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Brain, Vol. 122, No. 11, 2033-2046, November 1999
© 1999 Oxford University Press

Invited review

Language dominance in neurologically normal and epilepsy subjects

A functional MRI study

Jane A. Springer1, Jeffrey R. Binder2,3, Thomas A. Hammeke2, Sara J. Swanson2, Julie A. Frost2, Patrick S. F. Bellgowan2, Cameron C. Brewer6, Holly M. Perry5, George L. Morris2 and Wade M. Mueller4

1 University of Iowa Hospital and Clinics, Iowa City, Departments of 2 Neurology, 3 Cellular Biology and Anatomy and 4 Neurosurgery, Medical College of Wisconsin, 5 Department of Psychology, Marquette University, Milwaukee, USA and 6 Department of Psychology, University of Scotland, Glasgow, UK

Correspondence to: Jeffrey R. Binder, MD, Department of Neurology, Medical College of Wisconsin, 9200 West Wisconsin Avenue, Milwaukee, WI 53226, USA E-mail: jbinder{at}post.its.mcw.edu

Language dominance and factors that influence language lateralization were investigated in right-handed, neurologically normal subjects (n = 100) and right-handed epilepsy patients (n = 50) using functional MRI. Increases in blood oxygenation-dependent signal during a semantic language activation task relative to a non-linguistic, auditory discrimination task provided an index of language system lateralization. As expected, the majority of both groups showed left hemisphere dominance, although a continuum of activation asymmetry was evident, with nearly all subjects showing some degree of right hemisphere activation. Using a categorical dominance classification, 94% of the normal subjects were considered left hemisphere dominant and 6% had bilateral, roughly symmetric language representation. None of the normal subjects had rightward dominance. There was greater variability of language dominance in the epilepsy group, with 78% showing left hemisphere dominance, 16% showing a symmetric pattern and 6% showing right hemisphere dominance. Atypical language dominance in the epilepsy group was associated with an earlier age of brain injury and with weaker right hand dominance. Language lateralization in the normal group was weakly related to age, but was not significantly related to sex, education, task performance or familial left-handedness.

cerebral dominance; language; functional MRI; lateralization

EHI = Edinburgh Handedness Inventory; fMRI = functional MRI; IAP = intracarotid amobarbital procedure; LI = laterality index


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