Open Multilingual fMRI Battery (omfMRI)
The Object and Method fMRI (OMfMRI) battery is a standardised set of language fMRI tasks developed for pre-surgical language lateralisation and localisation in epilepsy.
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Overview
The OMfMRI battery was developed to provide a standardised, validated approach to language mapping with fMRI. It is designed for clinical pre-surgical planning — primarily in patients with epilepsy being evaluated for resective surgery — and provides robust assessment of language lateralisation and the localisation of key language regions.
The battery takes its name from its two core task types: object-based tasks, which engage semantic and lexical processes, and method-based tasks, which engage verb generation and action knowledge networks.
Task components
Object Naming
Object naming tasks are some of the oldest, most widely used measures of language function across fields, and are key measures used to quantify the risk surgery poses to language skill. The ability to retrieve names is the language skill that is most frequently influenced by temporal lobe surgery (Busch et al., 2017; Sherman et al., 2011).
In fMRI, a standard evaluation of naming involves an active condition where patients view objects and imagine saying the name of the object, and potentially also something they can do with it. The control condition used varies, and can be simple rest (eyes open, with or without a crosshair) or viewing of the same images, scrambled. A potential limitation of these tasks is that it can be difficult to monitor patient engagement and accuracy–i.e., could they actually perform the task? This can be mitigated with an estimate of accuracy by evaluating performance on the same task after scanning.
There are many early studies with different methods using naming protocols (e.g., PET; Bookheimer et al. 1995). When used in fMRI as part of a panel of tasks, correspondence with Wada results is good.
We have recently validated the version we make available here for language lateralization (Benjamin et al., 2017). Pairing this with other measures of naming skill using different modalities can be particularly effective.
References
Bookheimer et al., 1995. Regional Cerebral Blood Flow During Object Naming and Word Reading. Human Brain Mapping 3:93-106.
Bookheimer et al., 1997. A direct comparison of PET activation and electrocortical stimulation mapping for language localization. Neurology 48:1056-1065.
Benson et al., 1999. Language dominance determined by whole brain functional MRI in patients with brain lesions. Neurology, 52(4), 798–809.
Rutten et al., 2002. fMRI-Determined Language Lateralization in Patients with Unilateral or Mixed Language Dominance According to the Wada Test. NeuroImage 17, 447– 460.
Rutten et al., 2002. Reproducibility of fMRI-Determined Language Lateralization in Individual Subjects. Brain and Language 80, 421–437.
Benjamin et al., 2017. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping.
Visual/Verbal Responsive Naming (VRN)
Visual responsive naming tasks involve patients reading a short, written description of an object, and thinking of the object name. This is a text-based, visual analog of auditory naming tasks. This task is completed in a “block design,” where patients read a series of sentences describing different objects (often around 3 seconds per sentence) in a block (often around 24 seconds). These are alternated with blocks of a control task (of the same duration). Control conditions used are variable, and may constitute a crosshair, or a black screen; non-words; or images of the same sentences scrambled into visual white noise. These control tasks will result in different patterns of activation in the final images, because they activate different brain regions. For instance, using the same sentences scrambled will engage visual cortex only; using strings of letters will activate visual cortex as well as areas involved in processing word forms.
There are numerous examples from the fMRI literature (below), and agreement with Wada results as part of a panel of tasks was previously estimated at approximately 75-84%. Using a specific analysis approach with Object Naming and Auditory Responsive naming tasks we found overall 85% correspondence with Wada lateralization (Benjamin et al., 2017).
References
Gaillard et al. 2001. Cortical localization of reading in normal children: an fMRI language study. Neurology 57:47.
Gaillard et al. 2002. Language dominance in partial epilepsy patients identified with an fMRI reading task. Neurology 59:256.
Gaillard et al. 2004. fMRI language task panel improves determination of language dominance. Neurology 63:1403.
Benjamin et al., 2017. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping.
Auditory Responsive Naming (ARN)
Auditory naming tasks were developed as an auditory analog of visual object naming (e.g., Bookheimer et al., 1998). Such tasks form an ideal supplement to visual object naming; examining regions of overlap allows identification of language areas independent of lower-order visual or auditory sensory regions.
In these tasks patients hear simple auditory cues such as “you walk with them” and imagine speaking the answer (e.g., feet, legs). They keep their eyes closed throughout to remove visual activation. Control conditions vary from simple rest (eyes closed), to controls matched for auditory input (e.g., hearing the same stimuli scrambled, as white noise). As with visual object naming, a limitation of such tasks is that it is difficult to monitor task engagement and accuracy.
As noted, the use of auditory naming tasks also occurred in other modalities and was then used within fMRI. For instance, work with PET demonstrated that such that tasks activate primary auditory regions as well as traditional language areas (Bookheimer et al., 1998). When used in fMRI as part of a panel of fMRI tasks, agreement with Wada results has been good (Gaillard et al., 2004).
Using a specific analysis approach to combine Auditory Responsive Naming with Object Naming and Verbal Responsive naming tasks we found overall 85% correspondence with Wada lateralization (Benjamin et al., 2017).
Bookheimer et al., 1997. A direct comparison of PET activation and electrocortical stimulation mapping for language localization. Neurology 1997;48:1056-1065.
Bookheimer et al., 1998. Regional cerebral blood flow during auditory responsive naming: evidence for cross-modality neural activation. Neuroreport 9(10):2409-13.
Gaillard et al., 2004. fMRI language task panel improves determination of language dominance. Neurology 63:1403–1408.
Benjamin et al., 2017. Presurgical language fMRI: Mapping of six critical regions. Human Brain Mapping.
Semantic decision
Jeff Binder’s version of this task (1995) is perhaps the best-studied and comprehensively validated fMRI task for language lateralization. The task alternates blocks of task and control. In the task the patient hears animal names, and respond to a semantic judgment about them (e.g., pressing a button if the animal lives in the US and is used by humans). In the control they hear strings of tones, and press a button if they hear two high tones.
Evidence
The method has been directly contrasted with the Wada test in the largest patient series to date. Janecek and colleagues (2013) compared language laterality per fMRI (semantic decision) and a Wada protocol (Loring) in 229 patients (Wada language L/Bi/R=184/30/15). Overall fMRI-Wada agreement was 86% with the only measures predicting discordance in a given patient being the degree to which fMRI (and, less so) Wada laterality index trended right. This concordance rate approximated the (weighted) rate from prior studies (85%). Using slightly different criteria to define discordance, when fMRI classified cases as left dominant (n=182), Wada testing typically also did so (92%). fMRI bilateral cases (n=28) were variably left (46%), bilateral (36%) or right (18%) dominanton Wada. fMRI right cases were also most often right dominant on Wada (53%) or bilateral (26%), though 4 of these cases were Wada left dominant. While the only factor predicting discordance was the degree to which fMRI and (less so) Wada trended right, all 4 discordant cases were right handed and had right hemisphere pathology.
At least as importantly, the ability of the method to predict language change following surgery has also been examined (Sabsevitz et al., 2003). In a set of 56 patients undergoing a tailored anterior temporal lobectomy, fMRI was more effective than the Wada test at predicting post-surgical outcome when defined as a drop in the patient’s raw score on a naming task (Boston Naming Task). When marked decline–a drop of more than 2 standard deviations relative to the right temporal patients’ mean performance–occurred, fMRI predicted this with 100% sensitivity and 73% specificity (Wada 92% and 45%, respectively) in predicting outcome. Forty one percent of post-surgical naming variance was predicted.
This exact version of the task used in publications can be obtained directly from Professor Binder.
An abbreviated version is provided in this battery.
References
Sabsevitz et al. 2003. Use of preoperative functional neuroimaging to predict language deficits from epilepsy surgery. Neurology 60:1788–1792.
Janecek et al. 2013. Language Lateralization by fMRI and Wada Testing in 229 Epilepsy Patients: Rates and Predictors of Discordance. Epilepsia. 2013 February ; 54(2): 314–322. See also on Researchgate (free).
Other
Verbal Fluency and Noun-Verb generation tasks are also in widespread use, and validated versions are included in the battery.
Consulting
Dr. Benjamin consults to clinical programs on setting up or improving language fMRI services, including implementation of the OMfMRI battery. For enquiries, please use the contact page.