Comparison of fMRI and intraoperative direct cortical stimulation in localization of receptive language areas

Purpose: The purpose of this work was to compare the cortical localization of receptive speech using functional MRI (fMRI) and direct intraoperative e lectrical stimulation. Method: Three strongly right-handed patients with primary neoplasms of the left parasylvian region underwent fMRI while subjected to a passive listeni ng task designed to activate receptive language areas. All three subjects t hen underwent awake intraoperative language mapping using direct electrical stimulation of the cortex. Results: In all three subjects, similar, but nonidentical, cortical regions were identified as involved in receptive language function by fMRI and dir ect cortical stimulation mapping. Conclusion: fMRI provides excellent receptive language mapping, but its res ults must be interpreted with caution due to conceptual and technical diffe rences from direct cortical stimulation mapping.