fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca’s area

Functional MRI (fMRI) can assess language lateralization in brain tumor patients; however, this can be limited if the primary language area—Broca’s area (BA)—is affected by the tumor. We hypothesized that the middle frontal gyrus (MFG) can be used as a clinical indicator of hemispheric dominance for language during presurgical workup. Fifty-two right-handed subjects with solitary left-hemispheric primary brain tumors were retrospectively studied. Subjects performed a verbal fluency task during fMRI. The MFG was compared to BA for fMRI voxel activation, language laterality index (LI), and the effect of tumor grade on the LI. Language fMRI (verbal fluency) activated more voxels in MFG than in BA (MFG = 315, BA = 216, p