OS10.7.A Localization patterns of language errors during direct electrical brain stimulation: a systematic review

Abstract BACKGROUND Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. Language errors (paraphasias) are detected with DES and they indicate functional boundaries that need to be maintained to preserve quality of life. However, it is not fully clear in which brain locations paraphasias at different linguistic modalities and levels (production, comprehension, reading, writing, phonology, semantics, syntax) occur. MATERIALS AND METHODS A systematic review was conducted. We included 102 studies reporting on specific paraphasias and the corresponding brain locations during awake craniotomy with DES in adult glioma patients. RESULTS First, a wide distribution of brain locations for all paraphasias (n=930) was found, but patterns were observed. Cortically, paraphasias occurred most often in the precentral gyrus (22%), while subcortically, they occurred mainly at the inferior fronto-occipital fascicle (IFOF: 10%). Localization patterns for different paraphasia types and the corresponding language functions were also found: production/articulation (n=393)-precentral gyrus (41%), inferior frontal gyrus (9%), frontal aslant/striatal tract (4%), postcentral gyrus (3%); semantics (n=128)-IFOF (57%), superior temporal gyrus (9%); phonology (n=115)-arcuate fascicle (52%), superior longitudinal fascicle (10%), uncinate fascicle (3%); reading (n=25)-temporal lobe (48%), inferior longitudinal fascicle (32%); syntax (n=15)-inferior frontal gyrus (27%); speech initiation (n=9)-supplementary motor area (33%), frontal aslant tract (22%), frontal striatal tract (22%); writing (n=7)-superior parietal gyrus (71%). Second, 59% of all paraphasias occurred cortically, 40% subcortically and 1% at both levels. CONCLUSION The localization of most paraphasias are consistent with the assumed functionality of those brain locations as presented in the Dutch Linguistic Intraoperative Protocol model. However, new locations for production/articulation, phonology, reading and writing were found. This needs to be taken into consideration for future selection of pre, intra and postoperative language tasks at different language modalities and levels. Additionally, DES should always be applied at the subcortical level as a standard addition to the routine cortical mapping during awake craniotomy. In conclusion, this is the first systematic review on the localization of specific paraphasias during awake craniotomy. Based on the identified language localization patterns, language tasks could be selected more accurately. This could guide, and perhaps improve, pre, intra and postoperative language testing and monitoring, which in turn, may pave the way to a better postoperative language outcome. The possible relation between different intraoperative paraphasias and language outcome has yet to be determined.

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fMRI Evidence for Cortical Modification during Learning of Mandarin Lexical Tone

Journal of Cognitive Neuroscience ◽

10.1162/089892903770007407 ◽

2003 ◽

Vol 15 (7) ◽

pp. 1019-1027 ◽

Cited By ~ 115

Author(s):

Yue Wang ◽

Joan A. Sereno ◽

Allard Jongman ◽

Joy Hirsch

Keyword(s):

Second Language ◽

Inferior Frontal Gyrus ◽

Superior Temporal Gyrus ◽

Broca’S Area ◽

Lexical Tone ◽

Broca's Area ◽

Language Functions ◽

Before And After ◽

Cortical Regions ◽

Wernicke’S Area

Functional magnetic resonance imaging was employed before and after six native English speakers completed lexical tone training as part of a program to learn Mandarin as a second language. Language-related areas including Broca's area, Wernicke's area, auditory cortex, and supplementary motor regions were active in all subjects before and after training and did not vary in average location. Across all subjects, improvements in performance were associated with an increase in the spatial extent of activation in left superior temporal gyrus (Brodmann's area 22, putative Wernicke's area), the emergence of activity in adjacent Brodmann's area 42, and the emergence of activity in right inferior frontal gyrus (Brodmann's area 44), a homologue of putative Broca's area. These findings demonstrate a form of enrichment plasticity in which the early cortical effects of learning a tone-based second language involve both expansion of preexisting language-related areas and recruitment of additional cortical regions specialized for functions similar to the new language functions.

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Discordance between functional magnetic resonance imaging during silent speech tasks and intraoperative speech arrest

Journal of Neurosurgery ◽

10.3171/jns.2005.103.2.0267 ◽

2005 ◽

Vol 103 (2) ◽

pp. 267-274 ◽

Cited By ~ 49

Author(s):

Nicole Petrovich ◽

Andrei I. Holodny ◽

Viviane Tabar ◽

Denise D. Correa ◽

Joy Hirsch ◽

...

Keyword(s):

Magnetic Resonance ◽

Inferior Frontal Gyrus ◽

Hemispheric Dominance ◽

Cortical Mapping ◽

Precentral Gyrus ◽

Functional Magnetic Resonance ◽

Content Type ◽

Neurosurgical Planning ◽

Silent Speech ◽

Fine Print

Object. The goal of this study was to investigate discordance between the location of speech arrest during awake cortical mapping, a common intraoperative indicator of hemispheric dominance, and silent speech functional magnetic resonance (fMR) imaging maps of frontal language function. Methods. Twenty-one cases were reviewed retrospectively. Images of silent speech fMR imaging activation were coregistered to anatomical MR images obtained for neuronavigation. These were compared with the intraoperative cortical photographs and the behavioral results of electrocorticography during awake craniotomy. An fMR imaging control study of three healthy volunteers was then conducted to characterize the differences between silent and vocalized speech fMR imaging protocols used for neurosurgical planning. Conclusions. Results of fMR imaging showed consistent and predominant activation of the inferior frontal gyrus (IFG) during silent speech tasks. During intraoperative mapping, however, 16 patients arrested in the precentral gyrus (PRG), well posterior to the fMR imaging activity. Of those 16, 14 arrested only in the PRG and not in the IFG as silent speech fMR imaging predicted. The control fMR imaging study showed that vocalized speech fMR imaging shifts the location of the fMR imaging prediction to include the motor strip and may be more appropriate for neurosurgical planning.

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The Frontal Aslant Tract: A Systematic Review for Neurosurgical Applications

Frontiers in Neurology ◽

10.3389/fneur.2021.641586 ◽

2021 ◽

Vol 12 ◽

Author(s):

Emanuele La Corte ◽

Daniela Eldahaby ◽

Elena Greco ◽

Domenico Aquino ◽

Giacomo Bertolini ◽

...

Keyword(s):

Systematic Review ◽

White Matter ◽

Inferior Frontal Gyrus ◽

Primary Progressive Aphasia ◽

Autism Spectrum ◽

Sentence Production ◽

Microstructural Alterations ◽

Language Functions ◽

Brain White Matter ◽

Frontal Aslant Tract

The frontal aslant tract (FAT) is a recently identified white matter tract connecting the supplementary motor complex and lateral superior frontal gyrus to the inferior frontal gyrus. Advancements in neuroimaging and refinements to anatomical dissection techniques of the human brain white matter contributed to the recent description of the FAT anatomical and functional connectivity and its role in the pathogenesis of several neurological, psychiatric, and neurosurgical disorders. Through the application of diffusion tractography and intraoperative electrical brain stimulation, the FAT was shown to have a role in speech and language functions (verbal fluency, initiation and inhibition of speech, sentence production, and lexical decision), working memory, visual–motor activities, orofacial movements, social community tasks, attention, and music processing. Microstructural alterations of the FAT have also been associated with neurological disorders, such as primary progressive aphasia, post-stroke aphasia, stuttering, Foix–Chavany–Marie syndrome, social communication deficit in autism spectrum disorders, and attention–deficit hyperactivity disorder. We provide a systematic review of the current literature about the FAT anatomical connectivity and functional roles. Specifically, the aim of the present study relies on providing an overview for practical neurosurgical applications for the pre-operative, intra-operative, and post-operative assessment of patients with brain tumors located around and within the FAT. Moreover, some useful tests are suggested for the neurosurgical evaluation of FAT integrity to plan a safer surgery and to reduce post-operative deficits.

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Window anatomy for neurosurgical approaches

Journal of Neurosurgery ◽

10.3171/2008.10.jns08159 ◽

2009 ◽

Vol 111 (2) ◽

pp. 365-370 ◽

Cited By ~ 7

Author(s):

Simel Kendir ◽

Halil Ibrahim Acar ◽

Ayhan Comert ◽

Mevci Ozdemir ◽

Gokmen Kahilogullari ◽

...

Keyword(s):

Inferior Frontal Gyrus ◽

Superior Temporal Gyrus ◽

Angular Gyrus ◽

Precentral Gyrus ◽

Supramarginal Gyrus ◽

Surgical Interventions ◽

Postcentral Gyrus ◽

Human Skulls ◽

Formalin Fixed ◽

Heschl Gyrus

Object Knowledge of the cranium projections of the gyral structures is essential to reduce the surgical complications and to perform minimally invasive interventions in daily neurosurgical practice. Thus, in this study the authors aimed to provide detailed information on cranial projections of the eloquent cortical areas. Methods Ten formalin-fixed adult human skulls were obtained. Using sutures and craniometrical points, the crania were divided into 8 windows: superior frontal, inferior frontal, superior parietal, inferior parietal, sphenoidal, temporal, superior occipital, and inferior occipital. The projections of the precentral gyrus, postcentral gyrus, inferior frontal gyrus, superior temporal gyrus, transverse temporal gyri, Heschl gyrus, genu and splenium of the corpus callosum, supramarginal gyrus, angular gyrus, calcarine sulcus, and sylvian fissure to cranial vault were evaluated. Results Three-fourths of the precentral gyrus and postcentral gyrus were in the superior parietal window. The inferior frontal gyrus extended to the inferior parietal window in 80%. The 3 important parts of this gyrus were located below the superior temporal line in all hemispheres. The orbital and triangular parts were in the inferior frontal window, and the opercular part was in the inferior parietal window. The superior temporal gyrus was usually located in the inferior parietal and temporal windows, whereas the supramarginal gyrus and angular gyrus were usually located in the superior and inferior parietal windows. The farthest anterior point of the Heschl gyrus was usually located in the inferior parietal window. The mean positions of arachnoid granulations were measured as 3.9 ± 0.39 cm anterior and 7.3 ± 0.51 cm posterior to the bregma. Conclusions Given that recognition of the gyral patterns underlying the craniotomies is not always easy, awareness of the coordinates and projections of certain gyri according to the craniometric points may considerably contribute to surgical interventions.

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Altered amygdala effective connectivity in migraine without aura: evidence from resting‐state fMRI with Granger causality analysis

The Journal of Headache and Pain ◽

10.1186/s10194-021-01240-8 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Xiaobin Huang ◽

Di Zhang ◽

Peng Wang ◽

Cunnan Mao ◽

Zhengfei Miao ◽

...

Keyword(s):

Granger Causality ◽

Resting State ◽

Migraine Without Aura ◽

Effective Connectivity ◽

Inferior Frontal Gyrus ◽

Superior Temporal Gyrus ◽

Pain Modulation ◽

Precentral Gyrus ◽

Causality Analysis ◽

Granger Causality Analysis

AbstractBackgroundGranger causality analysis (GCA) has been used to investigate the pathophysiology of migraine. Amygdala plays a key role in pain modulation of migraine attack. However, the detailed neuromechanism remained to be elucidated. We applied GCA to explore the amygdala-based directional effective connectivity in migraine without aura (MwoA) and to determine the relation with clinical characteristics.MethodsForty-five MwoA patients and forty age-, sex-, and years of education-matched healthy controls(HCs) underwent resting-state functional magnetic resonance imaging (fMRI). Bilateral amygdala were used as seed regions in GCA to investigate directional effective connectivity and relation with migraine duration or attack frequency.ResultsMwoA patients showed significantly decreased effective connectivity from right amygdala to right superior temporal gyrus, left superior temporal gyrus and right precentral gyrus compared with HCs. Furthermore, MwoA patients demonstrated significantly decreased effective connectivity from the left amygdala to the ipsilateral superior temporal gyrus. Also, MwoA patients showed enhanced effective connectivity from left inferior frontal gyrus to left amygdala. Effective connectivity outflow from right amygdala to right precentral gyrus was negatively correlated to disease duration.ConclusionsAltered directional effective connectivity of amygdala demonstrated that neurolimbic pain networks contribute to multisensory integration abnormalities and deficits in pain modulation of MwoA patients.

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Identifying a supramodal language network in human brain with individual fingerprint

10.1101/2020.05.10.085787 ◽

2020 ◽

Author(s):

Lanfang Liu ◽

Xin Yan ◽

Hehui Li ◽

Dingguo Gao ◽

Guosheng Ding

Keyword(s):

Activity Pattern ◽

Brain Activity ◽

Inferior Frontal Gyrus ◽

Superior Temporal Gyrus ◽

Precentral Gyrus ◽

Functional Brain Mapping ◽

Signed Language ◽

Cortical Responses ◽

Core Language ◽

The Brain

AbstractWhere is human language processed in the brain independent of its form? We addressed this issue by analyzing the cortical responses to spoken, written and signed sentences at the level of individual subjects. By applying a novel fingerprinting method based on the distributed pattern of brain activity, we identified a left-lateralized network composed by the superior temporal gyrus/sulcus (STG/STS), inferior frontal gyrus (IFG), precentral gyrus/sulcus (PCG/PCS), and supplementary motor area (SMA). In these regions, the local distributed activity pattern induced by any of the three language modalities can predict the activity pattern induced by the other two modalities, and such cross-modal prediction is individual-specific. The prediction is successful for speech-sign bilinguals across all possible modality pairs, but fails for monolinguals across sign-involved pairs. In comparison, conventional group-mean focused analysis detects shared cortical activations across modalities only in the STG, PCG/PCS and SMA, and the shared activations were found in two groups. This study reveals the core language system in the brain that is shared by spoken, written and signed language, and demonstrates that it is possible and desirable to utilize the information of individual differences for functional brain mapping.

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Understanding Body Language Does Not Require Matching the Body's Egocentric Map to Body Posture: A Brain Activation fMRI Study

Perceptual and Motor Skills ◽

10.1177/0031512519876741 ◽

2019 ◽

Vol 127 (1) ◽

pp. 8-35 ◽

Cited By ~ 1

Author(s):

Cinzia Canderan ◽

Marta Maieron ◽

Franco Fabbro ◽

Barbara Tomasino

Keyword(s):

Inferior Frontal Gyrus ◽

Body Schema ◽

Superior Temporal Gyrus ◽

Body Language ◽

The Body ◽

Precentral Gyrus ◽

Intraparietal Sulcus ◽

Superior Parietal Lobule ◽

Body Postures ◽

Parietal Lobule

Body language (BL) is a type of nonverbal communication in which the body communicates the message. We contrasted participants' cognitive processing of body representations or meanings versus body positions. Participants ( N = 20) were shown pictures depicting body postures and were instructed to focus on their meaning (BL) or on the position of a body part relative to the position of another part (body structural description [BSD]). We examined activation in brain areas related to the two types of body representation—body schema and BSD—as modulated by the two tasks. We presumed that if understanding BL triggers embodiment of body posture, a matching procedure between the egocentric map coding the position of one's body segments in space and time should occur. We found that BL (vs. BSD) differentially activated the angular gyrus bilaterally, the anterior middle temporal gyrus, the temporal pole, and the right superior temporal gyrus, the inferior frontal gyrus, the superior medial gyrus, and the left superior frontal gyrus. BSD (vs. BL) differentially activated the superior parietal lobule (Area 7A) bilaterally, the posterior inferior temporal gyrus, the middle frontal gyrus, and the left precentral gyrus. Sensorimotor areas were differentially activated by BSD when compared with BL. Inclusive masking showed significant voxels in the superior colliculus and pulvinar, fusiform gyrus, inferior temporal gyrus, superior temporal gyrus, the intraparietal sulcus bilaterally, inferior frontal gyrus bilaterally, and precentral gyrus. These results indicate common brain networks for processing BL and BSD, for which some areas show differentially stronger or weaker processing of one task or the other, with the precuneus and the superior parietal lobule, the intraparietal sulcus, and sensorimotor areas most related to the BSD as activated by the BSD task. In contrast, the parietal operculum, an area related to the body schema, a representation crucial during embodiment of body postures, was not activated for implicit masking or for the differential contrasts.

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Motor theory modulated by task load: strategies of phonological processing in frontal aphasia revealed by tDCS over the LIFG

10.31234/osf.io/xn9tf ◽

2019 ◽

Author(s):

Lílian Rodrigues de Almeida ◽

Paul A. Pope ◽

Peter Hansen

Keyword(s):

Speech Perception ◽

Speech Production ◽

Phonological Processing ◽

Inferior Frontal Gyrus ◽

Dorsal Stream ◽

Superior Temporal Gyrus ◽

Motor Theory ◽

Task Load ◽

Cathodal Tdcs ◽

The Individual

In our previous studies we supported the claim that the motor theory is modulated by task load. Motoric participation in phonological processing increases from speech perception to speech production, with the endpoints of the dorsal stream having changing and complementary weightings for processing: the left inferior frontal gyrus (LIFG) being increasingly relevant and the left superior temporal gyrus (LSTG) being decreasingly relevant. Our previous results for neurostimulation of the LIFG support this model. In this study we investigated whether our claim that the motor theory is modulated by task load holds in (frontal) aphasia. Person(s) with aphasia (PWA) after stroke typically have damage on brain areas responsible for phonological processing. They may present variable patterns of recovery and, consequently, variable strategies of phonological processing. Here these strategies were investigated in two PWA with simultaneous fMRI and tDCS of the LIFG during speech perception and speech production tasks. Anodal tDCS excitation and cathodal tDCS inhibition should increase with the relevance of the target for the task. Cathodal tDCS over a target of low relevance could also induce compensation by the remaining nodes. Responses of PWA to tDCS would further depend on their pattern of recovery. Responses would depend on the responsiveness of the perilesional area, and could be weaker than in controls due to an overall hypoactivation of the cortex. Results suggest that the analysis of motor codes for articulation during phonological processing remains in frontal aphasia and that tDCS is a promising diagnostic tool to investigate the individual processing strategies.

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A Novel Language Paradigm for Intraoperative Language Mapping: Feasibility and Evaluation

Journal of Clinical Medicine ◽

10.3390/jcm10040655 ◽

2021 ◽

Vol 10 (4) ◽

pp. 655

Author(s):

Katharina Rosengarth ◽

Delin Pai ◽

Frank Dodoo-Schittko ◽

Katharina Hense ◽

Teele Tamm ◽

...

Keyword(s):

Healthy Subjects ◽

Intraoperative Complications ◽

Evaluation Study ◽

Awake Craniotomy ◽

Language Mapping ◽

Tumor Patients ◽

Language Functions ◽

Before And After ◽

Assessment Time ◽

Neuropsychological Outcomes

(1) Background—Mapping language using direct cortical stimulation (DCS) during an awake craniotomy is difficult without using more than one language paradigm that particularly follows the demand of DCS by not exceeding the assessment time of 4 s to prevent intraoperative complications. We designed an intraoperative language paradigm by combining classical picture naming and verb generation, which safely engaged highly relevant language functions. (2) Methods—An evaluation study investigated whether a single trial of the language task could be performed in less than 4 s in 30 healthy subjects and whether the suggested language paradigm sufficiently pictured the cortical language network using functional magnetic resonance imaging (fMRI) in 12 healthy subjects. In a feasibility study, 24 brain tumor patients conducted the language task during an awake craniotomy. The patients’ neuropsychological outcomes were monitored before and after surgery. (3) Results—The fMRI results in healthy subjects showed activations in a language-associated network around the (left) sylvian fissure. Single language trials could be performed within 4 s. Intraoperatively, all tumor patients showed DCS-induced language errors while conducting the novel language task. Postoperatively, mild neuropsychological impairments appeared compared to the presurgical assessment. (4) Conclusions—These data support the use of a novel language paradigm that safely monitors highly relevant language functions intraoperatively, which can consequently minimize negative postoperative neuropsychological outcomes.

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MS-1 Surgical strategy for brain tumor based on molecular and functional connectomics profiles

Neuro-Oncology Advances ◽

10.1093/noajnl/vdaa143.008 ◽

2020 ◽

Vol 2 (Supplement_3) ◽

pp. ii2-ii2

Author(s):

Tatsuya Abe

Keyword(s):

Overall Survival ◽

Brain Tumor ◽

Standard Procedure ◽

Awake Craniotomy ◽

Surgical Strategy ◽

Neurological Deficits ◽

Cortical Mapping ◽

Photodynamic Diagnosis ◽

Tumor Surgery ◽

Brain Tumor Surgery

Abstract It is reported that the development of new perioperative motor deficits was associated with decreased overall survival despite similar extent of resection and adjuvant therapy. The maximum safe resection without any neurological deficits is required to improve overall survival in patients with brain tumor. Surgery is performed with various modalities, such as neuro-monitoring, photodynamic diagnosis, neuro-navigation, awake craniotomy, intraoperative MRI, and so on. Above all, awake craniotomy technique is now the standard procedure to achieve the maximum safe resection in patients with brain tumor. It is well known that before any treatment, gliomas generate globally (and not only focally) altered functional connectomics profiles, with various patterns of neural reorganization allowing different levels of cognitive compensation. Therefore, perioperative cortical mapping and elucidation of functional network, neuroplasticity and reorganization are important for brain tumor surgery. On the other hand, recent studies have proposed several gene signatures as biomarkers for different grades of gliomas from various perspectives. Then, we aimed to identify these biomarkers in pre-operative and/or intra-operative periods, using liquid biopsy, immunostaining and various PCR methods including rapid genotyping assay. In this presentation, we would like to demonstrate our surgical strategy based on molecular and functional connectomics profiles.

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