Differences in functional MR imaging activation patterns associated with confrontation naming and responsive naming.

BACKGROUND AND PURPOSE Direct cortical stimulation studies suggest that responsive naming is more widely distributed within the temporal lobe than confrontation naming and involves anterior temporal regions typically resected in a standard temporal lobectomy. The aim of the current study was to further demonstrate the anatomic dissociation between confrontation and responsive naming by using functional MR imaging (fMRI). METHODS Twenty participants underwent fMRI while performing either a confrontation or responsive naming task. Regions of interest were identified within the anterior and posterior temporal lobe. RESULTS Responsive naming produced more activation than confrontation naming within the dominant temporal lobe, with activation extending into the temporal pole. Activation in the dominant temporal lobe associated with responsive naming was observed in the superior, middle, and inferior temporal gyri but was limited to the middle temporal gyrus for confrontation naming. Although both naming tasks produced activation within the posterior temporal region of interest in all participants, responsive and confrontation naming produced activation within the anterior temporal region of interest in 90% versus 60% of the sample, respectively. Areas of the dominant hemisphere activated by both tasks included parts of the middle occipital and middle temporal gyri, inferior frontal lobe, and hippocampus, among others. CONCLUSION Findings are consistent with cortical stimulation studies and suggest that responsive naming produces more widespread activation within the temporal lobe compared with confrontation naming. The activation more often included anterior temporal regions during responsive naming as compared with confrontation naming. In clinical cases where the functional assessment of the temporal lobe-particularly the anterior regions-is important, the current results suggest responsive naming should be a useful fMRI paradigm and may ultimately help predict the risk of postsurgical language changes.