Language Lateralization on resting state fMRI Vs task fMRI, in neurosurgical cases

Motivation: Understanding hemispheric language dominance is crucial for surgery, yet task-based fMRI has many challenges. Resting-state fMRI shows promise, but its ability to depict language lateralization is still evolving, with varied results in literature. Goal(s): To assess language dominance on rest fMRI in neurosurgical patients by different methods and seeing concordance with task-based fMRI. Approach: We explored three calculation techniques for lateralization: first using individual seed volumes, second using voxel activation in ipsilateral hemisphere, and third using net voxel activation generated in bilateral hemispheres Results: Maximum of 54.55% concordance of rest-fMRI with task-based fMRI was seen for language dominance, with one of the methods. Impact: Our results emphasize that rest fMRI for language dominance should be used with caution and as an adjunct to task fMRI in neurosurgical patients.