Movie-watching fMRI for presurgical language mapping in patients with brain tumour

Introduction

The primary goal of presurgical language mapping is localising critical language areas with high sensitivity (ie, capturing areas in which resection could lead to language deficits) and specificity (ie, excluding non-language areas) and reliably determining language hemispheric dominance, on an individual basis. Language mapping is challenging due to the widely distributed functional organisation of language in the frontal, temporal and parietal lobes, and in neurosurgical patients the possibility of tumour-induced functional reorganisation.

A major drawback of conventional task-based functional magnetic resonance imaging (tb-fMRI) recommended for presurgical language mapping1 is the contingency on patient performance of precisely timed tasks (eg, antonym generation—AntGen). Drawbacks of task-free resting-state fMRI (rs-fMRI) include confounding effects of ‘mind wandering’ and sensitivity to motion artefacts. In contrast, movie watching is a rich, stimulating and naturalistic activity, predicted to constrain cognitive processes and engage the distributed, multimodal neural networks supporting language function in real life.<cross-ref type="bib"…

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