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Nettekoven C, Pieczewski J, Neuschmelting V, Jonas K, Goldbrunner R, Grefkes C, Weiss Lucas C. Improving the efficacy and reliability of rTMS language mapping by increasing the stimulation frequency. Hum Brain Mapp 2021; 42:5309-5321. [PMID: 34387388 PMCID: PMC8519874 DOI: 10.1002/hbm.25619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 11/08/2022] Open
Abstract
Repetitive TMS (rTMS) with a frequency of 5–10 Hz is widely used for language mapping. However, it may be accompanied by discomfort and is limited in the number and reliability of evoked language errors. We, here, systematically tested the influence of different stimulation frequencies (i.e., 10, 30, and 50 Hz) on tolerability, number, reliability, and cortical distribution of language errors aiming at improved language mapping. 15 right‐handed, healthy subjects (m = 8, median age: 29 yrs) were investigated in two sessions, separated by 2–5 days. In each session, 10, 30, and 50 Hz rTMS were applied over the left hemisphere in a randomized order during a picture naming task. Overall, 30 Hz rTMS evoked significantly more errors (20 ± 12%) compared to 50 Hz (12 ± 8%; p <.01), whereas error rates were comparable between 30/50 and 10 Hz (18 ± 11%). Across all conditions, a significantly higher error rate was found in Session 1 (19 ± 13%) compared to Session 2 (13 ± 7%, p <.05). The error rate was poorly reliable between sessions for 10 (intraclass correlation coefficient, ICC = .315) and 30 Hz (ICC = .427), whereas 50 Hz showed a moderate reliability (ICC = .597). Spatial reliability of language errors was low to moderate with a tendency toward increased reliability for higher frequencies, for example, within frontal regions. Compared to 10 Hz, both, 30 and 50 Hz were rated as less painful. Taken together, our data favor the use of rTMS‐protocols employing higher frequencies for evoking language errors reliably and with reduced discomfort, depending on the region of interest.
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Affiliation(s)
- Charlotte Nettekoven
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Julia Pieczewski
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Volker Neuschmelting
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Kristina Jonas
- Faculty of Human Sciences, Department of Rehabilitation and Special Education, University of Cologne, Cologne, Germany
| | - Roland Goldbrunner
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Christian Grefkes
- Faculty of Medicine and University Hospital, Department of Neurology, University of Cologne, Cologne, Germany.,Juelich Research Centre, Institute of Neuroscience and Medicine (INM-3), Juelich, Germany
| | - Carolin Weiss Lucas
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
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Schiller K, Choudhri AF, Jones T, Holder C, Wheless JW, Narayana S. Concordance Between Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging (MRI) Derived Localization of Language in a Clinical Cohort. J Child Neurol 2020; 35:363-379. [PMID: 32122221 DOI: 10.1177/0883073820901415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)-derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI-derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI-derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters.
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Affiliation(s)
- Katherine Schiller
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Asim F Choudhri
- Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tamekia Jones
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Christen Holder
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - James W Wheless
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - Shalini Narayana
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Neurobiology and Anatomy, University of Tennessee Health Science Center, Memphis, TN, USA
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Papagno C, Casarotti A, Zarino B, Crepaldi D. A new test of action verb naming: normative data from 290 Italian adults. Neurol Sci 2020; 41:2811-2817. [PMID: 32281040 DOI: 10.1007/s10072-020-04353-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Accepted: 03/16/2020] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Verbs and nouns can be selectively impaired, suggesting that they are processed, at least in part, by distinct neural structures. While several tests of object naming are available, tasks involving action verb naming with normative data are lacking. We report the construction and standardization of a new test for the assessment of picture naming of actions. MATERIAL AND METHODS The test includes 50 stimuli, strictly controlled for several confounding variables. Normative data on 290 Italian subjects pooled across homogenous subgroups for age, sex, and education are reported. RESULTS Multiple regression analyses revealed that age and education significantly correlated with the subject's score. In particular, increasing age negatively affected performance, while the performance increased with a higher education. CONCLUSIONS In the clinical practice, the availability of equivalent scores will help the comparison with performance in the picture naming of objects. This test allows investigating action naming deficits in aphasic patients, in Parkinson's disease patients and in further neurodegenerative disorders, in which a specific impairment of action verbs is expected, filling a gap in the clinical neuropsychological assessment.
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Affiliation(s)
- Costanza Papagno
- CeRiN, CIMeC, University of Trento, Rovereto, Italy.
- Department of Psychology, University of Milano-Bicocca, Milan, Italy.
| | - Alessandra Casarotti
- Unit of Oncological Neurosurgery, Humanitas Research Hospital, Rozzano, Milan, Italy
| | - Barbara Zarino
- Neurosurgery Unit, Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, Milan, Italy
| | - Davide Crepaldi
- International School for Advanced Studies (SISSA), Trieste, Italy
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Wypych A, Wierzchowska M, Burduk P, Zawada E, Nadolska K, Serafin Z. Cortical presentation of language functions in patients after total laryngectomy: a fMRI study. Neuroradiology 2020; 62:843-849. [PMID: 32253455 PMCID: PMC7311494 DOI: 10.1007/s00234-020-02407-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 03/13/2020] [Indexed: 11/26/2022]
Abstract
Purpose The aim of this study is to use functional magnetic resonance (fMRI) to analyse the cortical presentation of selected language functions in patients after a total laryngectomy. Methods Eighteen patients after total laryngectomy treated with electrolarynx speech and 18 volunteers were included. The mean number of patients’ post-operative speech rehabilitation sessions was five (range of 3–8 sessions). Four paradigms were used, including noun generation, pseudoword reading, reading phrases with pseudowords, and nonliteral sign reproduction. Results In noun, the most significant difference between the groups was the stronger activation of both lingual gyri in the volunteers. Pseudoword reading resulted in stronger activations in patients than in volunteers in the lingual gyri, the right cerebellum, the right Broca’s area, and the right parietal operculum. Reading phrases with pseudowords involved different parts of the Brodmann area 40. During nonliteral sign reproduction, there was a stronger activation of the left Broca’s area in volunteers and a stronger activation of the left premotor cortex in patients. Conclusion This study provides evidence of altered cortical activation in response to language tasks in patients after a laryngectomy compared with healthy volunteers, which may be considered brain plasticity in response to a laryngectomy.
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Affiliation(s)
- Aleksandra Wypych
- The Interdisciplinary Center for Modern Technologies, Nicolaus Copernicus University, Toruń, Poland
| | - Małgorzata Wierzchowska
- Department of Otolaryngology, Oncology and Oral and Maxillofacial Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Paweł Burduk
- Department of Otolaryngology, Oncology and Oral and Maxillofacial Surgery, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Elżbieta Zawada
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
- Department of Geriatrics, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Katarzyna Nadolska
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland
| | - Zbigniew Serafin
- Department of Radiology and Diagnostic Imaging, Nicolaus Copernicus University, Collegium Medicum, Bydgoszcz, Poland.
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Yang X, Zhang K. Navigated transcranial magnetic stimulation brain mapping: Achievements, opportunities, and prospects. GLIOMA 2020. [DOI: 10.4103/glioma.glioma_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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