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NEUROLOGY 1994;44:2050
© 1994 American Academy of Neurology

MRI asymmetries and language dominance

P. D. Charles, MD, R. Abou-Khalil, MS, B. Abou-Khalil, MD, R. T. Wertz, PhD, D. H. Ashmead, PhD, L. Welch, EdD and H. S. Kirshner, MD

Department of Neurology (Drs. Charles, B. Abou-Khalil, and Kirshner), the Department of Psychiatry (Dr. Welch), and the Department of Hearing and Speech Sciences (Dr. Ashmead), Vanderbilt University School of Medicine; the Department of Speech Pathology and Audiology (Dr. Wertz), Veterans Administration Medical Center; and the Graduate School (R. Abou-Khalil), Vanderbilt University, Nashville, TN.

Objective: To examine the relationship between language dominance, as measured by Wada testing, and hemispheric asymmetries on MR brain images.

Background: A previous report that did not include verification of language dominance compared the length of the planum temporale with hemispheric asymmetries seen on CT and inferred that occipital lobe asymmetry is related to language dominance.

Methods: Language dominance was identified by the Wada test in 57 patients evaluated for surgical treatment of epilepsy. Fifty-five had an MRI scan that allowed accurate measurement. In a blinded fashion, two examiners independently measured bilateral frontal, parietal, and occipital lobe lengths on MR scan for each patient. Measurements of asymmetries were compared with language dominance established by the Wada test.

Results: Reliability of measurement between the examiners was 97%. Asymmetry of the occipital lobe length on MR scan 10 mm above the tentorium was the only measurement significantly related to language dominance (p < 0.01). Occipital lobe length was longer on the left in 19 (40%) and on the right in 10 (21%) patients with left dominance. The right lobe was longer in six of seven (86%) patients with bilateral dominance. One patient with right hemisphere dominance had a longer left lobe. None of the measurements significantly related to handedness.

Conclusion: Asymmetries of occipital lobe length relate to language dominance, but such dominance cannot be reliably identified by MR in an individual patient.

Address correspondence and reprint requests to Dr. Bassel Abou-Khalil, Department of Neurology, Vanderbilt University School of Medicine, 2100 Pierce Avenue, Nashville, TN 37212.

Received January 19,1994. Accepted in final form April 22, 1994.






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