Male, 76 years old, with progressive left temporal GBM. Functional assessment of speech is required for surgical planning. Of the tested language paradigms, the most reliable language related cortical activation was seen with the verb generation and sentence completion paradigms. While language related activity was variably observed in both hemispheres depending on the paradigm, overall language cortical activation is left dominant. Broca's area activity is seen on both paradigms in it's expected location of the left inferior frontal gyrus, primarily pars triangularis and pars orbitalis. Wernicke's area activity is best visualized on the sentence completion paradigm where it is seen along the posterior aspect of the superior left temporal sulcus. On comparison to the most recent outside MRI, both Broca's and Wernicke's areas appear to be well removed from the enhancing lesion in the left temporal lobe, but both areas are closed approached by the non-enhancing T2 signal abnormality which surrounds the lesion.
Successful functional MRI for language mapping with Broca's and Wernicke's areas identified on the left as above.