by: increased axial diffusivity in the left internal capsule (sublenticular region), and decreased functional activation in the left frontal eye fields (BA 8) during words presented diotically as compared to words presented dichotically, compared to children with right-ear advantage (REA). These results indicate that both sensory and attentional deficits may be predictive of LEA, and thus a finding of LEA, while possibly due to sensory factors, is not a specific indicator of APD as it may stem from a supramodal etiology.

•

Left-ear advantage (LEA) in speech-related dichotic listening tests is atypical.

•

LEA is predicted by differences in functional activation in frontal eye fields.

•

LEA also predicted by differences in WM microstructure in left auditory radiation.

•

LEA is therefore not specific for auditory processing disorder (APD) in children.

Functional magnetic resonance imaging reveals changes in language localization in children with benign childhood epilepsy with centrotemporal spikes

In children with benign childhood epilepsy with centrotemporal spikes, centrotemporal spikes may cause language dysfunction via disruption of underlying functional neuroanatomy. Fifteen patients with benign childhood epilepsy with centrotemporal spikes and 15 healthy controls completed 3 functional magnetic resonance imaging (MRI) language paradigms; standardized cognitive and language assessments were also performed. For all paradigms, children with benign childhood epilepsy with centrotemporal spikes showed specific regional differences in activation compared to controls. Children with benign childhood epilepsy with centrotemporal spikes also differed from controls on neuropsychological testing. They did not differ in general intelligence, but children with benign childhood epilepsy with centrotemporal spikes scored significantly lower than controls on tests of language, visuomotor integration, and processing speed. These results extend previous findings of lower language and cognitive skills in patients with benign childhood epilepsy with centrotemporal spikes, and suggest epilepsy-related remodeling of language networks that may underlie these observed differences.

BOLD fMRI in infants under sedation: Comparing the impact of pentobarbital and propofol on auditory and language activation

PURPOSE

To elucidate differences in the disruption of language network function, as measured by blood oxygenation level-dependent (BOLD) contrast functional MRI (fMRI), attributable to two common sedative agents administered to infants under clinical imaging protocols.

MATERIALS AND METHODS

The sedatives pentobarbital (Nembutal) and Propofol, administered clinically to infants at 1 year of age, were compared with respect to BOLD activation profiles in response to passive story-listening stimulation. An intermittent event-related imaging protocol was used with which the temporal evolution of language processing resulting from this stimulation was explored.

RESULTS

Propofol and Nembutal were found to have distinct and complementary responses to story-listening. Propofol exhibited more activation in higher processing networks with increasing response toward the end of narrative stimulus. Nembutal, in contrast, had much more robust activation of primary and secondary sensory cortices but a decreasing response over time in fronto-parietal default-mode regions. This may suggest a breakdown of top-down feedback for Propofol versus the lack of bottom-up feed-forward processing for Nembutal.

CONCLUSION

Two popular sedative agents for use in children for clinical fMRI were found to induce distinct alteration of activation patterns from a language stimulus. This has ramifications for clinical fMRI of sedated infants and encourages further study to build a framework for more confident interpretation.

Topological properties of large-scale structural brain networks in children with familial risk for reading difficulties

Developmental dyslexia is a neurobiological deficit characterized by persistent difficulty in learning to read in children and adults who otherwise possess normal intelligence. Functional and structural connectivity data suggest that developmental dyslexia could be a disconnection syndrome. However, whether abnormalities in connectivity exist in beginning readers at-risk for reading difficulties is unknown. Using graph-theoretical analysis, we investigated differences in global and regional topological properties of structural brain networks in 42 beginning readers with (FH+) and without (FH-) familial risk for reading difficulties. We constructed separate structural correlation networks based on measures of surface area and cortical thickness. Results revealed changes in topological properties in brain regions known to be abnormal in dyslexia (left supramarginal gyrus, left inferior frontal gyrus) in the FH+ group mainly in the network constructed from measures of cortical surface area. We also found alterations in topological properties in regions that are not often advertised as dyslexia but nonetheless play important role in reading (left posterior cingulate, hippocampus, and left precentral gyrus). To our knowledge, this is the first report of altered topological properties of structural correlation networks in children at risk for reading difficulty, and motivates future studies that examine the mechanisms underlying how these brain networks may mediate the influences of family history on reading outcome.

Language mapping in temporal lobe epilepsy in children: special considerations

Temporal lobe epilepsy (TLE) in children is a slightly different entity than TLE in adults not only because of its semiology and pathology but also because of the different approach to surgical treatment. Presurgical investigations for eloquent cortex, especially language, must take these differences into account. Most diagnostic tests were created for adults, and many of the assessment tools need to be adapted for children because they are not just small adults. This paper will highlight the specific challenges and solutions in mapping language in a pediatric population with TLE.

Cortical correlates of self-generation in verbal paired associate learning

Behavioral studies have shown that verbal information is better retained when it is self-generated rather than read (learned passively). We used fMRI and a paired associates task to examine brain networks underlying self-generated memory encoding. Subjects were 49 healthy English speakers ages 19-62 (30 female). In the fMRI task, related word pairs were presented in a "read" condition, where subjects viewed both words and read the second word aloud, or a "generate" condition, where the second word was presented with only the first letter and the subject was required to generate the word. Thirty word pairs were presented in each condition. After the fMRI scan, words that were read or generated were presented, each with two foils, in a forced-choice recognition task. On the recognition post-test, words from the "generate" condition were more correctly recognized than from the "read" condition (80.0% for generated words versus 72.0% for read words; t(48)=5.17, p<0.001). FMRI revealed increased activation for generate>read in inferior/middle frontal gyri bilaterally (L>R), anterior cingulate, and caudate nucleus and the temporo-parietal-occipital junction bilaterally. For the "read" condition, better subsequent memory performance across individual subjects was positively correlated with activation in the cuneus bilaterally. In the "generate" condition, better subsequent memory performance was positively correlated with activation in the left superior temporal gyrus. These results suggest that self-generation improves memory performance, that enhanced cortical activation accompanies self-generated encoding, and that recruitment of a specific brain network underlies self-generated encoding. The findings may have implications for the development of procedures to enhance memory performance.

Using functional transcranial Doppler ultrasonography to assess language lateralisation: Influence of task and difficulty level

Language is lateralised to the left hemisphere in most people, but it is unclear whether the same degree and direction of lateralisation is found for all verbal tasks and whether laterality is affected by task difficulty. We used functional transcranial Doppler ultrasonography (fTCD) to assess the lateralisation of language processing in 27 young adults using three tasks: word generation (WG), auditory naming (AN), and picture story (PS). WG and AN are active tasks requiring behavioural responses whereas PS is a passive task that involves listening to an auditory story accompanied by pictures. We also examined the effect of task difficulty by a post hoc behavioural categorisation of trials in the WG task and a word frequency manipulation in the AN task. fTCD was used to measure task-dependent blood flow velocity changes in the left and right middle cerebral arteries. All of these tasks were significantly left lateralised: WG, 77% of individuals left, 5% right; AN, 72% left: 4% right; PS, 56% left: 0% right. There were significant positive relationships between WG and AN (r=0.56) as well as AN and PS (r=.76) but not WG and PS (r = -0.22). The task difficulty manipulation affected accuracy in both WG and AN tasks, as well as reaction time in the AN task, but did not significantly influence laterality indices in either task. It is concluded that verbal tasks are not interchangeable when assessing cerebral lateralisation, but that differences between tasks are not a consequence of task difficulty.

Left inferior frontal cortex and syntax: function, structure and behaviour in patients with left hemisphere damage

For the past 150 years, neurobiological models of language have debated the role of key brain regions in language function. One consistently debated set of issues concern the role of the left inferior frontal gyrus in syntactic processing. Here we combine measures of functional activity, grey matter integrity and performance in patients with left hemisphere damage and healthy participants to ask whether the left inferior frontal gyrus is essential for syntactic processing. In a functional neuroimaging study, participants listened to spoken sentences that either contained a syntactically ambiguous or matched unambiguous phrase. Behavioural data on three tests of syntactic processing were subsequently collected. In controls, syntactic processing co-activated left hemisphere Brodmann areas 45/47 and posterior middle temporal gyrus. Activity in a left parietal cluster was sensitive to working memory demands in both patients and controls. Exploiting the variability in lesion location and performance in the patients, voxel-based correlational analyses showed that tissue integrity and neural activity-primarily in left Brodmann area 45 and posterior middle temporal gyrus-were correlated with preserved syntactic performance, but unlike the controls, patients were insensitive to syntactic preferences, reflecting their syntactic deficit. These results argue for the essential contribution of the left inferior frontal gyrus in syntactic analysis and highlight the functional relationship between left Brodmann area 45 and the left posterior middle temporal gyrus, suggesting that when this relationship breaks down, through damage to either region or to the connections between them, syntactic processing is impaired. On this view, the left inferior frontal gyrus may not itself be specialized for syntactic processing, but plays an essential role in the neural network that carries out syntactic computations.

Active versus passive listening to auditory streaming stimuli: a near-infrared spectroscopy study

We use near-infrared spectroscopy (NIRS) to assess listeners' cortical responses to a 10-s series of pure tones separated in frequency. Listeners are instructed to either judge the rhythm of these "streaming" stimuli (active-response listening) or to listen to the stimuli passively. Experiment 1 shows that active-response listening causes increases in oxygenated hemoglobin (oxy-Hb) in response to all stimuli, generally over the (pre)motor cortices. The oxy-Hb increases are significantly larger over the right hemisphere than over the left for the final 5 s of the stimulus. Hemodynamic levels do not vary with changes in the frequency separation between the tones and corresponding changes in perceived rhythm ("gallop," "streaming," or "ambiguous"). Experiment 2 shows that hemodynamic levels are strongly influenced by listening mode. For the majority of time windows, active-response listening causes significantly larger oxy-Hb increases than passive listening, significantly over the left hemisphere during the stimulus and over both hemispheres after the stimulus. This difference cannot be attributed to physical motor activity and preparation related to button pressing after stimulus end, because this is required in both listening modes.

Increased left prefrontal activation during an auditory language task in adolescents born preterm at high risk

Although individuals born preterm are at risk for cognitive dysfunction, few studies have examined functional brain reorganization in these individuals. We used magnetoencephalography (MEG) to examine cortical reorganization related to preterm birth. Thirty-one adolescents systemically selected from a longitudinal study on child development based on gestational age, birth weight and medical complications (full term, low risk preterm, high-risk preterm) performed real-word and non-word auditory rhyme tasks during MEG recording. Equivalent current dipoles were localized every 4ms during the 50- to 250-ms period following the onset of the auditory stimulus. The association between the number of dipoles (NODs) and birth group, language task, latency and phonological skills was examined. Adolescents born preterm at high risk demonstrated a greater NODs in the left Broca's and prefrontal areas combined, left cingulate gyrus and left superior temporal gyrus and a fewer NODs in the right superior temporal gyrus as compared to those born preterm at low risk and term. A greater NODs in the left Broca's and prefrontal areas combined and fewer NODs in the left cingulate gyrus was associated with better phonological skills only in adolescents born preterm at high risk. These results suggest that the language networks are reorganized in adolescents born preterm at high risk. Increased prefrontal activity has also been seen in adolescents born preterm during a reading task and in young adults with a history of dyslexia who are well compensated for their disorder. We suggest that this increased prefrontal activation may represent increased top-down control of weak posterior language networks.

Behavioral and neurophysiologic response to therapy for chronic aphasia

Breier JI, Juranek J, Maher LM, Schmadeke S, Men D, Papanicolaou AC. Behavioral and neurophysiologic response to therapy for chronic aphasia.

OBJECTIVE

To characterize the relationship between neurophysiologic changes in the brain and behavioral response to constraint-induced language therapy (CILT) by using magnetoencephalography (MEG).

DESIGN

Case series.

SETTING

Medical school.

PARTICIPANTS

Patients (N=23) with chronic aphasia after first-time unilateral stroke in the left hemisphere.

INTERVENTIONS

Constraint-induced language therapy administered for 3 hours 4 times per week for 3 weeks. Language testing and functional imaging during a language comprehension task using MEG before, immediately after, and 3 months after CILT with a subgroup of patients undergoing additional MEG scanning and language testing 3 weeks before CILT.

MAIN OUTCOME MEASURES

The percent of correct information units and the number of late dipoles normalized to total activation.

RESULTS

Three patterns of behavioral and neurophysiologic response to CILT were identified. Patients with significant improvement in language immediately after CILT who lost these gains at follow-up had greater right hemisphere activation than other patients at all MEG scanning sessions. Patients with significant improvement in language immediately after CILT who maintained these gains at follow-up exhibited an increase in left temporal activation after CILT, whereas patients who did not exhibit significant improvement in language after CILT exhibited comparably greater activation in left parietal areas.

CONCLUSIONS

Results suggest that although the right hemisphere may support recovery of language function in response to therapy, this recovery may not be stable, and some participation of perilesional areas of the left hemisphere may be necessary for a stable behavioral response.

Language networks in children: evidence from functional MRI studies

OBJECTIVE

The purpose of our study was to review functional MRI and other neuroimaging studies of language skills in children from infancy to adulthood.

CONCLUSION

Functional MRI (fMRI) and other neuroimaging studies show developmental changes in the networks of brain regions supporting language, which can be affected by brain injuries or neurologic disorders. Particular aspects of language rely on networks that lateralize to the dominant hemisphere; others rely on bilateral or nondominant mechanisms. Multiple fMRI tasks for pediatric patients characterize functional brain reorganization that may accompany language deficits.