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

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.

BRMP-02. Feasibility and evaluation of a novel language paradigm for intraoperative language testing

2021 ◽  
Vol 23 (Supplement_6) ◽  
pp. vi223-vi223
Author(s):  
Katharina Rosengarth ◽  
Delin Pain ◽  
Frank Dodoo-Schitto ◽  
Katharina Hense ◽  
Teele Tamm ◽  
...  
Keyword(s):  
Pilot Study ◽  
Healthy Subjects ◽  
Neuropsychological Testing ◽  
Time Frame ◽  
Middle Temporal Gyrus ◽  
The Novel ◽  
Language Functions ◽  
Before And After ◽  
Assessment Time ◽  
Task Trial

Abstract INTRODUCTION Mapping language during direct cortical stimulation (DCS) in the stetting of awake craniotomy might be challenging without using more than one language paradigm. Applying several language tasks leads to increasing surgery times and to patient’s exhaustion. Additionally, a single language trial must be performed in less than 4 seconds to avoid DCS-induced seizures. Therefore, we aimed to design a single language paradigm which pictures highly relevant language functions and simultaneously restrains the assessment time of single language trials up to 4 seconds. METHOD The intraoperative language task comprised a combination of picture naming and verb generation. During DCS patients should generate correct sentences according to the language stimulus by not exceeding 4 seconds. To assess the intraoperative feasibility of the language task we included 30 healthy subjects in a pilot study to measure subjects’ speed of performing a single language task trial and to evaluate the language paradigm according to its language sensitivity by using the paradigm as a task for functional MRI. Intraoperatively, 21 patients with brain tumors in language associated brain areas were included. Patients received neuropsychological testing before and after surgery. RESULTS The pilot study showed in healthy subjects that by applying the novel paradigm during fMRI there is activation in a left accentuated network of inferior frontal and parietal regions and the superior and middle temporal gyrus (p<.05, FEW). It was feasible to conduct a single language trial of the novel paradigm in a time frame of 4s (performance speed 2.53 s; SD=.32s). Intraoperatively, tumor patients showed DCS-associated language errors while conducting the language task. Postoperatively, mild language but no other neuropsychological deteriorations compared to presurgical assessment were observed (p<.05). CONCLUSION We present a novel language paradigm which safely pictures and monitors highly relevant language functions and consequently can minimize postoperative language deficits.

scholarly journals The Cologne Picture Naming Test for Language Mapping and Monitoring (CoNaT): An Open Set of 100 Black and White Object Drawings

2021 ◽  
Vol 12 ◽  
Author(s):  
Carolin Weiss Lucas ◽  
Julia Pieczewski ◽  
Sophia Kochs ◽  
Charlotte Nettekoven ◽  
Christian Grefkes ◽  
...  
Keyword(s):  
Task Performance ◽  
Brain Tumour ◽  
Educational Level ◽  
Picture Naming ◽  
Healthy Subjects ◽  
Clinical Use ◽  
Language Mapping ◽  
Black And White ◽  
Language Functions ◽  
Open Set

Language assessment using a picture naming task crucially relies on the interpretation of the given verbal response by the rater. To avoid misinterpretations, a language-specific and linguistically controlled set of unambiguous, clearly identifiable and common object–word pairs is mandatory. We, here, set out to provide an open-source set of black and white object drawings, particularly suited for language mapping and monitoring, e.g., during awake brain tumour surgery or transcranial magnetic stimulation, in German language. A refined set of 100 black and white drawings was tested in two consecutive runs of randomised picture order and was analysed in respect of correct, prompt, and reliable object recognition and naming in a series of 132 healthy subjects between 18 and 84 years (median 25 years, 64% females) and a clinical pilot cohort of 10 brain tumour patients (median age 47 years, 80% males). The influence of important word- and subject-related factors on task performance and reliability was investigated. Overall, across both healthy subjects and patients, excellent correct object naming rates (97 vs. 96%) as well as high reliability coefficients (Goodman–Kruskal's gamma = 0.95 vs. 0.86) were found. However, the analysis of variance revealed a significant, overall negative effect of low word frequency (p < 0.05) and high age (p < 0.0001) on task performance whereas the effect of a low educational level was only evident for the subgroup of 72 or more years of age (p < 0.05). Moreover, a small learning effect was observed across the two runs of the test (p < 0.001). In summary, this study provides an overall robust and reliable picture naming tool, optimised for the clinical use to map and monitor language functions in patients. However, individual familiarisation before the clinical use remains advisable, especially for subjects that are comparatively prone to spontaneous picture naming errors such as older subjects of low educational level and patients with clinically apparent word finding difficulties.

Intraoperative mapping of language functions: a longitudinal neurolinguistic analysis

2008 ◽  
Vol 109 (4) ◽  
pp. 583-592 ◽  
Author(s):  
Josef Ilmberger ◽  
Maximilian Ruge ◽  
Friedrich-Wilhelm Kreth ◽  
Josef Briegel ◽  
Hans-Juergen Reulen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Standardized Test ◽  
Intraoperative Complications ◽  
Tumor Resection ◽  
Cortical Mapping ◽  
Language Mapping ◽  
Logistic Regression Models ◽  
Language Functions ◽  
Language Deficit ◽  
Patients At Risk

Object This prospective longitudinally designed study was conducted to evaluate language functions pre- and postoperatively in patients who underwent microsurgical treatment of tumors in close proximity to or within language areas and to detect those patients at risk for a postoperative aphasic disturbance. Methods Between 1991 and 2005, 153 awake craniotomies with subsequent cortical mapping of language functions were performed in 149 patients. Language functions were assessed using a standardized test battery. Risk factors were obtained from multivariate logistic regression models. Results Language mapping was able to be performed in all patients, and complete tumor resection was achieved in 48.4%. Within 21 days after surgery a new language deficit (aphasic disturbance) was observed in 41 (32%) of the 128 cases without preoperative deficits. There were a total of 60 cases involving postoperative aphasic disturbances, including cases both with and without preoperative disturbances. Risk factors for postoperative aphasic disturbance were preoperative aphasia (p < 0.0002), intraoperative complications (p < 0.02), language-positive sites within the tumor (p < 0.001), and nonfrontal lesion location (p < 0.001). In patients without a preoperative deficit, a normal (yet submaximal) naming performance was a powerful predictor for an early postoperative aphasic disturbance (p < 0.0003). Seven months after treatment 10.9% of the 128 cases without preoperative aphasic disturbances continued to demonstrate new postoperative language disturbances. A total of 17.6% of all cases demonstrated new postoperative language disturbances after 7 months. Risk factors for persistent aphasic disturbance were increased age (> 40 years, p < 0.02) and preoperative aphasia (p < 0.001). Conclusions Every attempt should be undertaken to preserve language-relevant areas intraoperatively, even when they are located within the tumor. New postoperative deficits resolve in the majority of patients, which may be a result of cortical mapping as well as functional reorganization.

An Empirical Study on the Operative Treatment of Symptomatic Urolithiasis in Germany

2021 ◽  
pp. 1-7
Author(s):  
Alina Reicherz ◽  
Rüveyde Sahin ◽  
Lorine Häuser ◽  
Joachim Noldus ◽  
Peter Bach
Keyword(s):  
Response Rate ◽  
Intraoperative Complications ◽  
Nationwide Survey ◽  
Treatment Modalities ◽  
European Guidelines ◽  
Operative Care ◽  
Double J Stent ◽  
Before And After ◽  
Related Group ◽  
Ureteral Stenting

<b><i>Purpose:</i></b> The guidelines of the German, European, and American Urological Associations on urolithiasis advise against general ureteral stenting before and after an uncomplicated ureterorenoscopy (URS). However, German and European guidelines state that stenting prior to URS facilitates stone extraction and reduces intraoperative complications. According to the published literature, German practice seems to deviate from recommendations. This nationwide survey aimed to evaluate the treatment modalities of urolithiasis. <b><i>Methods:</i></b> In November 2018 and March 2019, a total of 199 urological hospital departments in Germany were anonymously surveyed about operative care of symptomatic urolithiasis. The response rate was 72.9%. The survey consisted of 25 questions about diagnostics, surgical technique, and aftercare of the URS. This questionnaire is available in the appendix. <b><i>Results:</i></b> A primary URS is performed in ≤10% in 49.6% of the hospitals. In every second urological department (49.7%), the German Diagnosis Related Group (G-DRG) system influences the period of pre-stenting before a secondary URS. After a secondary URS, which is performed in 53.8% of the departments in over 80% of the patients, 14% of the departments omit stenting. The standard for stenting seems to be a 28-cm-long 7 Charrière double-J stent in Germany. <b><i>Conclusion:</i></b> In Germany, the percentage of primary URS is low, and a ureter stenting is performed in most of the urological departments after URS. Delaying therapy due to economic aspects is the standard in almost half of all urological departments.

Changes In Prothrombin And Activated Partial Thromboplastin Time During Replacement Therapy With Human Recombinant Growth Hormone In Growth Hormone Deficient Adults

2020 ◽  
Vol 154 (Supplement_1) ◽  
pp. S102-S103
Author(s):  
Y S Kamel
Keyword(s):  
Growth Hormone ◽  
Replacement Therapy ◽  
Healthy Subjects ◽  
Recombinant Growth Hormone ◽  
Gh Replacement ◽  
Coagulation Tests ◽  
Before And After ◽  
Human Recombinant Growth Hormone ◽  
Male Patients ◽  
One Year

Abstract Introduction/Objective The aim of this study was to investigate the effects of GH administration on basic coagulation parameters: PT, aPTT and fibrinogen concentrations in adult GHD patients before and during one year of GH replacement. Methods Twenty-one adult patients with severe GHD (mean age +/- SE: 38.6 +/- 2.8 years) were included in this hospital based, prospective, interventional study. All patients were treated with rhGH for 12 months (GH dose: 0.4 mg/day for male and 0.6 mg/day for female patients). IGF-1 concentrations were determined using RIA-INEP kits. Basic coagulation tests, i.e. aPTT and fibrinogen concentrations, were measured before and after 3, 6 and 12 months of treatment with rhGH. Control values were obtained from fourteen “healthy” subjects matched by age, sex and body mass index (BMI). Results At baseline, we observed no significant differences in PT, aPTT and fibrinogen values between GHD and healthy subjects. IGF-1 concentrations increased significantly within 3 months of GH therapy (8.2 +/- 1.5 vs. 24.2 +/- 2.9 nmol/l, p &lt;0.05) and remained stable thereafter. A significant increase in PT values, which was more pronounced in female subjects, was noted after 6 and 12 months of treatment with GH. aPTT values increased significantly after 12 months of treatment only in male patients (28.8 +/- 4.6 vs. 39.7 +/- 2.1 s.; p &lt;0.05). No significant changes in fibrinogen concentrations were found during the study. Conclusion Twelve months of GH replacement therapy led to a significant increase in PT and aPTT values in adult GHD patients, while fibrinogen concentrations did not change. Changes in PT were more pronounced in female GHD patients, while an increase in aPTT values was observed only in male patients with GHD. The clinical significance of these changes needs further evaluation.

Effects of activation frequency and force on low-frequency fatigue in human skeletal muscle

1999 ◽  
Vol 86 (4) ◽  
pp. 1337-1346 ◽  
Author(s):  
Stuart A. Binder-Macleod ◽  
David W. Russ
Keyword(s):  
Healthy Subjects ◽  
Human Skeletal Muscle ◽  
Low Frequency ◽  
Variable Frequency ◽  
Activation Pattern ◽  
Constant Frequency ◽  
Mean Frequency ◽  
Before And After ◽  
Low Frequency Fatigue ◽  
Force Time

No comparison of the amount of low-frequency fatigue (LFF) produced by different activation frequencies exists, although frequencies ranging from 10 to 100 Hz have been used to induce LFF. The quadriceps femoris of 11 healthy subjects were tested in 5 separate sessions. In each session, the force-generating ability of the muscle was tested before and after fatigue and at 2, ∼13, and ∼38 min of recovery. Brief (6-pulse), constant-frequency trains of 9.1, 14.3, 33.3, and 100 Hz and a 6-pulse, variable-frequency train with a mean frequency of 14.3 Hz were delivered at 1 train/s to induce fatigue. Immediately postfatigue, there was a significant effect of fatiguing protocol frequency. Muscles exhibited greater LFF after stimulation with the 9.1-, 14.3-, and variable-frequency trains. These three trains also produced the greatest mean force-time integrals during the fatigue test. At 2, ∼13, and ∼38 min of recovery, however, the LFF produced was independent of the fatiguing protocol frequency. The findings are consistent with theories suggesting two independent mechanisms behind LFF and may help identify the optimal activation pattern when functional electrical stimulation is used.

Lymphocyte subsets are influenced by positivity levels in healthy subjects before and after mild acute stress

2017 ◽  
Vol 188 ◽  
pp. 13-20 ◽  
Author(s):  
Gian Vittorio Caprara ◽  
Roberto Nisini ◽  
Valeria Castellani ◽  
Pasquali Vittorio ◽  
Guido Alessandri ◽  
...  
Keyword(s):  
Healthy Subjects ◽  
Lymphocyte Subsets ◽  
Acute Stress ◽  
Before And After

Improving Student Creativity Activeness And Implementation Approach In Cbsa On Civics Lesson Grade Ii Sd Negeri 39 Lengayang Gompong.Kec Markets Academic Year 2016/2017

2018 ◽  
Vol 1 (2) ◽  
pp. 89-96
Author(s):  
Darleli Darleli
Keyword(s):  
Civic Education ◽  
Evaluation Study ◽  
Class Action ◽  
Peer Tutors ◽  
Implementation Approach ◽  
Before And After ◽  
Study Population ◽  
Grade Ii ◽  
The Subject ◽  
Academic Year

    The purpose of this study is to prove that the use of the environment around the school can improve students' understanding of the subject Civic Education in Elementary School student 39 Class II Gompong Market. This study uses a class action approach. The study population was taken of all students in grade II , the data collection techniques used artificial teacher learning achievement test. Actions performed a total of two cycles. Data analysis techniques used analysis of the percentage of change in the results of the evaluation study before and after tutoring services with peer tutors. Thus there is an increase in students' mastery of the first cycle and the second cycle. Based on the above, it can be made a conclusion as follows: " Improving Student Creativity activeness And Implementation Approach In CBSA On Civics Lesson Grade II SD Negeri 39 Lengayang Gompong.Kec Markets Academic Year 2016/2017 " .    

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