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Tumor location, grade, and genetics influence the communication between eloquent areas and tumor growth dynamics, which are drivers of language plasticity. We evaluated tumor-induced language reorganization studying the relationship of fMRI language laterality to tumor-related variables (grade, genetics, location), and patient-related variables (age, sex, handedness).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>The study was retrospective cross-sectional. We included patients with left-hemispheric tumors (study group) and right-hemispheric tumors (controls). We calculated five fMRI laterality indexes (LI): hemispheric, temporal lobe, frontal lobe, Broca\u2019s area (BA), Wernicke\u2019s area (WA). We defined LI\u2009\u2265\u20090.2 as left-lateralized (LL) and LI\u2009&lt;\u20090.2 as atypical lateralized (AL). Chi-square test (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.05) was employed to identify the relationship between LI and tumor\/patient variables in the study group. For those variables having significant results, confounding factors were evaluated in a multinomial logistic regression model.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>We included 405 patients (235\u00a0M, mean age: 51\u00a0years old) and 49 controls (36\u00a0M, mean age: 51\u00a0years old). Contralateral language reorganization was more common in patients than controls. The statistical analysis demonstrated significant association between BA LI and patient sex (<jats:italic>p<\/jats:italic>\u2009=\u20090.005); frontal LI, BA LI, and tumor location in BA (<jats:italic>p<\/jats:italic>\u2009&lt;\u20090.001); hemispheric LI and fibroblast growth factor receptor (FGFR) mutation (<jats:italic>p<\/jats:italic>\u2009=\u20090.019); WA LI and O6-methylguanine-DNA methyltransferase promoter (MGMT) methylation in high-grade gliomas (<jats:italic>p<\/jats:italic>\u2009=\u20090.016).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Tumor genetics, pathology, and location influence language laterality, possibly due to cortical plasticity. Increased fMRI activation in the right hemisphere was seen in patients with tumors in the frontal lobe, BA and WA, FGFR mutation, and MGMT promoter methylation.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Key Points<\/jats:title>\n                <jats:p>\u2022 <jats:italic>Patients harboring left-hemispheric tumors present with contralateral translocation of language function. Influential variables for this phenomenon included frontal tumor location, BA location, WA location, sex, MGMT promoter methylation, and FGFR mutation<\/jats:italic>.<\/jats:p>\n                <jats:p>\u2022 <jats:italic>Tumor location, grade, and genetics may influence language plasticity, thereby affecting both communication between eloquent areas and tumor growth dynamics<\/jats:italic>.<\/jats:p>\n                <jats:p>\u2022 <jats:italic>In this retrospective cross-sectional study, we evaluated language reorganization in 405 brain tumor patients by studying the relationship of fMRI language laterality to tumor-related variables (grade, genetics, location), and patient-related variables (age, sex, handedness)<\/jats:italic>.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00330-023-09610-3","type":"journal-article","created":{"date-parts":[[2023,4,19]],"date-time":"2023-04-19T05:02:01Z","timestamp":1681880521000},"page":"6069-6078","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":13,"title":["Effect of tumor genetics, pathology, and location on fMRI of language reorganization in brain tumor patients"],"prefix":"10.1007","volume":"33","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1679-6958","authenticated-orcid":false,"given":"Luca","family":"Pasquini","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Onur","family":"Yildirim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick","family":"Silveira","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christel","family":"Tamer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio","family":"Napolitano","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martina","family":"Lucignani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mehrnaz","family":"Jenabi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyung K.","family":"Peck","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrei","family":"Holodny","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2023,4,19]]},"reference":[{"key":"9610_CR1","doi-asserted-by":"publisher","first-page":"1855","DOI":"10.1212\/01.wnl.0000219623.28769.74","volume":"66","author":"KL Isaacs","year":"2006","unstructured":"Isaacs KL, Barr WB, Nelson PK, Devinsky O (2006) Degree of handedness and cerebral dominance. 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The other authors have no conflicts of interest relevant to this research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"The author Antonio Napolitano has significant statistical expertise, and provided statistical advice for this manuscript.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"The study was approved by the Institutional Review Board\/Privacy Board-A of Memorial Sloan Kettering Cancer Center, protocol # 16\u2013360.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"The design of the study was retrospective cross-sectional performed at one institution.","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}