|LETTER TO THE EDITOR
|Year : 2021 | Volume
| Issue : 2 | Page : 759-760
Role of functional MRI in language and speech disorders: an overview
Jamir P Rissardo, Ana L. F. Caprara
Department of Neurology; Department of Medicine, Federal University of Santa Maria, Santa Maria, Brazil
|Date of Submission||22-Oct-2019|
|Date of Decision||12-Nov-2019|
|Date of Acceptance||25-Nov-2019|
|Date of Web Publication||30-Jun-2021|
Jamir P Rissardo
Federal University of Santa Maria - Av. Roraima, 1000 - Camobi, Santa Maria - RS, 97105-900
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Rissardo JP, Caprara AL. Role of functional MRI in language and speech disorders: an overview. Menoufia Med J 2021;34:759-60
We read the article 'Role of functional MRI in assessment of voice, language, and speech disorders' in your esteemed Menoufia Medical Journal with great interest. Baraka et al.  reviewed the role of functional MRI (fMRI) in the diagnosis, stating, and outcomes of voice, language, and speech disorders. Their study concludes that fMRI can provide new ideas about the development of language, speech, and voice in the human brain since it showed information about the pathophysiological mapping of disease determining the treatment outcomes.
The fMRI is basically a noninvasive method that evaluates the areas of the brain with an enhanced hemodynamic response, in which the amount of oxygen by hemoglobin is assessed. In this context, the use of this method was largely done, because it does not require to give the individuals being studied any substance or expose to radiation ,.
Here, we like to highlight some important topics that together with the study of Baraka and colleagues could lead to a better comprehension of the fMRI in language disorders. Thus, we will discuss three recent articles.
Abrams et al.  studied voice processing and circuits that may predict social communication in children with autism spectrum disorder (ASD). Their result showed that when typical development versus ASD was compared in response to unfamiliar voices and mother's voice, the ASD had reduced activity, and this activity was only in relatively small brain regions mainly localized to the lateral temporal cortex. Therefore, they proposed that the different fMRI findings between the groups could predict social communication in children with autism. Moreover, their results probably support the theory of social motivation, which the reward system deficits are associated with, a critical social stimulus like mother's voice in infancy.
A Russian study examining six children with autism and other speech disorders performed fMRI and used a block design paradigm to assess speech perception patterns. Kliuev et al.  showed that participants with normal development had bilateral and symmetrical activation along the cortex, but patients with autism had lateralization and limited involvement of the cortex. Also, they showed that even during anesthesia with fluoromethyl, theparticipant's fMRI findings did not show any influence in the activation zones. Thus, they conclude that a better way to assess functional abnormalities in these individuals with ASD is under general anesthesia since the maps were the same and an important percentage of the patients had behavioral problems that could lead to wrong interpretation in fMRI.
Sreedharan et al.  evaluated the self-regulation of language areas performing real-time fMRI in expressive aphasia following stroke. The study was composed of three groups, one that the test was performed, another with healthy individuals who had neurofeedback, and the last with control patients. Their results showed that the first group had an important hemodynamic activity of Broca's area and its right homolog. Also, in this group perilesional and contralateral enhancements were observed. In this context, the feedback patients had an improvement in language ability and had significant activation of important language areas. However, they did not show behavioral or symptom modifications, which could be explained by an approach that needs some improvement to be effective.
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| References|| |
Baraka M, El-Dessouky H, Ezzat E, El-Hameed MG. Role of functional MRI in assessment of voice, language, and speech disorders. Menoufia Med J 2019; 32
Murphy K, Fox MD. Towards a consensus regarding global signal regression for resting state functional connectivity MRI. Neuroimage 2017; 154
Abrams DA, Padmanabhan A, Chen T, Odriozola P, Baker AE, Kochalka J, et al
. Impaired voice processing in reward and salience circuits predicts social communication in children with autism. eLife 2019; 8
Kliuev EA, Sheyko GE, Dunayev MG, Abramov SA, Dvoryaninova VV, Balandina OV, et al.
The role of functional MRI in understanding the origin of speech delay in autism spectrum disorders. Sovremennye Tehnologii v Medicine 2019; 11
Sreedharan S, Chandran A, Yanamala VR, Sylaja P, Kesavadas C, Sitaram R. Self-regulation of language areas using real-time functional MRI in stroke patients with expressive aphasia. Brain Imag Behav 2019:14