Identifizierung von eloquenten Kortexarealen der nicht-dominanten Hemisphäre mittels funktioneller transkranieller Dopplersonographie: Überprüfung einer mentalen Rotationsaufgabe und eines Memoryparadigmas
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Philipps-Universität Marburg
Abstract
Rationale: Functional transcranial Doppler sonography (fTCD) during word
generation is well established for language lateralization. In this study, we
evaluated an fTCD-paradigm to reliably identify the non-dominant hemisphere.
Methods: Twenty-nine right-handed healthy subjects (27.1 ± 7.6 years)
performed the ‘cube perspective test’ (Stumpf & Fay, 1983), a spatial orientation
task, while the cerebral blood flow velocity (CBFV) was simultaneously measured
in both middle cerebral arteries (MCA). In addition, the established word
generation paradigm for language lateralisation was performed. Subjects with
atypical language representation were excluded. Data were analysed offline with
the software Average®, which performed a heart-cycle integration and a baselinecorrection
and calculated a lateralization index (LI) with its standard error of the
mean increase in CBFV separately for both MCA.
Results: Twenty-one of 29 subjects (72.4%) lateralized to the right hemisphere
(χ²=5.828, p=0.016). The mean LI of the spatial orientation paradigm pointed to
the right hemisphere (x¯ = -1.9 ± 3.2) and was different from the LI of word
generation (x¯ = 3.9 ± 2.2; p<0.001). There was no correlation between the LI of
spatial orientation and word generation (R=0.095, p=0.624). Age of the subjects
did not correlate with the LI during spatial orientation (p>0.05) but negatively with
the LI during word generation (R=-0.468, p=0.010). The maximum increase of
CBFV was greater in the spatial orientation (14.0% ± 3.6%) than in the word
generation paradigm (9.4% ± 4.0%; p<0.001).
Conclusions: In more than two thirds of the subjects with left-sided language
dominance, the spatial orientation paradigm was able to identify the non-dominant
hemisphere. The results suggest both paradigms to be independent of each other.
The spatial orientation paradigm, therefore, appears to be a non-verbal fTCD
paradigm with possible clinical relevance.
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This item has been published with the following license: In Copyright