P14.51 Brain mapping for mentalizing in GBM patient

Abstract BACKGROUND Glioblastoma is a disease with very poor outcome. Most patients underwent maximal safe resection, especially focusing in the preservation of motor and language function. However, many caregivers were suffered from the blockage of emotion communication with patients. So the definition of maximal safe resection must include the preservation of cognition and mentalizing of patients. Here we present the experience of brain mapping in awake surgery to preserve mentalizing. MATERIAL AND METHODS A 61-year-old male patient with headache was transferred to our hospital because of brain tumor on CT scan checked in another hospital. On the initial MRI, multi-septate cystic tumor was shown on left medial prefrontal area. The patient was recommended the surgical resection, but patient discharged with the denial of the operation. Ten days later, patient visited our hospital again with slowness of response by the enlargement of tumor size. The tumor extensively involved left cingulum and corpus callosum at anterior part. On diffusion tensor image, tumor located at mediosuperior part of inferior fronto-occipital fasciculus (IFOF). The patient showed deficit of visual and verbal memory, generative naming ability, and phonemic generative naming ability on preoperative neuropsychological test (SNSB-II). Pyramid and palm tree test (PPTT) and ‘Reading the Mind in the Eyes’ test (RMET) were also performed to evaluate the semantic association function and mentalizing preoperatively. RESULTS The patient underwent awake surgery with asleep-awake-asleep technique. The tumor was resected until identification of incorrect response to PPTT or RMET on subcortical stimulation (Ojeman stimulator, 1.5mA, 60Hz, biphasic). The histopathologic diagnosis was glioblastoma. Small part of tumor was remained on cingulum, but patient was discharged without change of mentalizing. CONCLUSION Although the patients with glioblastomas show poor outcome, we think that it is important to consider the cognition and mentalizing of patients for emotion communication with caregivers. With awake surgery, mentalizing can be preserved in selective patients.

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Neurocognitive and functional outcomes in patients with diffuse frontal lower-grade gliomas undergoing intraoperative awake brain mapping

Journal of Neurosurgery ◽

10.3171/2019.3.jns19211 ◽

2020 ◽

Vol 132 (6) ◽

pp. 1683-1691 ◽

Cited By ~ 7

Author(s):

Kazuya Motomura ◽

Lushun Chalise ◽

Fumiharu Ohka ◽

Kosuke Aoki ◽

Kuniaki Tanahashi ◽

...

Keyword(s):

Working Memory ◽

Brain Mapping ◽

Functional Outcomes ◽

Digit Span ◽

Awake Surgery ◽

Motor Deficit ◽

Lower Grade ◽

Superior Frontal Gyrus ◽

Neurocognitive Functions ◽

Motor Disturbances

OBJECTIVELower-grade gliomas (LGGs) are often observed within eloquent regions, which indicates that tumor resection in these areas carries a potential risk for neurological disturbances, such as motor deficit, language disorder, and/or neurocognitive impairments. Some patients with frontal tumors exhibit severe impairments of neurocognitive function, including working memory and spatial awareness, after tumor removal. The aim of this study was to investigate neurocognitive and functional outcomes of frontal LGGs in both the dominant and nondominant hemispheres after awake brain mapping.METHODSData from 50 consecutive patients with diffuse frontal LGGs in the dominant and nondominant hemispheres who underwent awake brain surgery between December 2012 and September 2018 were retrospectively analyzed. The goal was to map neurocognitive functions such as working memory by using working memory tasks, including digit span testing and N-back tasks.RESULTSDue to awake language mapping, the frontal aslant tract was frequently identified as a functional boundary in patients with left superior frontal gyrus tumors (76.5%). Furthermore, functional boundaries were identified while evaluating verbal and spatial working memory function by stimulating the dorsolateral prefrontal cortex using the digit span and visual N-back tasks in patients with right superior frontal gyrus tumors (7.1%). Comparing the preoperative and postoperative neuropsychological assessments from the Wechsler Adult Intelligence Scale–Third Edition (WAIS-III) and Wechsler Memory Scale–Revised (WMS-R), significant improvement following awake surgery was observed in mean Perceptual Organization (Z = −2.09, p = 0.04) in WAIS-III scores. Postoperative mean WMS-R scores for Visual Memory (Z = −2.12, p = 0.03) and Delayed Recall (Z = −1.98, p = 0.04) were significantly improved compared with preoperative values for every test after awake surgery. No significant deterioration was noted with regard to neurocognitive functions in a comprehensive neuropsychological test battery. In the postoperative course, early transient speech and motor disturbances were observed in 30.0% and 28.0% of patients, respectively. In contrast, late permanent speech and motor disturbances were observed in 0% and 4.0%, respectively.CONCLUSIONSIt is noteworthy that no significant postoperative deterioration was identified compared with preoperative status in a comprehensive neuropsychological assessment. The results demonstrated that awake functional mapping enabled favorable neurocognitive and functional outcomes after surgery in patients with diffuse frontal LGGs.

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White matter network damage mediates association between cerebrovascular disease and cognition

Journal of Cerebral Blood Flow & Metabolism ◽

10.1177/0271678x21990980 ◽

2021 ◽

pp. 0271678X2199098

Author(s):

Saima Hilal ◽

Siwei Liu ◽

Tien Yin Wong ◽

Henri Vrooman ◽

Ching-Yu Cheng ◽

...

Keyword(s):

White Matter ◽

Cerebrovascular Disease ◽

Verbal Memory ◽

Visual Memory ◽

Diffusion Tensor ◽

Mean Diffusivity ◽

Domain Specific ◽

Epidemiology Of Dementia ◽

Z Scores ◽

White Matter Connectivity

To determine whether white matter network disruption mediates the association between MRI markers of cerebrovascular disease (CeVD) and cognitive impairment. Participants (n = 253, aged ≥60 years) from the Epidemiology of Dementia in Singapore study underwent neuropsychological assessments and MRI. CeVD markers were defined as lacunes, white matter hyperintensities (WMH), microbleeds, cortical microinfarcts, cortical infarcts and intracranial stenosis (ICS). White matter microstructure damage was measured as fractional anisotropy and mean diffusivity by tract based spatial statistics from diffusion tensor imaging. Cognitive function was summarized as domain-specific Z-scores. Lacunar counts, WMH volume and ICS were associated with worse performance in executive function, attention, language, verbal and visual memory. These three CeVD markers were also associated with white matter microstructural damage in the projection, commissural, association, and limbic fibers. Path analyses showed that lacunar counts, higher WMH volume and ICS were associated with executive and verbal memory impairment via white matter disruption in commissural fibers whereas impairment in the attention, visual memory and language were mediated through projection fibers. Our study shows that the abnormalities in white matter connectivity may underlie the relationship between CeVD and cognition. Further longitudinal studies are needed to understand the cause-effect relationship between CeVD, white matter damage and cognition.

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The Relation between Inflammation and Neuropsychological Test Performance

International Journal of Alzheimer s Disease ◽

10.1155/2012/703871 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Valerie H. Balldin ◽

James R. Hall ◽

Robert C. Barber ◽

Linda Hynan ◽

Ramon Diaz-Arrastia ◽

...

Keyword(s):

Verbal Memory ◽

Test Performance ◽

Inflammatory Markers ◽

Visual Memory ◽

Longitudinal Research ◽

Neuropsychological Functioning ◽

Neuropsychological Test ◽

Differential Relation ◽

Markers Of Inflammation ◽

Anti Inflammatory

Background. Considerable research documents an association between pro- and anti-inflammatory markers and Alzheimer's disease (AD), yet the differential relation between these markers and neuropsychological functioning in AD and nondemented controls has received less attention. The current study sought to evaluate the relationship between peripheral markers of inflammation (both pro- and anti-inflammatory) and neuropsychological functioning through the Texas Alzheimer's Research and Care Consortium (TARCC) cohort.Methods. There were 320 participants (Probable ADn=124, Controlsn=196) in the TARCC Longitudinal Research Cohort available for analysis. Regression analyses were utilized to examine the relation between proinflammatory and anti-inflammatory markers and neuropsychological functioning. Follow-up analyses were conducted separately by case versus control status.Results. Proinflammatory and anti-inflammatory markers were found to be associated with neuropsychological testing. Third tertile proinflammatory markers were negatively associated with measures of attention and language, and anti-inflammatory markers were positively associated with measures of immediate verbal memory and delayed verbal and visual memory.Conclusions. These findings support the link between peripheral inflammatory markers and neuropsychological functioning and suggest the utility of examining profiles of inflammatory markers in the future.

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Flipping the Script: Measuring Both Performance Validity and Cognitive Ability with the Forced Choice Recognition Trial of the RCFT

Perceptual and Motor Skills ◽

10.1177/00315125211019704 ◽

2021 ◽

pp. 003151252110197

Author(s):

Kaitlyn Abeare ◽

Kristoffer Romero ◽

Laura Cutler ◽

Christina D. Sirianni ◽

Laszlo A. Erdodi

Keyword(s):

Cognitive Ability ◽

Verbal Memory ◽

Visual Memory ◽

Large Scale ◽

Clinical Sample ◽

Neuropsychological Test ◽

Forced Choice ◽

Control Group ◽

Performance Validity ◽

Two Samples

In this study we attempted to replicate the classification accuracy of the newly introduced Forced Choice Recognition trial (FCR) of the Rey Complex Figure Test (RCFT) in a clinical sample. We administered the RCFT FCR and the earlier Yes/No Recognition trial from the RCFT to 52 clinically referred patients as part of a comprehensive neuropsychological test battery and incentivized a separate control group of 83 university students to perform well on these measures. We then computed the classification accuracies of both measures against criterion performance validity tests (PVTs) and compared results between the two samples. At previously published validity cutoffs (≤16 & ≤17), the RCFT FCR remained specific (.84–1.00) to psychometrically defined non-credible responding. Simultaneously, the RCFT FCR was more sensitive to examinees’ natural variability in visual-perceptual and verbal memory skills than the Yes/No Recognition trial. Even after being reduced to a seven-point scale (18-24) by the validity cutoffs, both RCFT recognition scores continued to provide clinically useful information on visual memory. This is the first study to validate the RCFT FCR as a PVT in a clinical sample. Our data also support its use for measuring cognitive ability. Replication studies with more diverse samples and different criterion measures are still needed before large-scale clinical application of this scale.

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Foix-Chavany-Marie syndrome caused by a disconnection between the right pars opercularis of the inferior frontal gyrus and the supplementary motor area

Journal of Neurosurgery ◽

10.3171/2012.7.jns12404 ◽

2012 ◽

Vol 117 (5) ◽

pp. 844-850 ◽

Cited By ~ 26

Author(s):

Juan Martino ◽

Enrique Marco de Lucas ◽

Francisco Javier Ibáñez-Plágaro ◽

José Manuel Valle-Folgueral ◽

Alfonso Vázquez-Barquero

Keyword(s):

Supplementary Motor Area ◽

Diffusion Tensor ◽

Anterior Part ◽

Inferior Frontal Gyrus ◽

Motor Area ◽

Lower Limbs ◽

Rare Type ◽

Orofacial Movement ◽

Pars Opercularis ◽

The Right

Foix-Chavany-Marie syndrome (FCMS) is a rare type of suprabulbar palsy characterized by an automaticvoluntary dissociation of the orofacial musculature. Here, the authors report an original case of FCMS that occurred intraoperatively while resecting the pars opercularis of the inferior frontal gyrus. This 25-year-old right-handed man with an incidentally diagnosed right frontotemporoinsular tumor underwent surgery using an asleep-awake-asleep technique with direct cortical and subcortical electrical stimulation and a transopercular approach to the insula. While resecting the anterior part of the pars opercularis the patient suffered sudden anarthria and bilateral facial weakness. He was unable to speak or show his teeth on command, but he was able to voluntarily move his upper and lower limbs. This syndrome lasted for 8 days. Postoperative diffusion tensor imaging tractography revealed that connections of the pars opercularis of the right inferior frontal gyrus with the frontal aslant tract (FAT) and arcuate fasciculus (AF) were damaged. This case supplies evidence for localizing the structural substrate of FCMS. It was possible, for the first time in the literature, to accurately correlate the occurrence of FCMS to the resection of connections between the FAT and AF, and the right pars opercularis of the inferior frontal gyrus. The FAT has been recently described, but it may be an important connection to mediate supplementary motor area control of orofacial movement. The present case also contributes to our knowledge of complication avoidance in operculoinsular surgery. A transopercular approach to insuloopercular gliomas can generate FCMS, especially in cases of previous contralateral lesions. The prognosis is favorable, but the patient should be informed of this particular hazard, and the surgeon should anticipate the surgical strategy in case the syndrome occurs intraoperatively in an awake patient.

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Effects of the anticonvulsant topiramate on language abilities in people with epilepsy: a cross-sectional study

Irish Journal of Psychological Medicine ◽

10.1017/s0790966700001488 ◽

2010 ◽

Vol 27 (4) ◽

pp. 179-183 ◽

Cited By ~ 2

Author(s):

Aisling Buckley ◽

Margaret Fitzgerald ◽

Doreen Hoerold ◽

Gavin P Davey ◽

Colin Doherty

Keyword(s):

Verbal Memory ◽

Word Association ◽

Neuropsychological Test ◽

Cross Sectional Study ◽

Neuropsychological Battery ◽

Boston Naming Test ◽

Language Abilities ◽

Cross Sectional ◽

Fluency And Comprehension ◽

Neuropsychological Tasks

AbstractObjectives: The aim of this study was to investigate the effects of topiramate (TPM) on cognitive function, specifically language, in patients with epilepsy, and to determine whether a specifically designed neuropsychological test battery can show such effects.Method: Twenty patients taking TPM, 25 epilepsy controls (taking medication other than TPM) and 25 healthy controls were recruited. We used a specific neuropsychological battery, including measures of visual and verbal memory, attention, fluency and comprehension. Separate one way between group ANOVAs were performed for each neuropsychological measure.Results: Bonferroni comparisons revealed that the TPM group performed significantly worse than epilepsy controls on digits forward (p<0.001), digits backward (p<0.05), controlled oral word association (COWA) (p<0.05) and token test (p<0.05). The TPM group also needed more multiple choice cues in the Boston naming test (p<0.05).Conclusions: The present study indicates that 15% of the sample tested had impaired language abilities and raises interesting questions regarding the nature of this effect. Furthermore, we have identified some short neuropsychological tasks that can be performed in routine clinical situations that can reliably identify patients who have negative linguistic effects of TPM.

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Intraoperative brain mapping during awake surgery in symptomatic supratentorial cavernomas

Neurocirugía ◽

10.1016/j.neucir.2020.07.004 ◽

2020 ◽

Author(s):

Ricardo Prat-Acín ◽

Inma Galeano-Senabre ◽

Pilar López-Ruiz ◽

Daniel García-Sánchez ◽

Angel Ayuso-Sacido ◽

...

Keyword(s):

Brain Mapping ◽

Awake Surgery

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Emotional Valence Affects Word Retrieval During Verb Fluency Tasks in Alzheimer’s Dementia

Frontiers in Psychology ◽

10.3389/fpsyg.2021.777116 ◽

2021 ◽

Vol 12 ◽

Author(s):

Eun Jin Paek

Keyword(s):

Verbal Memory ◽

Emotional Processing ◽

Neuropsychological Test ◽

Emotional Valence ◽

Memory Effects ◽

Word Retrieval ◽

Memory And Learning ◽

Learning Abilities ◽

Healthy Older Adults ◽

Insight Into

Individuals with amnestic Alzheimer’s disease (AD) often demonstrate preserved emotional processing skills despite the neurodegenerative disease that affects their limbic system. Emotional valence encompasses the encoding and retrieval of memory and it also affects word retrieval in healthy populations, but it remains unclear whether these effects are preserved in individuals with amnestic AD. Previous studies used a variety of encoding procedures and different retrieval methods that resulted in mixed findings. Therefore, the purpose of the current study is to investigate whether emotional enhancement of memory effects is observed in an experimental condition where the memory encoding process is not required, namely verb (action) fluency tasks. Seventeen participants who were cognitively healthy older adults (CHOA) and 15 participants with amnestic AD were asked to complete verb fluency tasks, and the relative degree of emotional valence observed in their responses was compared between the two groups. A neuropsychological test battery was administered to determine the participants’ cognitive and linguistic profiles, and correlational analyses were conducted to delineate relationships between emotional valence, verbal memory, and learning abilities. The results indicated that the participants with amnestic AD produced words with higher emotional valence (i.e., more pleasant words) compared to CHOA during action fluency testing. In addition, the degree of emotional valence in the words was negatively correlated with verbal memory and learning skills, showing that those with poorer memory skills tend to retrieve words with higher emotional valence. The findings are consistent with those previous studies that stressed that individuals with AD have preserved emotional enhancement of memory effects and may benefit from them for retrieval of information, which may offer some insight into the development of novel rehabilitative strategies for this population.

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Improved neuropathological identification of traumatic brain injury through quantitative neuroimaging and neural network analyses: Some practical approaches for the neurorehabilitation clinician

Neurorehabilitation ◽

10.3233/nre-218023 ◽

2021 ◽

pp. 1-19

Author(s):

Erin D. Bigler ◽

Steven Allder

Keyword(s):

Neural Network ◽

Traumatic Brain Injury ◽

Brain Injury ◽

Diffusion Tensor ◽

Neuropsychological Test ◽

Region Of Interest ◽

Neural Network Approach ◽

Additional Tool ◽

Network Analyses ◽

Quantitative Neuroimaging

BACKGROUND: Quantitative neuroimaging analyses have the potential to provide additional information about the neuropathology of traumatic brain injury (TBI) that more thoroughly informs the neurorehabilitation clinician. OBJECTIVE: Quantitative neuroimaging is typically not covered in the standard radiological report, but often can be extracted via post-processing of clinical neuroimaging studies, provided that the proper volume acquisition sequences were originally obtained. METHODS: Research and commercially available quantitative neuroimaging methods provide region of interest (ROI) quantification metrics, lesion burden volumetrics and cortical thickness measures, degree of focal encephalomalacia, white matter (WM) abnormalities and residual hemorrhagic pathology. If present, diffusion tensor imaging (DTI) provides a variety of techniques that aid in evaluating WM integrity. Using quantitatively identified structural and ROI neuropathological changes are most informative when done from a neural network approach. RESULTS: Viewing quantitatively identifiable damage from a neural network perspective provides the neurorehabilitation clinician with an additional tool for linking brain pathology to understand symptoms, problems and deficits as well as aid neuropsychological test interpretation. All of these analyses can be displayed in graphic form, including3-D image analysis. A case study approach is used to demonstrate the utility of quantitative neuroimaging and network analyses in TBI. CONCLUSIONS: Quantitative neuroimaging may provide additional useful information for the neurorehabilitation clinician.

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