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Barua NU, Williamson TR, Wiernik L, Mumtaz H, Mariotti S, Farrow M, David R, Piasecki AE. Awake craniotomy with English and British sign language mapping in a patient with a left temporal glioblastoma reveals discordant speech-sign language maps. Acta Neurochir (Wien) 2024; 166:260. [PMID: 38858238 DOI: 10.1007/s00701-024-06130-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/16/2024] [Indexed: 06/12/2024]
Abstract
The aim of this case study was to describe differences in English and British Sign Language (BSL) communication caused by a left temporal tumour resulting in discordant presentation of symptoms, intraoperative stimulation mapping during awake craniotomy and post-operative language abilities. We report the first case of a hearing child of deaf adults, who acquired BSL with English as a second language. The patient presented with English word finding difficulty, phonemic paraphasias, and reading and writing challenges, with BSL preserved. Intraoperatively, object naming and semantic fluency tasks were performed in English and BSL, revealing differential language maps for each modality. Post-operative assessment confirmed mild dysphasia for English with BSL preserved. These findings suggest that in hearing people who acquire a signed language as a first language, topographical organisation may differ to that of a second, spoken, language.
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Affiliation(s)
- Neil U Barua
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK.
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK.
| | - T R Williamson
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK
| | - Lydia Wiernik
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK
- School of Philosophy, Psychology, and Language Sciences, University of Edinburgh, Edinburgh, UK
| | - Hajira Mumtaz
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK
| | - Sonia Mariotti
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK
| | | | - Raenette David
- Southmead Hospital, North Bristol NHS Trust, Bristol, UK
| | - Anna E Piasecki
- Brain, Language, and Behaviour Laboratory, Bristol Centre for Linguistics, University of the West of England, Bristol, UK
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Veljanoski D, Ng XY, Hill CS, Jamjoom AAB. Theory and evidence-base for a digital platform for the delivery of language tests during awake craniotomy and collaborative brain mapping. BMJ SURGERY, INTERVENTIONS, & HEALTH TECHNOLOGIES 2024; 6:e000234. [PMID: 38756704 PMCID: PMC11097893 DOI: 10.1136/bmjsit-2023-000234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/20/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives Build the theoretical and evidence-base for a digital platform (map-OR) which delivers intraoperative language tests during awake craniotomy and facilitates collaborative sharing of brain mapping data. Design Mixed methodology study including two scoping reviews, international survey, synthesis of development guiding principles and a risk assessment using failure modes and effects analysis. Setting The two scoping reviews examined the literature published in the English language. International survey was completed by members of awake craniotomy teams from 14 countries. Main outcome measures Scoping review 1: number of technologies described for language mapping during awake craniotomy. Scoping review 2: barriers and facilitators to adopting novel technology in surgery. International survey: degree of language mapping technology penetration into clinical practice. Results A total of 12 research articles describing 6 technologies were included. The technologies required a range of hardware components including portable devices, virtual reality headsets and large integrated multiscreen stacks. The facilitators and barriers of technology adoption in surgery were extracted from 11 studies and mapped onto the 4 Unified Theory of Acceptance and Use of Technology constructs. A total of 37 awake craniotomy teams from 14 countries completed the survey. Of the responses, 20 (54.1%) delivered their language tests digitally, 10 (27.0%) delivered tests using cards and 7 (18.9%) used a combination of both. The most commonly used devices were tablet computers (67.7%; n=21) and the most common software used was Microsoft PowerPoint (60.6%; n=20). Four key risks for the proposed digital platform were identified, the highest risk being a software and internet connectivity failure during surgery. Conclusions This work represents a rigorous and structured approach to the development of a digital platform for standardized intraoperative language testing during awake craniotomy and for collaborative sharing of brain mapping data. Trial registration number Scoping review protocol registrations in OSF registries (scoping review 1: osf.io/su9xm; scoping review 2: osf.io/x4wsc).
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Affiliation(s)
| | - Xin Yi Ng
- Department of Medicine, Arrowe Park Hospital, Wirral, UK
| | - Ciaran Scott Hill
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Aimun A B Jamjoom
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Department of Neurosurgery, Barking Havering and Redbridge Hospitals NHS Trust, Romford, UK
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Kram L, Neu B, Schroeder A, Wiestler B, Meyer B, Krieg SM, Ille S. Toward a systematic grading for the selection of patients to undergo awake surgery: identifying suitable predictor variables. Front Hum Neurosci 2024; 18:1365215. [PMID: 38756845 PMCID: PMC11096515 DOI: 10.3389/fnhum.2024.1365215] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2024] [Accepted: 04/11/2024] [Indexed: 05/18/2024] Open
Abstract
Background Awake craniotomy is the standard of care for treating language eloquent gliomas. However, depending on preoperative functionality, it is not feasible in each patient and selection criteria are highly heterogeneous. Thus, this study aimed to identify broadly applicable predictor variables allowing for a more systematic and objective patient selection. Methods We performed post-hoc analyses of preoperative language status, patient and tumor characteristics including language eloquence of 96 glioma patients treated in a single neurosurgical center between 05/2018 and 01/2021. Multinomial logistic regression and stepwise variable selection were applied to identify significant predictors of awake surgery feasibility. Results Stepwise backward selection confirmed that a higher number of paraphasias, lower age, and high language eloquence level were suitable indicators for an awake surgery in our cohort. Subsequent descriptive and ROC-analyses indicated a cut-off at ≤54 years and a language eloquence level of at least 6 for awake surgeries, which require further validation. A high language eloquence, lower age, preexisting semantic and phonological aphasic symptoms have shown to be suitable predictors. Conclusion The combination of these factors may act as a basis for a systematic and standardized grading of patients' suitability for an awake craniotomy which is easily integrable into the preoperative workflow across neurosurgical centers.
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Affiliation(s)
- Leonie Kram
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
| | - Beate Neu
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Axel Schroeder
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Benedikt Wiestler
- Section of Diagnostic and Interventional Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sandro M. Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
- Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University of Heidelberg, Heidelberg, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, School of Medicine, Munich, Germany
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Albuquerque LAF, de Macêdo Filho LJM, Borges FS, Diógenes GS, Pessoa FC, Rocha CJV, Almeida JP, Ghizoni E, Joaquim AF. Performance of intraoperative neurocognitive tests during awake surgery for patients with diffuse low-grade glioma. Neurosurg Rev 2024; 47:129. [PMID: 38532178 DOI: 10.1007/s10143-024-02364-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 02/17/2024] [Accepted: 03/16/2024] [Indexed: 03/28/2024]
Abstract
Despite great advancements and the diffusion of awake surgery for brain tumors, the literature shows that the tests applied during the procedure are heterogeneous and non-standardized. This prospective, observational, descriptive study collected data on intraoperative brain mapping and the performance of multiple neurocognitive tests in 51 awake surgeries for diffuse low-grade glioma. Frequency of use and rate of intraoperative findings of different neurocognitive tests were analyzed. Patients mean age at the time of surgery was 35.1 (20-57) years. We performed 26 (51.0%) surgeries on the left hemisphere (LH) and 25 (49.0%) on the right hemisphere (RH). Significant differences were observed between the total number of functional findings (cortical and subcortical) identified in the LH and RH (p = 0.004). In subcortical findings alone, the differences remained significant (p = 0.0004). The RH subcortical region showed the lowest number of intraoperative findings, and this was correlated with functional outcome: Karnofsky performance scale at five days (p = 0.022), three months (p = 0.002) and one year (p = 0.002) post-surgery. On average, more tests were used to map the RH, with a lower frequency of both cortical and subcortical functional findings. Even though subcortical findings were less frequent than cortical findings, they were crucial to defining the resection margins. Based on the intraoperative findings, frequency of use, and rate of findings per use of the tests analyzed, the most relevant tests for each hemisphere for awake brain mapping were identified.
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Affiliation(s)
- Lucas Alverne F Albuquerque
- Department of Neurosurgery, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil.
- Department of Neurology, Universidade de Campinas, Campinas, São Paulo, Brazil.
| | | | - Felipe Silva Borges
- Department of Anesthesiology, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil
| | | | - Fátima C Pessoa
- Speech Therapist, Hospital Geral de Fortaleza, Fortaleza, Ceará, Brazil
| | | | | | - Enrico Ghizoni
- Division of Neurosurgery, Department of Neurology, Universidade de Campinas, Campinas, São Paulo, Brazil
| | - Andrei F Joaquim
- Division of Neurosurgery, Department of Neurology, Universidade de Campinas, Campinas, São Paulo, Brazil
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van Ierschot FC, Veenstra W, Miozzo A, Santini B, Jeltema HR, Spena G, Miceli G. Written language preservation in glioma patients undergoing awake surgery: The value of tailored intra-operative assessment. J Neuropsychol 2024; 18 Suppl 1:205-229. [PMID: 37840529 DOI: 10.1111/jnp.12349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 09/15/2023] [Accepted: 09/15/2023] [Indexed: 10/17/2023]
Abstract
Written language is increasingly important, as contemporary society strongly relies on text-based communication. Nonetheless, in neurosurgical practice, language preservation has classically focused on spoken language. The current study aimed to evaluate the potential role of intra-operative assessments in the preservation of written language skills in glioma patients undergoing awake surgery. It is the first feasibility study to use a standardized and detailed Written language battery in glioma patients undergoing awakening surgery. Reading and spelling were assessed pre- and post-operatively in eleven patients. Intra-operatively, 7 cases underwent written language assessment in addition to spoken object naming. Results show that reading and spelling deficits may arise before and after glioma surgery and that written language may be differently affected than spoken language. In our case series, task-specific preservation of function was obtained in all cases when a specific written language skill was monitored intra-operatively. However, the benefits of intra-operative testing did not always generalize, and non-monitored written language tasks may not be preserved. Hence, when a specific written language skill needs to be preserved, to facilitate return to work and maintain quality of life, results indicate that intra-operative assessment of that skill is advised. An illustrative case report demonstrates how profile analyses can be used pre-operatively to identify cognitive components at risk and intra-operatively to preserve written language abilities in clinical practice.
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Affiliation(s)
- Fleur Céline van Ierschot
- Center for Mind/Brain Sciences (CiMeC), University of Trento, Rovereto, Italy
- International Doctorate for Experimental Approaches to Language and Brain (IDEALAB), Universities of Trento, Groningen, Newcastle, Potsdam and Macquarie University, Trento, Groningen, Newcastle, Potsdam, Sydney, Italy, Netherlands, Australia, Germany, Australia
| | - Wencke Veenstra
- Department of Neurosurgery, University Medical Center Groningen, Groningen, The Netherlands
- Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, Groningen, The Netherlands
| | - Antonio Miozzo
- Centre for Aging Brain and Neurodegenerative Disorders, University of Brescia, Brescia, Italy
| | - Barbara Santini
- Department of Neuroscience, Neurosurgery Clinic, University of Verona, Verona, Italy
| | - Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Groningen, The Netherlands
| | - Giannantonio Spena
- Centre for Aging Brain and Neurodegenerative Disorders, University of Brescia, Brescia, Italy
| | - Gabriele Miceli
- Center for Mind/Brain Sciences (CiMeC), University of Trento, Rovereto, Italy
- International Doctorate for Experimental Approaches to Language and Brain (IDEALAB), Universities of Trento, Groningen, Newcastle, Potsdam and Macquarie University, Trento, Groningen, Newcastle, Potsdam, Sydney, Italy, Netherlands, Australia, Germany, Australia
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Collée E, van den Berg E, Visch-Brink E, Vincent A, Dirven C, Satoer D. Differential contribution of language and executive functioning to verbal fluency performance in glioma patients. J Neuropsychol 2024; 18 Suppl 1:19-40. [PMID: 38087828 DOI: 10.1111/jnp.12356] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 11/22/2023] [Accepted: 11/27/2023] [Indexed: 04/13/2024]
Abstract
Glioma patients often suffer from deficits in language and executive functioning. Performance in verbal fluency (generating words within one minute according to a semantic category-category fluency, or given letter-letter fluency) is typically impaired in this patient group. While both language and executive functioning play a role in verbal fluency, the relative contribution of both domains remains unclear. We aim to retrospectively investigate glioma patients' performance on verbal and nonverbal fluency and to explore the influence of language and executive functioning on verbal fluency. Sixty-nine adults with gliomas in eloquent areas underwent a neuropsychological test battery (verbal fluency, nonverbal fluency, language, and executive functioning tests) before surgery (T1) and a subgroup of 31 patients also at three (T2) and twelve months (T3) after surgery. Preoperatively, patients were impaired in all verbal fluency tasks and dissociations were found based on tumour location. In contrast, nonverbal fluency was intact. Different language and executive functioning tests predicted performance on category fluency animals and letter fluency, while no significant predictors for category fluency professions were found. The longitudinal results indicated that category fluency professions deteriorated after surgery (T1-T2, T1-T3) and that nonverbal fluency improved after surgery (T1-T3, T2-T3). Verbal fluency performance can provide information on different possible underlying deficits in language and executive functioning in glioma patients, depending on verbal fluency task selection. Efficient task (order) selection can be based on complexity. Category fluency professions can be selected to detect more permanent long-term deficits.
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Affiliation(s)
- Ellen Collée
- Department of Neurosurgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands
| | - Esther van den Berg
- Department of Neurology and Alzheimer Center Erasmus MC, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands
| | - Clemens Dirven
- Department of Neurosurgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands
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Kram L, Ohlerth AK, Ille S, Meyer B, Krieg SM. CompreTAP: Feasibility and reliability of a new language comprehension mapping task via preoperative navigated transcranial magnetic stimulation. Cortex 2024; 171:347-369. [PMID: 38086145 DOI: 10.1016/j.cortex.2023.09.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 02/01/2023] [Accepted: 09/25/2023] [Indexed: 02/12/2024]
Abstract
OBJECTIVE Stimulation-based language mapping approaches that are used pre- and intraoperatively employ predominantly overt language tasks requiring sufficient language production abilities. Yet, these production-based setups are often not feasible in brain tumor patients with severe expressive aphasia. This pilot study evaluated the feasibility and reliability of a newly developed language comprehension task with preoperative navigated transcranial magnetic stimulation (nTMS). METHODS Fifteen healthy subjects and six brain tumor patients with severe expressive aphasia unable to perform classic overt naming tasks underwent preoperative nTMS language mapping based on an auditory single-word Comprehension TAsk for Perioperative mapping (CompreTAP). Comprehension was probed by button-press responses to auditory stimuli, hence not requiring overt language responses. Positive comprehension areas were identified when stimulation elicited an incorrect or delayed button press. Error categories, case-wise cortical error rate distribution and inter-rater reliability between two experienced specialists were examined. RESULTS Overall, the new setup showed to be feasible. Comprehension-disruptions induced by nTMS manifested in no responses, delayed or hesitant responses, searching behavior or selection of wrong target items across all patients and controls and could be performed even in patients with severe expressive aphasia. The analysis agreement between both specialists was substantial for classifying comprehension-positive and -negative sites. Extensive left-hemispheric individual cortical comprehension sites were identified for all patients. Apart from one case presenting with transient worsening of aphasic symptoms, pre-existing language deficits did not aggravate if results were used for subsequent surgical planning. CONCLUSION Employing this new comprehension-based nTMS setup allowed to identify language relevant cortical sites in all healthy subjects and severely aphasic patients who were thus far precluded from classic production-based mapping. This pilot study, moreover, provides first indications that the CompreTAP mapping results may support the preservation of residual language function if used for subsequent surgical planning.
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Affiliation(s)
- Leonie Kram
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany
| | - Ann-Katrin Ohlerth
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; Neurobiology of Language Department, Max Planck Institute for Psycholinguistics, Nijmegen, the Netherlands
| | - Sebastian Ille
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; TUM Neuroimaging Center, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; TUM Neuroimaging Center, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Germany; Department of Neurosurgery, Heidelberg University Hospital, Ruprecht-Karls-University Heidelberg, Germany.
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Satoer D, Koudstaal PJ, Visch-Brink E, van der Giessen RS. Cerebellar-Induced Aphasia After Stroke: Evidence for the "Linguistic Cerebellum". CEREBELLUM (LONDON, ENGLAND) 2024:10.1007/s12311-024-01658-1. [PMID: 38244134 DOI: 10.1007/s12311-024-01658-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 01/22/2024]
Abstract
The cerebellum is traditionally known to subserve motor functions. However, for several decades, the concept of the "cerebellar cognitive affective syndrome" has evolved. Studies in healthy participants and patients have confirmed the cerebellar role in language. The exact involvement of the cerebellum regarding cerebellar aphasia remains uncertain. We included 43 cerebellar stroke patients who were tested at 3 months post-onset with the Boston Naming Test (BNT), the Token Test (TT), and the Diagnostic Instrument for Mild Aphasia (DIMA). Lesion side (left/right) and volume (cm3) were investigated. Patients significantly deviated on the following: BNT (p<0.001), TT (p<0.05), DIMA subtests: sentences repetition (p=0.001), semantic odd-picture-out (p<0.05), sentence completion (p<0.05) without an effect of lesion location (left/right) or volume (cm3) (p>0.05). Our clinical study confirms a non-lateralized cerebellar aphasia post-stroke, characterized by impairments in word retrieval, phonology, semantics, and syntax resembling cerebral-induced aphasia. The integral cerebellum appears to interact with eloquent cortico-subcortical language areas.
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Affiliation(s)
- Djaina Satoer
- Department of Neurosurgery, Erasmus MC University Medical Center, Dr. Molewaterplein 40, room Na-2106, 3015, GD, Rotterdam, The Netherlands.
| | - Peter J Koudstaal
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus MC University Medical Center, Dr. Molewaterplein 40, room Na-2106, 3015, GD, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
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Guidelines for Awake Surgery. Neurol Med Chir (Tokyo) 2024; 64:1-27. [PMID: 38220155 PMCID: PMC10835579 DOI: 10.2176/jns-nmc.2023-0111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/07/2023] [Indexed: 01/16/2024] Open
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Alduais A, Trivkovic T, Allegretta S, Alfadda H. Neuropragmatics: A scientometric review. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-31. [PMID: 37708841 DOI: 10.1080/23279095.2023.2251634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/16/2023]
Abstract
Neuropragmatics investigates brain functions and neural activities responsible for pragmatic language abilities, often impaired in disorders such as hemisphere damage, autism, schizophrenia, and neurodegenerative disorders. This study examined the development of neuropragmatics and existing neuroimaging evidence using bibliometric and scientometric indicators, analyzing 4,247 documents published between 1967 and 2022 with CiteSpace and VOSviewer. Our cluster analysis revealed key themes. 1) Language comprehension loss due to brain injury: Studies exploring the impact of brain injuries on language comprehension and underlying neural mechanisms. 2) Right hemisphere damage and pragmatic language skills: Research focusing on the relationship between right hemisphere damage and pragmatic language abilities, investigating impairments in social language use and potential neural correlates. 3) Traumatic brain injury and social communication assessment: Research on traumatic brain injury effects on social communication skills, using various assessment tools to evaluate communication effectiveness in social situations. These clusters provide valuable insights into the neuropragmatics field and serve as a framework for future investigations. By building upon existing knowledge, researchers can improve our understanding of brain functions, language behavior, and enhance rehabilitation for individuals with pragmatic language impairments.
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Affiliation(s)
- Ahmed Alduais
- Department of Human Sciences (Psychology), University of Verona, Verona, Italy
| | - Tamara Trivkovic
- Department of Speech and Language Pathology, College of Social Work, Belgrade, Serbia
| | | | - Hind Alfadda
- Department of Curriculum and Instruction, King Saud University, Riyadh, Saudi Arabia
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Ntemou E, Rybka L, Lubbers J, Tuncer MS, Vajkoczy P, Rofes A, Picht T, Faust K. Lesion-symptom mapping of language impairments in people with brain tumours: The influence of linguistic stimuli. J Neuropsychol 2023; 17:400-416. [PMID: 36651346 DOI: 10.1111/jnp.12305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 12/18/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023]
Abstract
People with tumours in specific brain sites might face difficulties in tasks with different linguistic material. Previous lesion-symptom mapping studies (VLSM) demonstrated that people with tumours in posterior temporal regions have more severe linguistic impairments. However, to the best of our knowledge, preoperative performance and lesion location on tasks with different linguistic stimuli have not been examined. In the present study, we performed VLSM on 52 people with left gliomas to examine whether tumour distribution differs depending on the tasks of the Aachen Aphasia Test. The VLSM analysis revealed that single-word production (e.g. object naming) was associated with the inferior parietal lobe and that compound and sentence production were additionally associated with posterior temporal gyri. Word repetition was affected in people with tumours in inferior parietal areas, whereas sentence repetition was the only task to be associated with frontal regions. Subcortically, word and sentence production were found to be affected in people with tumours reaching the arcuate fasciculus, and compound production was primarily associated with tumours affecting the inferior longitudinal and inferior fronto-occipital fasciculus. Our work shows that tasks with linguistic stimuli other than single-word naming (e.g. compound and sentence production) relate to additional cortical and subcortical brain areas. At a clinical level, we show that tasks that target the same processes (e.g. repetition) can have different neural correlates depending on the linguistic stimuli used. Also, we highlight the importance of left temporoparietal areas.
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Affiliation(s)
- Effrosyni Ntemou
- International Doctorate for Approaches to Language and Brain (IDEALAB), University of Groningen, Groningen, The Netherlands
- International Doctorate for Approaches to Language and Brain (IDEALAB), University of Potsdam, Potsdam, Germany
- International Doctorate for Approaches to Language and Brain (IDEALAB), Newcastle University, Newcastle upon Tyne, UK
- International Doctorate for Approaches to Language and Brain (IDEALAB), Macquarie University, Sydney, New South Wales, Australia
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lena Rybka
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Jocelyn Lubbers
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Mehmet Salih Tuncer
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Adrià Rofes
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, The Netherlands
| | - Thomas Picht
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Cluster of Excellence: "Matters of Activity. Image Space Material", Humboldt University, Berlin, Germany
| | - Katharina Faust
- Department of Neurosurgery, Charité - Universitätsmedizin Berlin, Berlin, Germany
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de Sain A, Mantione M, Wajer IH, van Zandvoort M, Willems P, Robe P, Ruis C. A timeline of cognitive functioning in glioma patients who undergo awake brain tumor surgery. Acta Neurochir (Wien) 2023; 165:1645-1653. [PMID: 37097374 PMCID: PMC10227103 DOI: 10.1007/s00701-023-05588-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Accepted: 03/10/2023] [Indexed: 04/26/2023]
Abstract
BACKGROUND The purpose of awake brain tumor surgery is to maximize the resection of the tumor and to minimize the risk of neurological and cognitive impairments. The aim of this study is to gain understanding of the development of possible postoperative cognitive deficits after awake brain tumor surgery in patients with suspected gliomas, by comparing preoperative, early postoperative, and late postoperative functioning. A more detailed timeline will be helpful in informing candidates for surgery about what to expect regarding their cognitive functioning. METHODS Thirty-seven patients were included in this study. Cognitive functioning was measured by means of a broad cognitive screener preoperatively, days after surgery and months after surgery in patients who underwent awake brain tumor surgery with cognitive monitoring. The cognitive screener included tests for object naming, reading, attention span, working memory, inhibition, inhibition/switching, and visuoperception. We performed a Friedman ANOVA to analyze on group level. RESULTS Overall, no significant differences were found between preoperative cognitive functioning, early postoperative cognitive functioning, and late postoperative cognitive functioning, except for performances on the inhibition task. Directly after surgery, patients were significantly slower on this task. However, in the following months after surgery, they returned to their preoperative level. CONCLUSION The timeline of cognitive functioning after awake tumor surgery appeared overall stable in the early and late postoperative phase, except for inhibition, which is more difficult in the first days after awake brain tumor surgery. This more detailed timeline of cognitive functioning, in combination with future research, can possibly be contributing in informing patients and caregivers what to expect after awake brain tumor surgery.
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Affiliation(s)
- A.M. de Sain
- Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - M.H.M. Mantione
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - I.M.C. Huenges Wajer
- Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - M.J.E. van Zandvoort
- Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - P.W.A. Willems
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - P.A. Robe
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
| | - C. Ruis
- Department of Experimental Psychology, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, the Netherlands
- Department of Neurology & Neurosurgery, University Medical Center Utrecht, Heidelberglaan 100, 3584 CX Utrecht, the Netherlands
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St-Denis A, Hooker M, L'Abbée Lacas K, Corriveau I, Pirmoradi M, Simard-Tremblay E, Atkinson J, Myers KA. Awake Craniotomy Language Mapping in Children With Drug-Resistant Epilepsy due to Focal Cortical Dysplasia. Pediatr Neurol 2023; 144:39-43. [PMID: 37141669 DOI: 10.1016/j.pediatrneurol.2023.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 01/02/2023] [Accepted: 04/03/2023] [Indexed: 05/06/2023]
Abstract
BACKGROUND Language mapping during awake craniotomy can allow for precise resection of epileptogenic lesions, while reducing the risk of damage to eloquent cortex. There are few reports in the literature of language mapping during awake craniotomy in children with epilepsy. Some centers may avoid awake craniotomy in the pediatric age group due to concerns that children are unable to cooperate with such procedures. METHODS We reviewed pediatric patients from our center with drug-resistant focal epilepsy who underwent language mapping during awake craniotomy and subsequent resection of the epileptogenic lesion. RESULTS Two patients were identified, both female, aged 17 years and 11 years at the time of surgery. Both patients had frequent and disabling focal seizures despite trials of multiple antiseizure medications. Both patients had resection of their epileptogenic lesions with the aid of intraoperative language mapping; in both cases pathology was consistent with focal cortical dysplasia. Both patients had transient language difficulties in the immediate postoperative period but no deficits at six-month follow-up. Both patients are now seizure-free. CONCLUSIONS Awake craniotomy should be considered in pediatric patients with drug-resistant epilepsy in whom the suspected epileptogenic lesion is in close proximity to cortical language areas.
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Affiliation(s)
- Ariane St-Denis
- Faculty of Medicine and Health Sciences, McGill University, Montreal, Quebec, Canada
| | - Meredith Hooker
- Department of Speech-Language Pathology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Katherine L'Abbée Lacas
- Department of Speech-Language Pathology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Isabelle Corriveau
- Department of Psychology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Mona Pirmoradi
- Department of Psychology, Montreal Children's Hospital, Montreal, Quebec, Canada
| | - Elisabeth Simard-Tremblay
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Jeffrey Atkinson
- Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada
| | - Kenneth A Myers
- Division of Neurology, Department of Pediatrics, Montreal Children's Hospital, McGill University Health Centre, Montreal, Quebec, Canada; Department of Neurology and Neurosurgery, McGill University Health Centre, Montreal, Quebec, Canada; Research Institute of the McGill University Health Centre, Montreal, Quebec, Canada.
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14
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Al-Adli NN, Young JS, Sibih YE, Berger MS. Technical Aspects of Motor and Language Mapping in Glioma Patients. Cancers (Basel) 2023; 15:cancers15072173. [PMID: 37046834 PMCID: PMC10093517 DOI: 10.3390/cancers15072173] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 03/29/2023] [Accepted: 04/04/2023] [Indexed: 04/08/2023] Open
Abstract
Gliomas are infiltrative primary brain tumors that often invade functional cortical and subcortical regions, and they mandate individualized brain mapping strategies to avoid postoperative neurological deficits. It is well known that maximal safe resection significantly improves survival, while postoperative deficits minimize the benefits associated with aggressive resections and diminish patients’ quality of life. Although non-invasive imaging tools serve as useful adjuncts, intraoperative stimulation mapping (ISM) is the gold standard for identifying functional cortical and subcortical regions and minimizing morbidity during these challenging resections. Current mapping methods rely on the use of low-frequency and high-frequency stimulation, delivered with monopolar or bipolar probes either directly to the cortical surface or to the subcortical white matter structures. Stimulation effects can be monitored through patient responses during awake mapping procedures and/or with motor-evoked and somatosensory-evoked potentials in patients who are asleep. Depending on the patient’s preoperative status and tumor location and size, neurosurgeons may choose to employ these mapping methods during awake or asleep craniotomies, both of which have their own benefits and challenges. Regardless of which method is used, the goal of intraoperative stimulation is to identify areas of non-functional tissue that can be safely removed to facilitate an approach trajectory to the equator, or center, of the tumor. Recent technological advances have improved ISM’s utility in identifying subcortical structures and minimized the seizure risk associated with cortical stimulation. In this review, we summarize the salient technical aspects of which neurosurgeons should be aware in order to implement intraoperative stimulation mapping effectively and safely during glioma surgery.
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Affiliation(s)
- Nadeem N. Al-Adli
- Department of Neurological Surgery, University of California, San Francisco, CA 94131, USA
- School of Medicine, Texas Christian University, Fort Worth, TX 76109, USA
| | - Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, CA 94131, USA
| | - Youssef E. Sibih
- School of Medicine, University of California, San Francisco, CA 94131, USA
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, CA 94131, USA
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15
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Kabir SS, Jahangiri FR, Rinesmith C, Vilches CS, Chakarvarty S. Intraoperative Testing During the Mapping of the Language Cortex. Cureus 2023; 15:e36718. [PMID: 37123781 PMCID: PMC10139678 DOI: 10.7759/cureus.36718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/26/2023] [Indexed: 03/28/2023] Open
Abstract
Intracranial lesions, particularly in the language-eloquent areas of the brain, can affect one's speaking ability. Despite advances in surgery, the excision of these lesions can be challenging. Intraoperative neurophysiological monitoring (IONM) during awake craniotomies can help identify language-eloquent areas and minimize postoperative impairments. Preoperative language testing is performed to establish a baseline before intraoperative language testing. This involves subjecting patients to predetermined tasks in the operating room to evaluate their phonological, semantic, and syntactic capabilities. The current state and future directions of intraoperative language testing procedures are discussed in this paper. The most common intraoperative tasks are counting and picture naming. However, some experts recommend utilizing more nuanced tasks that involve regions affected by infrequently occurring tumor patterns. Low-frequency bipolar Penfield stimulation is optimal for language mapping. Exception cases are discussed where awake craniotomies are not feasible. When dealing with multilingual patients, the patient's age of learning and skill level can be accounted for in terms of making informed task choices and mapping techniques to avoid any damage to language areas.
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16
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Lu S, Chu M, Wang X, Wu Y, Hou Y, Liu A. Anterior temporal lobectomy improved mood status and quality of life in Chinese patients with mesial temporal lobe epilepsy: a single-arm cohort study. Chin Med J (Engl) 2023; 136:407-414. [PMID: 36867545 PMCID: PMC10106264 DOI: 10.1097/cm9.0000000000002094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Indexed: 03/04/2023] Open
Abstract
BACKGROUND Many studies have emphasized that selective resection of epileptic lesions in temoral lobe is associated with better preservation of cognition function; whether this applies to patients with refractory mesial temporal lobe epilepsy (MTLE) remains unknown. The objective of this study was to evaluate changes in cognitive functions, mood status, and quality of life after anterior temporal lobectomy in patients with refractory MTLE. METHODS This single-arm cohort study assessed cognitive function, mood status, and quality of life, as well as electroencephalography findings, in patients with refractory MTLE who underwent anterior temporal lobectomy at Xuanwu Hospital from January 2018 to March 2019. Pre- and post-operative characteristics were compared to evaluate the effects of surgery. RESULTS Anterior temporal lobectomy significantly reduced the frequencies of epileptiform discharges. The overall success rate of surgery was acceptable. Anterior temporal lobectomy did not result in significant changes in overall cognitive functions (P > 0.05), although changes in certain domains, including visuospatial ability, executive ability, and abstract thinking, were detected. Anterior temporal lobectomy resulted in improvements in anxiety and depression symptoms and quality of life. CONCLUSIONS Anterior temporal lobectomy reduced epileptiform discharges and incidence of post-operative seizures as well as resulted in improved mood status and quality of life without causing significant changes in cognitive function.
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Affiliation(s)
- Song Lu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
- Fuxing Hospital, Capital Medical University, Beijing 100069, China
| | - Min Chu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Xian Wang
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yating Wu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Yue Hou
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
| | - Aihua Liu
- Department of Neurology, Xuanwu Hospital Capital Medical University, Beijing 100053, China
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Collée E, Vincent A, Visch-Brink E, De Witte E, Dirven C, Satoer D. Localization patterns of speech and language errors during awake brain surgery: a systematic review. Neurosurg Rev 2023; 46:38. [PMID: 36662312 PMCID: PMC9859901 DOI: 10.1007/s10143-022-01943-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Revised: 11/22/2022] [Accepted: 12/31/2022] [Indexed: 01/21/2023]
Abstract
Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with eloquent area gliomas. DES detects speech and language errors, which indicate functional boundaries that must be maintained to preserve quality of life. During DES, traditional object naming or other linguistic tasks such as tasks from the Dutch Linguistic Intraoperative Protocol (DuLIP) can be used. It is not fully clear which speech and language errors occur in which brain locations. To provide an overview and to update DuLIP, a systematic review was conducted in which 102 studies were included, reporting on speech and language errors and the corresponding brain locations during awake craniotomy with DES in adult glioma patients up until 6 July 2020. The current findings provide a crude overview on language localization. Even though subcortical areas are in general less often investigated intraoperatively, still 40% out of all errors was reported at the subcortical level and almost 60% at the cortical level. Rudimentary localization patterns for different error types were observed and compared to the dual-stream model of language processing and the DuLIP model. While most patterns were similar compared to the models, additional locations were identified for articulation/motor speech, phonology, reading, and writing. Based on these patterns, we propose an updated DuLIP model. This model can be applied for a more adequate "location-to-function" language task selection to assess different linguistic functions during awake craniotomy, to possibly improve intraoperative language monitoring. This could result in a better postoperative language outcome in the future.
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Affiliation(s)
- Ellen Collée
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands.
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands
| | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands
| | - Elke De Witte
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands
| | - Clemens Dirven
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC University Medical Centre, Doctor Molewaterplein 40, NA2118, 3015, GD, Rotterdam, the Netherlands
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18
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Kappen PR, van den Brink J, Jeekel J, Dirven CMF, Klimek M, Donders-Kamphuis M, Docter-Kerkhof CS, Mooijman SA, Collee E, Nandoe Tewarie RDS, Broekman MLD, Smits M, Vincent AJPE, Satoer D. The effect of musicality on language recovery after awake glioma surgery. Front Hum Neurosci 2023; 16:1028897. [PMID: 36704093 PMCID: PMC9873262 DOI: 10.3389/fnhum.2022.1028897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 12/21/2022] [Indexed: 01/11/2023] Open
Abstract
Introduction Awake craniotomy is increasingly used to resect intrinsic brain tumors while preserving language. The level of musical training might affect the speed and extend of postoperative language recovery, as increased white matter connectivity in the corpus callosum is described in musicians compared to non-musicians. Methods In this cohort study, we included adult patients undergoing treatment for glioma with an awake resection procedure at two neurosurgical centers and assessed language preoperatively (T1) and postoperatively at three months (T2) and one year (T3) with the Diagnostic Instrument for Mild Aphasia (DIMA), transferred to z-scores. Moreover, patients' musicality was divided into three groups based on the Musical Expertise Criterion (MEC) and automated volumetric measures of the corpus callosum were conducted. Results We enrolled forty-six patients, between June 2015 and September 2021, and divided in: group A (non-musicians, n = 19, 41.3%), group B (amateur musicians, n = 17, 36.9%) and group C (trained musicians, n = 10, 21.7%). No significant differences on postoperative language course between the three musicality groups were observed in the main analyses. However, a trend towards less deterioration of language (mean/SD z-scores) was observed within the first three months on the phonological domain (A: -0.425/0.951 vs. B: -0.00100/1.14 vs. C: 0.0289/0.566, p-value = 0.19) with a significant effect between non-musicians vs. instrumentalists (A: -0.425/0.951 vs. B + C: 0.201/0.699, p = 0.04). Moreover, a non-significant trend towards a larger volume (mean/SD cm3) of the corpus callosum was observed between the three musicality groups (A: 6.67/1.35 vs. B: 7.09/1.07 vs. C: 8.30/2.30, p = 0.13), with the largest difference of size in the anterior corpus callosum in non-musicians compared to trained musicians (A: 3.28/0.621 vs. C: 4.90/1.41, p = 0.02). Conclusion With first study on this topic, we support that musicality contributes to language recovery after awake glioma surgery, possibly attributed to a higher white matter connectivity at the anterior part of the corpus callosum. Our conclusion should be handled with caution and interpreted as hypothesis generating only, as most of our results were not significant. Future studies with larger sample sizes are needed to confirm our hypothesis.
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Affiliation(s)
- Pablo R. Kappen
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands,*Correspondence: Pablo R. Kappen,
| | - Jan van den Brink
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Johannes Jeekel
- Department of Neuroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Clemens M. F. Dirven
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Markus Klimek
- Department of Anesthesiology, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marike Donders-Kamphuis
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands,Department of Speech and Language Pathology, Haaglanden Medisch Centrum, The Hague, Netherlands
| | | | - Saskia A. Mooijman
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Ellen Collee
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | | | - Marike L. D. Broekman
- Department of Neurosurgery, Haaglanden Medisch Centrum, The Hague, Netherlands,Department of Neurosurgery, Leiden University Medical Center, Leiden, Netherlands
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus University Medical Center, Rotterdam, Netherlands,Medical Delta, Delft, Netherlands,Brain Tumor Center, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | | | - Djaina Satoer
- Department of Neurosurgery, Erasmus University Medical Center, Rotterdam, Netherlands
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Moon RDC, Barua NU. Usability of mixed reality in awake craniotomy planning. Br J Neurosurg 2022:1-5. [PMID: 36537230 DOI: 10.1080/02688697.2022.2152429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 03/08/2022] [Accepted: 09/08/2022] [Indexed: 06/17/2023]
Abstract
PURPOSE This study aimed to describe our institutional use of a commercially available mixed reality viewer within a multi-disciplinary planning workflow for awake craniotomy surgery and to report an assessment of its usability. MATERIALS AND METHODS Three Tesla MRI scans, including 32-direction diffusion tensor sequences, were reconstructed with BrainLab Elements auto-segmentation software. Magic Leap mixed reality viewer headsets were registered to a shared virtual viewing space to display image reconstructions. System Usability Scale was used to assess the usability of the mixed reality system. RESULTS The awake craniotomy planning workflow utilises the mixed reality viewer to facilitate a stepwise discussion through four progressive anatomical layers; the skin, cerebral cortex, subcortical white matter tracts and tumour with surrounding vasculature. At each stage relevant members of the multi-disciplinary team review key operative considerations, including patient positioning, cortical and subcortical speech mapping protocols and surgical approaches to the tumour.The mixed reality system was used for multi-disciplinary awake craniotomy planning in 10 consecutive procedures over a 5-month period. Ten participants (2 Anaesthetists, 5 Neurosurgical trainees, 2 Speech therapists, 1 Neuropsychologist) completed System Usability Scale assessments, reporting a mean score of 71.5. Feedback highlighted the benefit of being able to rehearse important steps in the procedure, including patient positioning and anaesthetic access and visualising the testing protocol for cortical and subcortical speech mapping. CONCLUSIONS This study supports the use of mixed reality for multidisciplinary planning for awake craniotomy surgery, with an acceptable degree of usability of the interface. We highlight the need to consider the requirements of non-technical, non-neurosurgical team members when involving mixed reality activities.
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Affiliation(s)
- Richard D C Moon
- Department of Neurosurgery, Southmead Hospital, North Bristol NHS Trust, Bristol, UK
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Collée E, Vincent A, Dirven C, Satoer D. Speech and Language Errors during Awake Brain Surgery and Postoperative Language Outcome in Glioma Patients: A Systematic Review. Cancers (Basel) 2022; 14:cancers14215466. [PMID: 36358884 PMCID: PMC9658495 DOI: 10.3390/cancers14215466] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 10/17/2022] [Accepted: 10/20/2022] [Indexed: 11/09/2022] Open
Abstract
Awake craniotomy with direct electrical stimulation (DES) is the standard treatment for patients with gliomas in eloquent areas. Even though language is monitored carefully during surgery, many patients suffer from postoperative aphasia, with negative effects on their quality of life. Some perioperative factors are reported to influence postoperative language outcome. However, the influence of different intraoperative speech and language errors on language outcome is not clear. Therefore, we investigate this relation. A systematic search was performed in which 81 studies were included, reporting speech and language errors during awake craniotomy with DES and postoperative language outcomes in adult glioma patients up until 6 July 2020. The frequencies of intraoperative errors and language status were calculated. Binary logistic regressions were performed. Preoperative language deficits were a significant predictor for postoperative acute (OR = 3.42, p < 0.001) and short-term (OR = 1.95, p = 0.007) language deficits. Intraoperative anomia (OR = 2.09, p = 0.015) and intraoperative production errors (e.g., dysarthria or stuttering; OR = 2.06, p = 0.016) were significant predictors for postoperative acute language deficits. Postoperatively, the language deficits that occurred most often were production deficits and spontaneous speech deficits. To conclude, during surgery, intraoperative anomia and production errors should carry particular weight during decision-making concerning the optimal onco-functional balance for a given patient, and spontaneous speech should be monitored. Further prognostic research could facilitate intraoperative decision-making, leading to fewer or less severe postoperative language deficits and improvement of quality of life.
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21
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Clément A, Perez A, Mandonnet E, Satoer D, Visch-Brink E, De Witte E, Pierret H, Barberis M, Poisson I. DIMA-fr: a French adaptation and standardization of the Dutch Diagnostic Instrument for Mild Aphasia (DIMA-nl). CLINICAL LINGUISTICS & PHONETICS 2022; 36:954-967. [PMID: 35899475 DOI: 10.1080/02699206.2021.1983022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 09/03/2021] [Accepted: 09/10/2021] [Indexed: 06/15/2023]
Abstract
The Dutch Diagnostic Instrument for Mild Aphasia (DIMA-nl) is a standardized battery recently created for evaluating the language performance of patients during the perioperative period of glioma surgery. Our aim was to establish normative data for the DIMA-fr, a French version of the DIMA-nl. The DIMA-nl was first adapted to French. The 14 subtasks of the DIMA-fr were then administered to 391 participants recruited from the general French population. The effects of sex, age and level of education were determined by analysis of variance (ANOVA). Normative data were computed as means, medians, standard deviations and percentiles. Our results demonstrated that age and level of education had an effect on the performance of all subtests but not sex. We thus stratified the norms into four different groups: (i) 18-69 years-old with Baccalauréat (Bac, the French High School Diploma) (n = 246); (ii) 18-69 years-old without Bac (n = 70); (iii) >70 years-old with Bac (n = 48); (iv) >70 years-old without Bac (n = 27). The DIMA-fr is thus the first standardized French battery of tests to specifically assess language during the perioperative period of awake glioma surgery. However, to be used in the clinic, the DIMA-fr must now be validated in patients. The DIMA, which is currently standardized in several languages, could become a reference tool for international studies.
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Affiliation(s)
- Aurélie Clément
- Department of Neurosurgery, Lariboisière Hospital, Ap-hp, Paris, France
| | - Anne Perez
- Department of Neurosurgery, Lariboisière Hospital, Ap-hp, Paris, France
| | - Emmanuel Mandonnet
- Department of Neurosurgery, Lariboisière Hospital, Ap-hp, Paris, France
- Frontlab, Institut du Cerveau de La Moelle, Cnrs Umr 7225, Inserm U1127, Paris, France
- Université de Paris, Paris, France
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus Mc - University Medical Center, Rotterdam, The Netherlands
| | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus Mc - University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus Mc - University Medical Center, Rotterdam, The Netherlands
| | - Elke De Witte
- Department of Clinical and Experimental Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Héloïse Pierret
- Department of Neurology, Erasmus Mc - University Medical Center, Rotterdam, The Netherlands
- Utrecht University, Utrecht, The Netherlands
| | - Marion Barberis
- Department of Neurosurgery, Lariboisière Hospital, Ap-hp, Paris, France
| | - Isabelle Poisson
- Department of Neurosurgery, Lariboisière Hospital, Ap-hp, Paris, France
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22
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Satoer D, De Witte E, Bulté B, Bastiaanse R, Smits M, Vincent A, Mariën P, Visch-Brink E. Dutch Diagnostic Instrument for Mild Aphasia (DIMA): standardisation and a first clinical application in two brain tumour patients. CLINICAL LINGUISTICS & PHONETICS 2022; 36:929-953. [PMID: 35899484 DOI: 10.1080/02699206.2021.1992797] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/17/2021] [Accepted: 10/06/2021] [Indexed: 06/15/2023]
Abstract
Brain tumour patients with mild language disturbances are typically underdiagnosed due to lack of sensitive tests leading to negative effects in daily communicative and social life. We aim to develop a Dutch standardised test-battery, the Diagnostic Instrument for Mild Aphasia (DIMA) to detect characteristics of mild aphasia at the main linguistic levels phonology, semantics and (morpho-)syntax in production and comprehension. We designed 4 DIMA subtests: 1) repetition (words, non-words, compounds and sentences), 2) semantic odd-picture-out (objects and actions), 3) sentence completion and 4) sentence judgment (accuracy and reaction time). A normative study was carried out in a healthy Dutch-speaking population (N = 211) divided into groups of gender, age and education. Clinical application of DIMA was demonstrated in two brain tumour patients (glioma and meningioma). Standard language tests were also administered: object naming, verbal fluency (category and letter), and Token Test. Performance was at ceiling on all sub-tests, except semantic odd-picture-out actions, with an effect of age and education on most subtests. Clinical application DIMA: repetition was impaired in both cases. Reaction time in the sentence judgment test (phonology and syntax) was impaired (not accuracy) in one patient. Standard language tests: category fluency was impaired in both cases and object naming in one patient. The Token Test was not able to detect language disturbances in both cases. DIMA seems to be sensitive to capture mild aphasic deficits. DIMA is expected to be of great potential for standard assessment of language functions in patients with also other neurological diseases than brain tumours.
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Affiliation(s)
- Djaina Satoer
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Elke De Witte
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
- Department of Clinical and Experimental Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Bram Bulté
- Centre for Linguistics, Vrije Universiteit Brussel, Brussels, Belgium
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Groningen, The Netherlands
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russian Federation
| | - Marion Smits
- Department of Nuclear Medicine and Radiology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
| | | | - Evy Visch-Brink
- Department of Neurosurgery, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
- Department of Neurology, Erasmus MC - University Medical Center, Rotterdam, The Netherlands
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Fiore G, Abete-Fornara G, Forgione A, Tariciotti L, Pluderi M, Borsa S, Bana C, Cogiamanian F, Vergari M, Conte V, Caroli M, Locatelli M, Bertani GA. Indication and eligibility of glioma patients for awake surgery: A scoping review by a multidisciplinary perspective. Front Oncol 2022; 12:951246. [PMID: 36212495 PMCID: PMC9532968 DOI: 10.3389/fonc.2022.951246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 08/22/2022] [Indexed: 11/13/2022] Open
Abstract
Background Awake surgery (AS) permits intraoperative mapping of cognitive and motor functions, allowing neurosurgeons to tailor the resection according to patient functional boundaries thus preserving long-term patient integrity and maximizing extent of resection. Given the increased risks of the awake scenario, the growing importance of AS in surgical practice favored the debate about patient selection concerning both indication and eligibility criteria. Nonetheless, a systematic investigation is lacking in the literature. Objective To provide a scoping review of the literature concerning indication and eligibility criteria for AS in patients with gliomas to answer the questions:1) "What are the functions mostly tested during AS protocols?" and 2) "When and why should a patient be excluded from AS?". Materials and methods Pertinent studies were retrieved from PubMed, PsycArticles and Cochrane Central Register of Controlled Trials (CENTRAL), published until April 2021 according to the PRISMA Statement Extension for Scoping Reviews. The retrieved abstracts were checked for the following features being clearly stated: 1) the population described as being composed of glioma(LGG or HGG) patients; 2) the paper had to declare which cognitive or sensorimotor function was tested, or 2bis)the decisional process of inclusion/exclusion for AS had to be described from at least one of the following perspectives: neurosurgical, neurophysiological, anesthesiologic and psychological/neuropsychological. Results One hundred and seventy-eight studies stated the functions being tested on 8004 patients. Language is the main indication for AS, even if tasks and stimulation techniques changed over the years. It is followed by monitoring of sensorimotor and visuospatial pathways. This review demonstrated an increasing interest in addressing other superior cognitive functions, such as executive functions and emotions. Forty-five studies on 2645 glioma patients stated the inclusion/exclusion criteria for AS eligibility. Inability to cooperate due to psychological disorder(i.e. anxiety),severe language deficits and other medical conditions(i.e.cardiovascular diseases, obesity, etc.)are widely reported as exclusion criteria for AS. However, a very few papers gave scale exact cut-off. Likewise, age and tumor histology are not standardized parameters for patient selection. Conclusion Given the broad spectrum of functions that might be safely and effectively monitored via AS, neurosurgeons and their teams should tailor intraoperative testing on patient needs and background as well as on tumor location and features. Whenever the aforementioned exclusion criteria are not fulfilled, AS should be strongly considered for glioma patients.
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Affiliation(s)
- Giorgio Fiore
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giorgia Abete-Fornara
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Arianna Forgione
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Leonardo Tariciotti
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Mauro Pluderi
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Stefano Borsa
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Cristina Bana
- Department of Neuropathophysiology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Filippo Cogiamanian
- Department of Neuropathophysiology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Maurizio Vergari
- Department of Neuropathophysiology, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Valeria Conte
- Neuro Intensive Care Unit, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Manuela Caroli
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Marco Locatelli
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Giulio Andrea Bertani
- Department of Neurosurgery, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
- *Correspondence: Giulio Andrea Bertani,
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Duffau H, Ng S, Lemaitre AL, Moritz-Gasser S, Herbet G. Constant Multi-Tasking With Time Constraint to Preserve Across-Network Dynamics Throughout Awake Surgery for Low-Grade Glioma: A Necessary Step to Enable Patients Resuming an Active Life. Front Oncol 2022; 12:924762. [PMID: 35712489 PMCID: PMC9196728 DOI: 10.3389/fonc.2022.924762] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 04/25/2022] [Indexed: 12/18/2022] Open
Abstract
Awake surgery for brain gliomas improves resection while minimizing morbidity. Although intraoperative mapping was originally used to preserve motor and language functions, the considerable increase of life expectancy, especially in low-grade glioma, resulted in the need to enhance patients’ long-term quality of life. If the main goal of awake surgery is to resume normal familial and socio-professional activities, preventing hemiparesis and aphasia is not sufficient: cognitive and emotional functions must be considered. To monitor higher-order functions, e.g., executive control, semantics or mentalizing, further tasks were implemented into the operating theater. Beyond this more accurate investigation of function-specific neural networks, a better exploration of the inter-system communication is required. Advances in brain connectomics led to a meta-network perspective of neural processing, which emphasizes the pivotal role of the dynamic interplay between functional circuits to allow complex and flexible, goal-directed behaviors. Constant multi-tasking with time constraint in awake patients may be proposed during intraoperative mapping, since it provides a mirror of the (dys)synchronization within and across neural networks and it improves the sensitivity of behavioral monitoring by increasing cognitive demand throughout the resection. Electrical mapping may hamper the patient to perform several tasks simultaneously whereas he/she is still capable to achieve each task in isolation. Unveiling the meta-network organization during awake mapping by using a more ecological multi-demand testing, more representative of the real-life conditions, constitutes a reliable way to tailor the surgical onco-functional balance based upon the expectations of each patient, enabling him/her to resume an active life with long-lasting projects.
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Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier, France
| | - Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier, France
| | - Anne-Laure Lemaitre
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier, France.,Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors", U1191 Laboratory, Institute of Functional Genomics, National Institute for Health and Medical Research (INSERM), University of Montpellier, Montpellier, France.,Department of Speech-Language Pathology, University of Montpellier, Montpellier, France
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Collée E, Satoer D, Wegener Sleeswijk B, Klimek M, Smits M, Van Veelen ML, Dirven C, Vincent A. Language improvement after awake craniotomy in a 12-year-old child: illustrative case. JOURNAL OF NEUROSURGERY. CASE LESSONS 2022; 3:CASE2293. [PMID: 35733631 PMCID: PMC9204911 DOI: 10.3171/case2293] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 03/09/2022] [Indexed: 11/10/2022]
Abstract
BACKGROUND Although the standard procedure to treat adult patients with lesions in eloquent brain areas is awake craniotomy with direct electrical stimulation, this procedure is not often used in children because of feasibility concerns. Some studies have shown that the procedure is feasible in children. They reported the postoperative language ability, which was not based on standardized language tests for children. To give an objective overview of preoperative assessment of the language ability of a child before and after this procedure, the authors described the perioperative course, including standardized language tests for children and the awake surgery setting, of a 12-year-old child undergoing awake craniotomy with brain mapping for the indication of cavernoma in the left somatosensory cortex close to the motor cortex. OBSERVATIONS The patient performed better on language tests after surgery, showing that his language ability improved. He also cooperated well during the entire perioperative period. His mother was present during the awake surgery, and the patient tolerated the surgery well. LESSONS The authors conclude that awake craniotomy is indeed feasible in a child and that it can even result in an improved postoperative language outcome. It is, however, crucial to carefully assess, inform, and monitor the child and their proxies.
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Affiliation(s)
| | | | | | | | - Marion Smits
- Ear, Nose, and Throat, Hearing and Speech Center, Erasmus MC - University Medical Center, Rotterdam, Zuid-Holland, The Netherlands
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26
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Wolthuis N, Bosma I, Bastiaanse R, Cherian PJ, Smits M, Veenstra W, Wagemakers M, Vincent A, Satoer D. Distinct Slow-Wave Activity Patterns in Resting-State Electroencephalography and Their Relation to Language Functioning in Low-Grade Glioma and Meningioma Patients. Front Hum Neurosci 2022; 16:748128. [PMID: 35399357 PMCID: PMC8986989 DOI: 10.3389/fnhum.2022.748128] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 02/16/2022] [Indexed: 12/03/2022] Open
Abstract
Introduction Brain tumours frequently cause language impairments and are also likely to co-occur with localised abnormal slow-wave brain activity. However, it is unclear whether this applies specifically to low-grade brain tumours. We investigate slow-wave activity in resting-state electroencephalography (EEG) in low-grade glioma and meningioma patients, and its relation to pre- and postoperative language functioning. Method Patients with a glioma (N = 15) infiltrating the language-dominant hemisphere and patients with a meningioma (N = 10) with mass effect on this hemisphere underwent extensive language testing before and 1 year after surgery. EEG was registered preoperatively, postoperatively (glioma patients only), and once in healthy individuals. Slow-wave activity in delta- and theta- frequency bands was evaluated visually and quantitatively by spectral power at three levels over the scalp: the whole brain, the affected hemisphere, and the affected region. Results Glioma patients had increased delta activity (affected area) and increased theta activity (all levels) before and after surgery. In these patients, increased preoperative theta activity was related to the presence of language impairment, especially to poor word retrieval and grammatical performance. Preoperative slow-wave activity was also related to postoperative language outcomes. Meningioma patients showed no significant increase in EEG slow-wave activity compared to healthy individuals, but they presented with word retrieval, grammatical, and writing problems preoperatively, as well as with writing impairments postoperatively. Discussion Although the brain-tumour pathology in low-grade gliomas and meningiomas has a different effect on resting-state brain activity, patients with low-grade gliomas and meningiomas both suffer from language impairments. Increased theta activity in glioma patients can be considered as a language-impairment marker, with prognostic value for language outcome after surgery.
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Affiliation(s)
- Nienke Wolthuis
- Center for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
| | - Ingeborg Bosma
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
- National Research University Higher School of Economics, Moscow, Russia
| | - Perumpillichira J. Cherian
- Department of Neurology, University Medical Center Rotterdam, Rotterdam, Netherlands
- Division of Neurology, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
- Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Wencke Veenstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, Groningen, Netherlands
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC – University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC – University Medical Center Rotterdam, Rotterdam, Netherlands
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27
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Gerritsen JKW, Broekman MLD, De Vleeschouwer S, Schucht P, Nahed BV, Berger MS, Vincent AJPE. Safe Surgery for Glioblastoma: Recent Advances and Modern Challenges. Neurooncol Pract 2022; 9:364-379. [PMID: 36127890 PMCID: PMC9476986 DOI: 10.1093/nop/npac019] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
One of the major challenges during glioblastoma surgery is balancing between maximizing extent of resection and preventing neurological deficits. Several surgical techniques and adjuncts have been developed to help identify eloquent areas both preoperatively (fMRI, nTMS, MEG, DTI) and intraoperatively (imaging (ultrasound, iMRI), electrostimulation (mapping), cerebral perfusion measurements (fUS)), and visualization (5-ALA, fluoresceine)). In this review, we give an update of the state-of-the-art management of both primary and recurrent glioblastomas. We will review the latest surgical advances, challenges, and approaches that define the onco-neurosurgical practice in a contemporary setting and give an overview of the current prospective scientific efforts.
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Affiliation(s)
| | | | | | - Philippe Schucht
- Department of Neurosurgery, University Hospital Bern, Switzerland
| | - Brian Vala Nahed
- Department of Neurosurgery, Massachusetts General Hospital/Harvard Medical School, Boston MA, USA
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28
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Kent RD, Kim Y, Chen LM. Oral and Laryngeal Diadochokinesis Across the Life Span: A Scoping Review of Methods, Reference Data, and Clinical Applications. JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2022; 65:574-623. [PMID: 34958599 DOI: 10.1044/2021_jslhr-21-00396] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE The aim of this study was to conduct a scoping review of research on oral and laryngeal diadochokinesis (DDK) in children and adults, either typically developing/developed or with a clinical diagnosis. METHOD Searches were conducted with PubMed/MEDLINE, Google Scholar, CINAHL, and legacy sources in retrieved articles. Search terms included the following: DDK, alternating motion rate, maximum repetition rate, sequential motion rate, and syllable repetition rate. RESULTS Three hundred sixty articles were retrieved and included in the review. Data source tables for children and adults list the number and ages of study participants, DDK task, and language(s) spoken. Cross-sectional data for typically developing children and typically developed adults are compiled for the monosyllables /pʌ/, /tʌ/, and /kʌ/; the trisyllable /pʌtʌkʌ/; and laryngeal DDK. In addition, DDK results are summarized for 26 disorders or conditions. DISCUSSION A growing number of multidisciplinary reports on DDK affirm its role in clinical practice and research across the world. Atypical DDK is not a well-defined singular entity but rather a label for a collection of disturbances associated with diverse etiologies, including motoric, structural, sensory, and cognitive. The clinical value of DDK can be optimized by consideration of task parameters, analysis method, and population of interest.
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Affiliation(s)
- Ray D Kent
- Department of Communication Sciences and Disorders, University of Wisconsin-Madison
| | - Yunjung Kim
- School of Communication Sciences & Disorders, Florida State University, Tallahassee
| | - Li-Mei Chen
- Department of Foreign Languages and Literature, National Cheng Kung University, Tainan, Taiwan
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29
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Ohlerth AK, Bastiaanse R, Nickels L, Neu B, Zhang W, Ille S, Sollmann N, Krieg SM. Dual-Task nTMS Mapping to Visualize the Cortico-Subcortical Language Network and Capture Postoperative Outcome-A Patient Series in Neurosurgery. Front Oncol 2022; 11:788122. [PMID: 35127493 PMCID: PMC8814635 DOI: 10.3389/fonc.2021.788122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Perioperative assessment of language function in brain tumor patients commonly relies on administration of object naming during stimulation mapping. Ample research, however, points to the benefit of adding verb tasks to the testing paradigm in order to delineate and preserve postoperative language function more comprehensively. This research uses a case series approach to explore the feasibility and added value of a dual-task protocol that includes both a noun task (object naming) and a verb task (action naming) in perioperative delineation of language functions. Materials and Methods Seven neurosurgical cases underwent perioperative language assessment with both object and action naming. This entailed preoperative baseline testing, preoperative stimulation mapping with navigated Transcranial Magnetic Stimulation (nTMS) with subsequent white matter visualization, intraoperative mapping with Direct Electrical Stimulation (DES) in 4 cases, and postoperative imaging and examination of language change. Results We observed a divergent pattern of language organization and decline between cases who showed lesions close to the delineated language network and hence underwent DES mapping, and those that did not. The latter displayed no new impairment postoperatively consistent with an unharmed network for the neural circuits of both object and action naming. For the cases who underwent DES, on the other hand, a higher sensitivity was found for action naming over object naming. Firstly, action naming preferentially predicted the overall language state compared to aphasia batteries. Secondly, it more accurately predicted intraoperative positive language areas as revealed by DES. Thirdly, double dissociations between postoperatively unimpaired object naming and impaired action naming and vice versa indicate segregated skills and neural representation for noun versus verb processing, especially in the ventral stream. Overlaying postoperative imaging with object and action naming networks revealed that dual-task nTMS mapping can explain the drop in performance in those cases where the network appeared in proximity to the resection cavity. Conclusion Using a dual-task protocol for visualization of cortical and subcortical language areas through nTMS mapping proved to be able to capture network-to-deficit relations in our case series. Ultimately, adding action naming to clinical nTMS and DES mapping may help prevent postoperative deficits of this seemingly segregated skill.
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Affiliation(s)
- Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, Groningen, Netherlands.,International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, and Macquarie University), Sydney, NSW, Australia
| | - Roelien Bastiaanse
- Center for Language and Brain, Higher School of Economics, National Research University, Moscow, Russia
| | - Lyndsey Nickels
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Beate Neu
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wei Zhang
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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30
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Wolthuis N, Satoer D, Veenstra W, Smits M, Wagemakers M, Vincent A, Bastiaanse R, Cherian PJ, Bosma I. Resting-State Electroencephalography Functional Connectivity Networks Relate to Pre- and Postoperative Language Functioning in Low-Grade Glioma and Meningioma Patients. Front Neurosci 2021; 15:785969. [PMID: 34955732 PMCID: PMC8693574 DOI: 10.3389/fnins.2021.785969] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/29/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Preservation of language functioning in patients undergoing brain tumor surgery is essential because language impairments negatively impact the quality of life. Brain tumor patients have alterations in functional connectivity (FC), the extent to which brain areas functionally interact. We studied FC networks in relation to language functioning in glioma and meningioma patients. Method: Patients with a low-grade glioma (N = 15) or meningioma (N = 10) infiltrating into/pressing on the language-dominant hemisphere underwent extensive language testing before and 1 year after surgery. Resting-state EEG was registered preoperatively, postoperatively (glioma patients only), and once in healthy individuals. After analyzing FC in theta and alpha frequency bands, weighted networks and Minimum Spanning Trees were quantified by various network measures. Results: Pre-operative FC network characteristics did not differ between glioma patients and healthy individuals. However, hub presence and higher local and global FC are associated with poorer language functioning before surgery in glioma patients and predict worse language performance at 1 year after surgery. For meningioma patients, a greater small worldness was related to worse language performance and hub presence; better average clustering and global integration were predictive of worse outcome on language function 1 year after surgery. The average eccentricity, diameter and tree hierarchy seem to be the network metrics with the more pronounced relation to language performance. Discussion: In this exploratory study, we demonstrated that preoperative FC networks are informative for pre- and postoperative language functioning in glioma patients and to a lesser extent in meningioma patients.
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Affiliation(s)
- Nienke Wolthuis
- Center for Language and Cognition Groningen, University of Groningen, Groningen, Netherlands
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Wencke Veenstra
- Department of Rehabilitation Medicine, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands.,Brain Tumour Centre, Erasmus MC Cancer Institute, Rotterdam, Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, Groningen, Netherlands
| | - Arnaud Vincent
- Department of Neurosurgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, Netherlands
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Groningen, Netherlands.,National Research University Higher School of Economics, Moscow, Russia
| | - Perumpillichira J Cherian
- Department of Neurology, University Medical Center Rotterdam, Rotterdam, Netherlands.,Division of Neurology, Department of Medicine, McMaster University and Hamilton Health Sciences, Hamilton, ON, Canada
| | - Ingeborg Bosma
- Department of Neurology, University Medical Center Groningen, Groningen, Netherlands
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Alves J, Cardoso M, Morgado M, De Witte E, Satoer D, Hall A, Jesus LMT. Language assessment in awake brain surgery: the Portuguese adaptation of the Dutch linguistic intraoperative protocol (DuLIP). CLINICAL LINGUISTICS & PHONETICS 2021; 35:1113-1131. [PMID: 33412951 DOI: 10.1080/02699206.2020.1868022] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Revised: 12/17/2020] [Accepted: 12/20/2020] [Indexed: 06/12/2023]
Abstract
Awake brain surgery, combined with neurophysiological evaluation and intraoperative mapping, is one of the preferential lines of treatment when approaching low-grade gliomas. Speech and language assessment is used while applying Direct Electrical Stimulation (DES) and during the resection of a lesion/tumour, as it allows to establish related eloquent areas and optimise the extent of the resection and avoid impairments. Patients need to be assessed pre, intra and post-surgery, but in under resourced countries such as Portugal, there are still no standardised and validated tools to conduct this type of evaluation. To address this need, the tasks of the Dutch Linguistic Intraoperative Protocol (DuLIP) were adapted to European Portuguese, and the resulting materials were standardised for a group of 144 Portuguese participants. For each task, the impact of age, gender and schooling were measured. The resulting Portuguese version of the DuLIP (DuLIP-EP) consists of 17 tasks, including phonological, syntactic, semantic, naming and articulatory tests. No significant differences were found between male and female participants. However, schooling influenced phonological and syntactic fluency, object naming and verb generation. Schooling and age had a significant impact on semantic fluency and reading with semantic odd word out tasks. This is the first contribution to the standardisation of a tool that can be used during an awake brain surgery in Portugal, which includes a new phonological odd word out task that is not currently available in the Dutch version.
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Affiliation(s)
- Joana Alves
- Hospital das Forças Armadas - Pólo Porto, Porto, Portugal
| | - Mafalda Cardoso
- Unidade de Cuidados Continuados Solar Billadonnes, Penacova, Portugal
| | | | - Elke De Witte
- Department of Neurosurgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Djaina Satoer
- Department of Neurosurgery, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Andreia Hall
- Department of Mathematics (DMat) and Center for Research and Development in Mathematics and Applications (CIDMA), University of Aveiro, Aveiro, Portugal
| | - Luis M T Jesus
- School of Health Sciences (ESSUA) and Institute of Electronics and Informatics Engineering of Aveiro (IEETA), University of Aveiro, Aveiro, Portugal
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Ohlerth AK, Bastiaanse R, Negwer C, Sollmann N, Schramm S, Schröder A, Krieg SM. Benefit of Action Naming Over Object Naming for Visualization of Subcortical Language Pathways in Navigated Transcranial Magnetic Stimulation-Based Diffusion Tensor Imaging-Fiber Tracking. Front Hum Neurosci 2021; 15:748274. [PMID: 34803634 PMCID: PMC8603927 DOI: 10.3389/fnhum.2021.748274] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Accepted: 10/11/2021] [Indexed: 11/13/2022] Open
Abstract
Visualization of functionally significant subcortical white matter fibers is needed in neurosurgical procedures in order to avoid damage to the language network during resection. In an effort to achieve this, positive cortical points revealed during preoperative language mapping with navigated transcranial magnetic stimulation (nTMS) can be employed as regions of interest (ROIs) for diffusion tensor imaging (DTI) fiber tracking. However, the effect that the use of different language tasks has on nTMS mapping and subsequent DTI-fiber tracking remains unexplored. The visualization of ventral stream tracts with an assumed lexico-semantic role may especially benefit from ROIs delivered by the lexico-semantically demanding verb task, Action Naming. In a first step, bihemispheric nTMS language mapping was administered in 18 healthy participants using the standard task Object Naming and the novel task Action Naming to trigger verbs in a small sentence context. Cortical areas in which nTMS induced language errors were identified as language-positive cortical sites. In a second step, nTMS-based DTI-fiber tracking was conducted using solely these language-positive points as ROIs. The ability of the two tasks’ ROIs to visualize the dorsal tracts Arcuate Fascicle and Superior Longitudinal Fascicle, the ventral tracts Inferior Longitudinal Fascicle, Uncinate Fascicle, and Inferior Fronto-Occipital Fascicle, the speech-articulatory Cortico-Nuclear Tract, and interhemispheric commissural fibers was compared in both hemispheres. In the left hemisphere, ROIs of Action Naming led to a significantly higher fraction of overall visualized tracts, specifically in the ventral stream’s Inferior Fronto-Occipital and Inferior Longitudinal Fascicle. No difference was found between tracking with Action Naming vs. Object Naming seeds for dorsal stream tracts, neither for the speech-articulatory tract nor the inter-hemispheric connections. While the two tasks appeared equally demanding for phonological-articulatory processes, ROI seeding through the task Action Naming seemed to better visualize lexico-semantic tracts in the ventral stream. This distinction was not evident in the right hemisphere. However, the distribution of tracts exposed was, overall, mirrored relative to those in the left hemisphere network. In presurgical practice, mapping and tracking of language pathways may profit from these findings and should consider inclusion of the Action Naming task, particularly for lesions in ventral subcortical regions.
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Affiliation(s)
- Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, University of Groningen, Groningen, Netherlands.,International Doctorate for Experimental Approaches to Language and Brain (IDEALAB), University of Groningen, Groningen, Netherlands
| | - Roelien Bastiaanse
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Chiara Negwer
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Severin Schramm
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Axel Schröder
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, School of Medicine, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum Rechts der Isar, Technical University of Munich, Munich, Germany
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Bihemispheric Navigated Transcranial Magnetic Stimulation Mapping for Action Naming Compared to Object Naming in Sentence Context. Brain Sci 2021; 11:brainsci11091190. [PMID: 34573211 PMCID: PMC8469437 DOI: 10.3390/brainsci11091190] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2021] [Accepted: 09/03/2021] [Indexed: 11/17/2022] Open
Abstract
Preoperative language mapping with navigated transcranial magnetic stimulation (nTMS) is currently based on the disruption of performance during object naming. The resulting cortical language maps, however, lack accuracy when compared to intraoperative mapping. The question arises whether nTMS results can be improved, when another language task is considered, involving verb retrieval in sentence context. Twenty healthy German speakers were tested with object naming and a novel action naming task during nTMS language mapping. Error rates and categories in both hemispheres were compared. Action naming showed a significantly higher error rate than object naming in both hemispheres. Error category comparison revealed that this discrepancy stems from more lexico-semantic errors during action naming, indicating lexico-semantic retrieval of the verb being more affected than noun retrieval. In an area-wise comparison, higher error rates surfaced in multiple right-hemisphere areas, but only trends in the left ventral postcentral gyrus and middle superior temporal gyrus. Hesitation errors contributed significantly to the error count, but did not dull the mapping results. Inclusion of action naming coupled with a detailed error analysis may be favorable for nTMS mapping and ultimately improve accuracy in preoperative planning. Moreover, the results stress the recruitment of both left- and right-hemispheric areas during naming.
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Intraoperative brain mapping during awake surgery in symptomatic supratentorial cavernomas. ACTA ACUST UNITED AC 2021; 32:217-223. [PMID: 34493402 DOI: 10.1016/j.neucie.2020.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/13/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND Complete resection of symptomatic supratentorial cavernoma (SCA) and removal of the surrounding gliotic area is recommended to minimize the risk of persistent seizures or (re)bleeding. Surgery of SCA located in an eloquent area, can carry out severe postoperative neurological morbidity. We report a study aimed to assess feasibility, extent of resection and outcome after surgical removal of CA by cortico-subcortical intraoperative brain stimulation (ioBS) in the awake patient. METHODS Six patients diagnosed of symptomatic SCA located on an eloquent area and operated on while awake under local anaesthesia ioBS, were included. Preoperative planning included neuropsychologic assessment of language-related functions, sociocognitive functions and executive functions. Intraoperatively, we recorded the results achieved in the planned neuropsychological tasks when stimulation was applied (cortical and subcortical). Postoperative control 3D MRI was scheduled at 1 month after surgery to calculate extent of resection. Neuropsychological assessment at 6 months after surgery was performed in all cases. RESULTS Six patients (5 females, 1 male) aged 24-48 years were included in our study. Locations of the lesions were right insular (n=1), left insular (n=1), left temporo-insular (n=1), left temporal (n=2) and left frontal (n=1). In all patients, positive findings were obtained during ioBS. In 5 patients, complete surgical resection was achieved. Two patients had postoperative transient neurological deficits, one case of hemiparesis, one case of dysnomia, both cleared over a 6-month period. Clinical follow-up revealed that all patients experienced complete recovery from preoperative symptoms within a year and five patients with seizures showed marked improvement and eventually quit antiepileptic drugs. Neuropsychological assessment at 6 months provided normal results compared to preoperative baseline in all domains. CONCLUSIONS Our study suggests that ioBS in the awake surgery of symptomatic SCA located in eloquent areas, allows to increase the rate of complete resection, minimizing postoperative neurological and neuropsychological deficit, and improving postoperative seizures control.
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Thakkar I, Arraño-Carrasco L, Cortes-Rivera B, Zunino-Pesce R, Mery-Muñoz F, Rodriguez-Fernández M, Smits M, Mendez-Orellana C. Alternative language paradigms for functional magnetic resonance imaging as presurgical tools for inducing crossed cerebro-cerebellar language activations in brain tumor patients. Eur Radiol 2021; 32:300-307. [PMID: 34189601 DOI: 10.1007/s00330-021-08137-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Revised: 05/11/2021] [Accepted: 06/02/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Crossed cerebro-cerebellar BOLD activations have recently come to light as additional diagnostic features for patients with brain tumors. The covert verb generation (VG) task is a widely used language paradigm to determine these language-related crossed activations. Here we demonstrate these crossed activations in two additional language paradigms, the semantic and phonological association tasks. We propose the merit of these tasks to language lateralization determination in the clinic as they are easy to monitor and suitable for patients with aphasia. METHODS Patients with brain tumors localized at different cortical sites (n = 71) performed three language paradigms, namely the VG task as well as the semantic (SA) and phonological (PA) association tasks with button-press responses. Respective language activations in disparate cortical regions and the cerebellum were assigned laterality. Agreements in laterality between the two new tasks and the verb generation task were tested using Cohen's kappa. RESULTS Both tasks significantly agreed in cortical and cerebellar lateralization with the verb generation task in patients. Additionally, a McNemar test confirmed the presence of crossed activations in the cortex and the cerebellum in the entire subject population. CONCLUSION We demonstrated that the semantic and phonological association tasks resulted in crossed cerebro-cerebellar language lateralization activations as those observed due to the covert verb generation task. This may suggest the possibility of these tasks being used conjointly with the traditional verb generation task, especially for subjects that may be unable to perform the latter. KEY POINTS • The semantic and phonological association tasks can be useful as additional presurgical fMRI language lateralization paradigms for brain tumor patients along with the standard verb generation task. • All three tasks also confirm the presence of crossed cerebro-cerebellar language activations in the current subject population.
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Affiliation(s)
- Ishani Thakkar
- Interdisciplinary Center for Neuroscience, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Leonardo Arraño-Carrasco
- Department of Radiology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Barbara Cortes-Rivera
- School of Speech and Language Pathology, Faculty of Health, Universidad Santo Tomás, Santiago, Chile
| | - Romina Zunino-Pesce
- Department of Radiology, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Francisco Mery-Muñoz
- Department of Neurosurgery, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - María Rodriguez-Fernández
- Institute for Biological and Medical Engineering, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Marion Smits
- Department of Radiology & Nuclear Medicine, Erasmus MC-University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolina Mendez-Orellana
- School of Speech and Language Pathology, Health Sciences Department, Faculty of Medicine, Pontificia Universidad Católica de Chile, Santiago, Chile.
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De Witt Hamer PC, Klein M, Hervey-Jumper SL, Wefel JS, Berger MS. Functional Outcomes and Health-Related Quality of Life Following Glioma Surgery. Neurosurgery 2021; 88:720-732. [PMID: 33517431 PMCID: PMC7955971 DOI: 10.1093/neuros/nyaa365] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/25/2020] [Indexed: 12/19/2022] Open
Abstract
Functional outcome following glioma surgery is defined as how the patient functions or feels. Functional outcome is a coprimary end point of surgery in patients with diffuse glioma, together with oncological outcome. In this review, we structure the functional outcome measurements following glioma surgery as reported in the last 5 yr. We review various perspectives on functional outcome of glioma surgery with available measures, and offer suggestions for their use. From the recent neurosurgical literature, 160 publications were retrieved fulfilling the selection criteria. In these publications, neurological outcomes were reported most often, followed by activities of daily living, seizure outcomes, neurocognitive outcomes, and health-related quality of life or well-being. In more than a quarter of these publications functional outcome was not reported. A minimum essential consensus set of functional outcome measurements would benefit comparison across neurosurgical reports. The consensus set should be based on a combination of clinician- and patient-reported outcomes, assessed at a predefined time before and after surgery. The selected measurements should have psychometric properties supporting the intended use including validity-related evidence, reliability, and sensitivity to detect meaningful change with minimal burden to ensure compliance. We circulate a short survey as a start towards reporting guidelines. Many questions remain to better understand, report, and improve functional outcome following glioma surgery.
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Affiliation(s)
- Philip C De Witt Hamer
- Correspondence: Philip C. De Witt Hamer, MD, PhD, Amsterdam UMC, Vrije Universiteit, Department of Neurosurgery, Cancer Center Amsterdam, De Boelelaan 1117, 1081 HV Amsterdam, Netherlands.
| | - Martin Klein
- Amsterdam UMC, Vrije Universiteit, Department of Medical Psychology, Neuroscience Campus, Amsterdam, Netherlands
| | - Shawn L Hervey-Jumper
- University of California San Francisco, Department of Neurological Surgery, San Francisco, California
| | - Jeffrey S Wefel
- University of Texas MD Anderson Cancer Center, Department of Neuro-Oncology and Department of Radiation Oncology, Houston, Texas
| | - Mitchel S Berger
- University of California San Francisco, Department of Neurological Surgery, San Francisco, California
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Papatzalas C, Fountas K, Brotis A, Kapsalaki E, Papathanasiou I. The Greek linguistic assessment for awake brain surgery: development process and normative data. CLINICAL LINGUISTICS & PHONETICS 2021; 35:458-488. [PMID: 32666837 DOI: 10.1080/02699206.2020.1792997] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Revised: 06/30/2020] [Accepted: 07/03/2020] [Indexed: 06/11/2023]
Abstract
Language mapping with direct electrical stimulation is considered the gold standard in surgical treatment of brain tumors. Assessing a variety of language functions intraoperatively can affect the extent of the tumor resection as well as the patient's postoperative quality of life. Although most tests include preoperative sessions where tasks are personalised to each patient, normative data are essential since they can ensure that the presented stimuli can be responded appropriately. In this study, we describe the development and standardisation procedures of the first linguistic test in Greek, designed specifically for brain mapping during awake craniotomies. The tasks are developed to comply with the special conditions and restrictions of language assessment inside the operating room. Each task is controlled for various psycholinguistic and lexical variables and it is associated with specific neuroanatomical areas and linguistic processes. Our population consists of 80 right-handed, healthy, Greek-speaking individuals aged 20-60 years. We found only a few main effects and interactions of demographic variables on our test scores. Most differences were found between age groups, since older participants tend to perform slightly worse than younger ones. Therefore, percentiles and cut-off scores were calculated separately for each demographic group. Regarding the clinical application of GLAABS, we describe the procedures we followed to administer it to brain tumor patients from our department and also discuss how sensitivity and specificity can affect patients' postoperative course.
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Affiliation(s)
- Christos Papatzalas
- Faculty of Medicine, University of Thessaly, Larisa, Greece
- Department of Neurosurgery, General University Hospital of Larisa, Larisa, Greece
| | - Kostas Fountas
- Faculty of Medicine, University of Thessaly, Larisa, Greece
- Department of Neurosurgery, General University Hospital of Larisa, Larisa, Greece
| | - Alexandros Brotis
- Department of Neurosurgery, General University Hospital of Larisa, Larisa, Greece
| | - Eftychia Kapsalaki
- Faculty of Medicine, University of Thessaly, Larisa, Greece
- Department of Radiology, General University Hospital of Larisa, Larisa, Greece
| | - Ilias Papathanasiou
- Department of Speech & Language Therapy, University of Patras, Pátrai, Greece
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Papatzalas C, Fountas K, Kapsalaki E, Papathanasiou I. The Use of Standardized Intraoperative Language Tests in Awake Craniotomies: A Scoping Review. Neuropsychol Rev 2021; 32:20-50. [PMID: 33786797 DOI: 10.1007/s11065-021-09492-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Accepted: 02/22/2021] [Indexed: 12/12/2022]
Abstract
Assessment of speech and language functions is an essential part of awake craniotomies. Although standardized and validated tests have several advantages compared to homemade (or mixed) batteries, in the literature it is unclear how such tests are used or whether they are used at all. In this study, we performed a scoping review in order to locate standardized and validated intraoperative language tests. Our inquiry included two databases (PubMED and MEDLINE), gray literature, and snowball referencing. We discovered 87 studies reporting use of mixed batteries, which consist of homemade tasks and tests borrowed from other settings. The tests we found to meet the validation and standardization criteria we set were ultimately three (n = 3) and each one has its own advantages and disadvantages. We argue that tests with high sensitivity and specificity not only can lead to better outcomes postoperatively, but they can also help us to gain a better understanding of the neuroanatomy of language.
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Affiliation(s)
- Christos Papatzalas
- Department of Medicine, University of Thessaly, Larisa, Greece.
- Department of Neurosurgery, University Hospital of Larisa, Larisa, Greece.
| | - Kostas Fountas
- Department of Medicine, University of Thessaly, Larisa, Greece
- Department of Neurosurgery, University Hospital of Larisa, Larisa, Greece
| | - Eftychia Kapsalaki
- Department of Medicine, University of Thessaly, Larisa, Greece
- Department of Radiology, University Hospital of Larisa, Larisa, Greece
| | - Ilias Papathanasiou
- Department of Speech & Language Therapy, University of Patras, Patras, Greece
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Hazem SR, Awan M, Lavrador JP, Patel S, Wren HM, Lucena O, Semedo C, Irzan H, Melbourne A, Ourselin S, Shapey J, Kailaya-Vasan A, Gullan R, Ashkan K, Bhangoo R, Vergani F. Middle Frontal Gyrus and Area 55b: Perioperative Mapping and Language Outcomes. Front Neurol 2021; 12:646075. [PMID: 33776898 PMCID: PMC7988187 DOI: 10.3389/fneur.2021.646075] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2020] [Accepted: 01/29/2021] [Indexed: 12/20/2022] Open
Abstract
Background: The simplistic approaches to language circuits are continuously challenged by new findings in brain structure and connectivity. The posterior middle frontal gyrus and area 55b (pFMG/area55b), in particular, has gained a renewed interest in the overall language network. Methods: This is a retrospective single-center cohort study of patients who have undergone awake craniotomy for tumor resection. Navigated transcranial magnetic simulation (nTMS), tractography, and intraoperative findings were correlated with language outcomes. Results: Sixty-five awake craniotomies were performed between 2012 and 2020, and 24 patients were included. nTMS elicited 42 positive responses, 76.2% in the inferior frontal gyrus (IFG), and hesitation was the most common error (71.4%). In the pMFG/area55b, there were seven positive errors (five hesitations and two phonemic errors). This area had the highest positive predictive value (43.0%), negative predictive value (98.3%), sensitivity (50.0%), and specificity (99.0%) among all the frontal gyri. Intraoperatively, there were 33 cortical positive responses—two (6.0%) in the superior frontal gyrus (SFG), 15 (45.5%) in the MFG, and 16 (48.5%) in the IFG. A total of 29 subcortical positive responses were elicited−21 in the deep IFG–MFG gyri and eight in the deep SFG–MFG gyri. The most common errors identified were speech arrest at the cortical level (20 responses−13 in the IFG and seven in the MFG) and anomia at the subcortical level (nine patients—eight in the deep IFG–MFG and one in the deep MFG–SFG). Moreover, 83.3% of patients had a transitory deterioration of language after surgery, mainly in the expressive component (p = 0.03). An increased number of gyri with intraoperative positive responses were related with better preoperative (p = 0.037) and worse postoperative (p = 0.029) outcomes. The involvement of the SFG–MFG subcortical area was related with worse language outcomes (p = 0.037). Positive nTMS mapping in the IFG was associated with a better preoperative language outcome (p = 0.017), relating to a better performance in the expressive component, while positive mapping in the MFG was related to a worse preoperative receptive component of language (p = 0.031). Conclusion: This case series suggests that the posterior middle frontal gyrus, including area 55b, is an important integration cortical hub for both dorsal and ventral streams of language.
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Affiliation(s)
- Sally Rosario Hazem
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Mariam Awan
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Jose Pedro Lavrador
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Sabina Patel
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Hilary Margaret Wren
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Oeslle Lucena
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Carla Semedo
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Hassna Irzan
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Andrew Melbourne
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom.,Department of Medical Physics and Biomedical Engineering, University College London, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Jonathan Shapey
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,School of Biomedical Engineering and Imaging Sciences, King's College London, London, United Kingdom
| | - Ahilan Kailaya-Vasan
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Richard Gullan
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Keyoumars Ashkan
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Ranjeev Bhangoo
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
| | - Francesco Vergani
- Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom.,King's Neuro Lab, Department of Neurosurgery, King's College Hospital National Health Service Foundation Trust, London, United Kingdom
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El Ouardi L. The Moroccan Arabic verb and noun test for language mapping (MAVNT-LP) under nTMS and DES. APPLIED NEUROPSYCHOLOGY-ADULT 2021; 29:1413-1424. [PMID: 33689513 DOI: 10.1080/23279095.2021.1883020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
To maximize tumor resection and minimize postoperative neurological sequelae, intraoperative Direct Electrical Stimulation (DES) coupled with preoperative Navigated Transcranial Magnetic Stimulation (nTMS) is adopted as a more valid procedure when a tumor is located in or near language-positive cortical and subcortical brain areas/networks. To map language functions peri- and intraoperatively, naming tasks are usually administered given their sensitivity and practicality in mapping language networks and their association with positive postoperative outcomes. Linguistic protocols designed for stimulation under nTMS are relatively scarce, and non-existent in the Arabic language. The present study attempts to fill these gaps by presenting the processes of development, piloting, and standardization of the first (Moroccan) Arabic object and action naming protocol for use preoperatively under nTMS, and intraoperatively under DES. The MAVNT-LP was developed in accordance with both DES and nTMS time requirements and was balanced for relevant psycholinguistic as well as intrinsic factors. The test underwent piloting on a population of 10 Moroccan Arabic (MA)-speaking individuals and was validated on a population of 50 participants. The standardized version of the test consisted of 61 nouns and 61 verbs. The 122 items included in the test were named accurately by at least 80% of the participants and had a high naming agreement. Correlations between psycholinguistic factors and lexical retrieval are reported and discussed. The MAVNT-LP was found to be a valid instrument for use in a clinical setting either as a planning tool or as a protocol used to stimulate eloquent brain areas under awake brain surgery.
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Affiliation(s)
- Loubna El Ouardi
- Applied Language and Culture Studies Lab, Chouaib Doukalli University, El Jadida, Morocco
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Verst SM, de Castro I, Scappini-Junior W, de Melo MN, de Oliveira JR, de Almeida SS, Alvarez NRC, Sucena ACB, Barros MR, Marrone CD, Maldaun MVC. Methodology for creating and validating object naming and semantic tests used by Verst-Maldaun Language Assessment during awake craniotomies. Clin Neurol Neurosurg 2021; 202:106485. [PMID: 33476885 DOI: 10.1016/j.clineuro.2021.106485] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Revised: 11/29/2020] [Accepted: 01/07/2021] [Indexed: 11/17/2022]
Abstract
Verst-Maldaun Language Assessment (VMLA) is a new intraoperative neuropsychological test (NT) within our local culture, e.g., native Portuguese speaking Brazilians. It aims to fill the specific need of an objective and dynamic approach for assessing the language network during awake craniotomies. The test includes object naming (ON) and semantic functions. This paper describes the process of validation, allowing for other centers to create their own language assessment. The validation process included 248 volunteers and the results were associated with age, gender and educational level (EL). The factor with the greatest impact was EL, followed by age. Intraoperative image learning by repetition is unlikely, since it is composed of 388 items and 70 combinations. The test will be available for free use under http://www.vemotests.com/ (beginning in February 2021).
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Affiliation(s)
- Silvia Mazzali Verst
- Brain Spine Neurophysiologia, Intraoperative Neurophysiology at Hospital Sirio Libanês, São Paulo, Brazil; Rua Barão de Teffé, 1000 sala 55, Jundiai, SP 13208-761, Brazil.
| | - Isac de Castro
- Neuromuscular Diseases Sector, Department of Neurology, Universidade Federal de São Paulo, SP, Brazil.
| | - Wilson Scappini-Junior
- Brain Spine Neurofisiologia, Rua Barão de Teffé, 1000 sala 55, Jundiai, SP 13208-761, Brazil.
| | - Mônica Nascimento de Melo
- Brain Spine Neurofisiologia, Rua dos Salgueiros, QD 09 lote 03, Jardins Valência Goiânia, GO 74885-860, Brazil.
| | - Jean Ramos de Oliveira
- Brain Spine Neurofisiologia, Rua Elzira Sammarco Palma, 405/242, Ribeirão Preto, SP 14021-684, Brazil.
| | - Soraya Soares de Almeida
- Brain Spine Neurofisiologia, Rua Antônio Muniz, 182, Pontalzinho, Itabuna, BA 45603-023, Brazil.
| | | | | | - Maria Rufina Barros
- Vitória Apart Hospital, Rodovia Mário Covas, 591 Sala 113-B, Bairro Boa Vista 1, Vitória, ES, 29161-001, Brazil.
| | - Carlo Domenico Marrone
- Clinica Marrone, Av. Túlio de Rose, 400 apto 501 Torre E Porto, Alegre, RS 91340-110, Brazil.
| | - Marcos Vinicius Calfat Maldaun
- Neuro-Oncology postgraduate course at Sirio Libanês Hospital, São Paulo, Rua Barata Ribeiro, 414, cj 63, São Paulo, SP, 01308-000, Brazil.
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Milman L, Anderson E, Thatcher K, Amundson D, Johnson C, Jones M, Valles L, Willis D. Integrated Discourse Therapy After Glioblastoma: A Case Report of Face-To-Face and Tele-NeuroRehabilitation Treatment Delivery. Front Neurol 2020; 11:583452. [PMID: 33329328 PMCID: PMC7710897 DOI: 10.3389/fneur.2020.583452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 10/27/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Language and communication impairments are among the most frequently reported long-term behavioral consequences of brain tumor. Such deficits may persist long after a patient has been discharged from the hospital and can significantly impact return to work, resumption of prior social roles, and interpersonal relations, as well as full engagement in leisure activities. While considerable research has centered on identifying and describing communication impairments in brain tumor survivors, relatively little research has investigated language therapy for this population. Aims: This report (1) reviews the literature and describes the language and cognitive-communicative profile of a 35-year-old man 6 years post glioblastoma excision with subsequent chemo- and radiation therapies; (2) presents cognitive-communication outcome data for this individual following an integrated discourse therapy; and (3) assesses treatment feasibility in face-to-face (F2F) and tele-neurorehabilitation (TNR) contexts. Methods: A battery of tests and weekly conversation probes were administered to evaluate baseline performance and potential changes associated with F2F and TNR treatment delivery. Integrated Conversation Therapy (ICT) was administered across four alternating (F2F and TNR) treatment blocks over 2 months. ICT is a solution-focused discourse intervention that simultaneously targets word finding, sentence processing, and authentic patient-selected conversational interactions. Results: Although the participant presented with long term-language impairments that were clinically distinct from stroke-associated aphasia, statistically significant post-treatment gains (>2 SEM) were evident following F2F and TNR treatment delivery on standardized measures of apraxia, discourse production, verbal memory, and self-ratings of discourse production, communication, and living with aphasia. While objective measures of treatment effect size (probes of CIU discourse data) were consistent across F2F and TNR delivery models, results of a satisfaction survey indicated a slight but statistically significant participant preference for TNR treatment delivery. Conclusions: This study provides preliminary support for F2F and TNR delivery of ICT discourse intervention for glioblastoma survivors. It also highlights the need for more research specifically dedicated to language therapy for this population.
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Affiliation(s)
- Lisa Milman
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Emma Anderson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Katelyn Thatcher
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Deborah Amundson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Chance Johnson
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Morgan Jones
- Language and Aphasia NeuroRehabilitation Lab, Department of Communicative Disorders and Deaf Education, Utah State University, Logan, UT, United States
| | - Louie Valles
- Utah Education and Telehealth Network, Logan, UT, United States
| | - Dale Willis
- Utah Education and Telehealth Network, Logan, UT, United States
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Intraoperative brain mapping of language, cognitive functions, and social cognition in awake surgery of low-grade gliomas located in the right non-dominant hemisphere. Clin Neurol Neurosurg 2020; 200:106363. [PMID: 33203593 DOI: 10.1016/j.clineuro.2020.106363] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Revised: 10/24/2020] [Accepted: 11/07/2020] [Indexed: 01/19/2023]
Abstract
OBJECTIVE The aim of our study was to evaluate the usefulness of cortical-subcortical intraoperative brain mapping (ioBM) in resective awake surgery of low-grade gliomas (LGG) of the right non-dominant hemisphere (RndH). It was estimated how ioBM may affect both the extent of resection and postoperative outcome of language, spatial cognition, social cognition, and executive functions including attention and working memory. PATIENTS AND METHODS Fifteen patients that underwent ioBM in resective awake surgery of LGG located on the RndH, were included. A cohort of 15 patients with the same tumour location operated under general anaesthesia without brain mapping was used as control. Specific intraoperative tasks for each location were carried out and results registered. Neuropsychological assessment was performed preoperatively and at 6 months after surgery. RESULTS In the group of patients operated by using ioBM in awake surgery, an 86.66 % mean of resection was obtained compared to 60.33 % in the control group. Speech arrest and incorrect naming responses were elicited in higher proportion in frontal and insular locations. Parietal stimulation associated higher number of incorrect responses in social cognition task. Parietal and temporal stimulation were more frequently associated with incorrect performance of spatial cognition task. Parietal stimulation associated with higher frequency incorrect execution of attention and working memory tasks. After comparing clinical and neuropsychological results in both cohorts, worst outcome at 6 months was observed in the group of patients operated under general anaesthesia without brain mapping, especially in parietal and insular locations. CONCLUSIONS Intraoperative identification of language, cognitive functions, and social cognition of RndH by means of ioBM, can be of paramount importance in improving the extent of resection of low-grade gliomas and positively affects clinical and neuropsychological outcome at six months.
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Talabaev M, Venegas K, Zabrodets G, Zmachinskaya V, Antonenko A, Naumenko D, Salauyeva H, Churyla N. Result of awake surgery for pediatric eloquent brain area tumors: single-center experience. Childs Nerv Syst 2020; 36:2667-2673. [PMID: 32435891 DOI: 10.1007/s00381-020-04666-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 05/06/2020] [Indexed: 12/14/2022]
Abstract
PURPOSE About half of brain tumors are located in supratentorial regions and 20% of them in eloquent brain cortex areas. The use of fMRI and intraoperative neuromonitoring allows safe surgery of these areas. Carrying out awake brain surgery (ABS) operations provides additional opportunities for direct-function monitoring. In pediatric practice, this method has not been used widely yet. METHODS We present the retrospective analysis of the results of pre-operative examination and surgical treatment of 12 patients with glial tumors located in eloquent cortex areas. Two patients had ABS operations twice. Intraoperative neuromonitoring was used in all the cases. RESULTS Twelve patients in total underwent fourteen ABS operations. According to histology results, patients with low-grade tumors prevailed, 11 (91.7%) out of 12. Seven (58.3%) patients had the tumor located in the projection of speech cortex area, four (33.3%) patients in the motor cortex area, and one (8.4%) patient in the visual cortex area. The youngest male was 8 years old. Temporary neurological deficit was diagnosed in three (25%) cases. The tumor was removed completely in 66.7% (eight) cases. Three patients were operated upon twice, two of whom had ABS operations twice. The awake phase of the surgery lasted from 30 to 110 min, 61.2 min on average. CONCLUSIONS Our experience has shown sufficient safety of pediatric ABS operations. The achieved functional result and radicality of tumor removal prove that further application and development of this method for children with eloquent brain area tumors (EBATs) is reasonable.
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Affiliation(s)
- Mikle Talabaev
- Pediatric Neurosurgery Department, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus.
| | - Kevin Venegas
- Pediatric Neurosurgery Department, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Gleb Zabrodets
- Intraoperative Neurophysiological Monitoring Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Volha Zmachinskaya
- Intraoperative Neurophysiological Monitoring Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Alexander Antonenko
- Department of Neuroradiology, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Dmitry Naumenko
- Department of Neuroradiology, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Hanna Salauyeva
- Pediatric Neurosurgery Department, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
| | - Natalia Churyla
- Psychological Service, Republican Research and Clinical Center of Neurology and Neurosurgery, Minsk, Belarus
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Wykes V, Zisakis A, Irimia M, Ughratdar I, Sawlani V, Watts C. Importance and Evidence of Extent of Resection in Glioblastoma. J Neurol Surg A Cent Eur Neurosurg 2020; 82:75-86. [PMID: 33049795 DOI: 10.1055/s-0040-1701635] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Maximal safe resection is an essential part of the multidisciplinary care of patients with glioblastoma. A growing body of data shows that gross total resection is an independent prognostic factor associated with improved clinical outcome. The relationship between extent of glioblastoma (GB) resection and clinical benefit depends critically on the balance between cytoreduction and avoiding neurologic morbidity. The definition of the extent of tumor resection, how this is best measured pre- and postoperatively, and its relation to volume of residual tumor is still discussed. We review the literature supporting extent of resection in GB, highlighting the importance of a standardized definition and measurement of extent of resection to allow greater collaboration in research projects and trials. Recent developments in neurosurgical techniques and technologies focused on maximizing extent of resection and safety are discussed.
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Affiliation(s)
- Victoria Wykes
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland.,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Athanasios Zisakis
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Mihaela Irimia
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Ismail Ughratdar
- Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Vijay Sawlani
- Department of Radiology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
| | - Colin Watts
- Institute of Cancer and Genomic Sciences, University of Birmingham College of Medical and Dental Sciences, Birmingham, United Kingdom of Great Britain and Northern Ireland.,Department of Neurosurgery, University Hospitals Birmingham NHS Foundation Trust, Birmingham, United Kingdom of Great Britain and Northern Ireland
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Prat-Acín R, Galeano-Senabre I, López-Ruiz P, García-Sánchez D, Ayuso-Sacido A, Espert-Tortajada R. Intraoperative brain mapping during awake surgery in symptomatic supratentorial cavernomas. Neurocirugia (Astur) 2020; 32:S1130-1473(20)30105-6. [PMID: 33060022 DOI: 10.1016/j.neucir.2020.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/13/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND Complete resection of symptomatic supratentorial cavernoma (SCA) and removal of the surrounding gliotic area is recommended to minimize the risk of persistent seizures or (re)bleeding. Surgery of SCA located in an eloquent area, can carry out severe postoperative neurological morbidity. We report a study aimed to assess feasibility, extent of resection and outcome after surgical removal of CA by cortico-subcortical intraoperative brain stimulation (ioBS) in the awake patient. METHODS Six patients diagnosed of symptomatic SCA located on an eloquent area and operated on while awake under local anaesthesia ioBS, were included. Preoperative planning included neuropsychologic assessment of language-related functions, sociocognitive functions and executive functions. Intraoperatively, we recorded the results achieved in the planned neuropsychological tasks when stimulation was applied (cortical and subcortical). Postoperative control 3D MRI was scheduled at 1 month after surgery to calculate extent of resection. Neuropsychological assessment at 6 months after surgery was performed in all cases. RESULTS Six patients (5 females, 1 male) aged 24-48 years were included in our study. Locations of the lesions were right insular (n=1), left insular (n=1), left temporo-insular (n=1), left temporal (n=2) and left frontal (n=1). In all patients, positive findings were obtained during ioBS. In 5 patients, complete surgical resection was achieved. Two patients had postoperative transient neurological deficits, one case of hemiparesis, one case of dysnomia, both cleared over a 6-month period. Clinical follow-up revealed that all patients experienced complete recovery from preoperative symptoms within a year and five patients with seizures showed marked improvement and eventually quit antiepileptic drugs. Neuropsychological assessment at 6 months provided normal results compared to preoperative baseline in all domains. CONCLUSIONS Our study suggests that ioBS in the awake surgery of symptomatic SCA located in eloquent areas, allows to increase the rate of complete resection, minimizing postoperative neurological and neuropsychological deficit, and improving postoperative seizures control.
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Affiliation(s)
- Ricardo Prat-Acín
- Servicio de Neurocirugía. Hospital Universitario I Politècnic La Fe, Valencia, Spain; Unidad Mixta Nanomedicina y Sensores: Fundación Hospital La Fe, Universidad Politécnica de Valencia, Spain.
| | - Inma Galeano-Senabre
- Servicio de Neurocirugía. Hospital Universitario I Politècnic La Fe, Valencia, Spain; Unidad Mixta Nanomedicina y Sensores: Fundación Hospital La Fe, Universidad Politécnica de Valencia, Spain
| | | | - Daniel García-Sánchez
- Servicio de Neurocirugía. Hospital Universitario I Politècnic La Fe, Valencia, Spain
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Dragoy O, Zyryanov A, Bronov O, Gordeyeva E, Gronskaya N, Kryuchkova O, Klyuev E, Kopachev D, Medyanik I, Mishnyakova L, Pedyash N, Pronin I, Reutov A, Sitnikov A, Stupina E, Yashin K, Zhirnova V, Zuev A. Functional linguistic specificity of the left frontal aslant tract for spontaneous speech fluency: Evidence from intraoperative language mapping. BRAIN AND LANGUAGE 2020; 208:104836. [PMID: 32673898 DOI: 10.1016/j.bandl.2020.104836] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/11/2019] [Revised: 05/22/2020] [Accepted: 07/02/2020] [Indexed: 06/11/2023]
Abstract
The left frontal aslant tract (FAT) has been proposed to be relevant for language, and specifically for spontaneous speech fluency. However, there is missing causal evidence that stimulation of the FAT affects spontaneous speech, and not language production in general. We present a series of 12 neurosurgical cases with awake language mapping of the cortex near the left FAT. Tasks for language mapping included the commonly used action picture naming, and sentence completion, tapping more specifically into spontaneous speech. A task dissociation was found in 10 participants: while being stimulated on specific sites, they were able to name a picture but could not complete a sentence. Overlaying of these sites on preoperative white-matter tract reconstructions revealed that in each individual case they were located on cortical terminations of the FAT. This corroborates the language functional specificity of the left FAT as a tract underlying fluent spontaneous speech.
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Affiliation(s)
- Olga Dragoy
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia.
| | - Andrey Zyryanov
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Oleg Bronov
- Department of Radiology, National Medical and Surgical Center Named after N. I. Pirogov, Moscow, Russia
| | - Elizaveta Gordeyeva
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Natalya Gronskaya
- Faculty of Humanities, National Research University Higher School of Economics, Nizhny Novgorod, Russia
| | - Oksana Kryuchkova
- Department of Radiology, Central Clinical Hospital with Outpatient Health Center of the Business Administration for the President of the Russian Federation, Moscow, Russia
| | - Evgenij Klyuev
- Department of Radiology, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Dmitry Kopachev
- Department of Neurosurgery, National Medical Research Center for Neurosurgery Named after N. N. Burdenko, Moscow, Russia
| | - Igor Medyanik
- Department of Neurosurgery, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Lidiya Mishnyakova
- Department of Neurosurgery, Federal Centre of Treatment and Rehabilitation of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Nikita Pedyash
- Department of Neurosurgery, National Medical and Surgical Center Named after N. I. Pirogov, Moscow, Russia
| | - Igor Pronin
- Department of Neuroradiology, National Medical Research Center for Neurosurgery Named after N. N. Burdenko, Moscow, Russia
| | - Andrey Reutov
- Department of Neurosurgery, Central Clinical Hospital with Outpatient Health Center of the Business Administration for the President of the Russian Federation, Moscow, Russia
| | - Andrey Sitnikov
- Department of Neurosurgery, Federal Centre of Treatment and Rehabilitation of the Ministry of Healthcare of the Russian Federation, Moscow, Russia
| | - Ekaterina Stupina
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Konstantin Yashin
- Department of Neurosurgery, Privolzhsky Research Medical University, Nizhny Novgorod, Russia
| | - Valeriya Zhirnova
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Andrey Zuev
- Department of Neurosurgery, National Medical and Surgical Center Named after N. I. Pirogov, Moscow, Russia
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Piai V, De Witte E, Sierpowska J, Zheng X, Hinkley LB, Mizuiri D, Knight RT, Berger MS, Nagarajan SS. Language Neuroplasticity in Brain Tumor Patients Revealed by Magnetoencephalography. J Cogn Neurosci 2020; 32:1497-1507. [PMID: 32286133 PMCID: PMC8330634 DOI: 10.1162/jocn_a_01561] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Little is known about language impairment in brain tumor patients, especially in the presurgical phase. Impairment in this population may be missed because standardized tests fail to capture mild deficits. Additionally, neuroplasticity may also contribute to minimizing language impairments. We examined 14 presurgical patients with brain tumors in the language-dominant hemisphere using magnetoencephalography (MEG) while they performed a demanding picture-word interference task, that is, participants name pictures while ignoring distractor words. Brain tumor patients had behavioral picture-naming effects typically observed in healthy controls. The MEG responses also showed the expected pattern in its timing and amplitude modulation typical of controls, but with an altered spatial distribution of right hemisphere sources, in contrast to the classic left hemisphere source found in healthy individuals. This finding supports tumor-induced neural reorganization of language before surgery. Crucially, the use of electrophysiology allowed us to show the "same" neuronal response in terms of its timing and amplitude modulation in the right hemisphere, supporting the hypothesis that the processes performed by the right hemisphere following reorganization are similar in nature to those (previously) performed by the left hemisphere. We also identified one participant with a fast-growing tumor affecting large parts of critical language areas and underlying ventral and dorsal white matter tracts who showed a deviant pattern in behavior and in the MEG event-related responses. In conclusion, our results attest to the validity of using a demanding picture-naming task in presurgical patients and provide evidence for neuroplasticity, with the right hemisphere performing similar computations as the left hemisphere typically performs.
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Affiliation(s)
- Vitória Piai
- Radboud University, Nijmegen, the Netherlands
- Radboud University Medical Center, Nijmegen, the Netherlands
| | - Elke De Witte
- Free University of Brussels
- University of California, San Francisco
| | - Joanna Sierpowska
- Radboud University, Nijmegen, the Netherlands
- Radboud University Medical Center, Nijmegen, the Netherlands
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Leote J, Loução R, Viegas C, Lauterbach M, Perez-Hick A, Monteiro J, Nunes RG, Ferreira HA. Impact of Navigated Task-specific fMRI on Direct Cortical Stimulation. J Neurol Surg A Cent Eur Neurosurg 2020; 81:555-564. [PMID: 32610351 DOI: 10.1055/s-0040-1712496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND AND STUDY AIMS Cortical mapping (CM) with direct cortical stimulation (DCS) in awake craniotomy is used to preserve cognitive functions such as language. Nevertheless, patient collaboration during this procedure is influenced by previous neurological symptoms and growing discomfort with DCS duration. Our study aimed to evaluate the impact of navigated task-specific functional magnetic resonance imaging (nfMRI) on the practical aspects of DCS. MATERIAL AND METHODS We recruited glioma patients scheduled for awake craniotomy for prior fMRI-based CM, acquired during motor and language tasks (i.e., verb generation, semantic and syntactic decision tasks). Language data was combined to generate a probabilistic map indicating brain regions activated with more than one paradigm. Presurgical neurophysiological language tests (i.e., verb generation, picture naming, and semantic tasks) were also performed. We considered for subsequent study only the patients with a minimum rate of correct responses of 50% in all tests. These patients were then randomized to perform intraoperative language CM either using the multimodal approach (mCM), using nfMRI and DCS combined, or electrical CM (eCM), with DCS alone. DCS was done while the patient performed picture naming and nonverbal semantic decision tasks. Methodological features such as DCS duration, number of stimuli, total delivered stimulus duration per task, and frequency of seizures were analyzed and compared between groups. The correspondence between positive responses obtained with DCS and nfMRI was also evaluated. RESULTS Twenty-one surgeries were included, thirteen of which using mCM (i.e., test group). Patients with lower presurgical neuropsychological performance (correct response rate between 50 and 80% in language tests) showed a decreased DCS duration in comparison with the control group. None of the compared methodological features showed differences between groups. Correspondence between DCS and nfMRI was 100/84% in the identification of the precentral gyrus for motor function/opercular frontal inferior gyrus for language function, respectively. CONCLUSION Navigated fMRI data did not influence DCS in practice. Presurgical language disturbances limited the applicability of DCS mapping in awake surgery.
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Affiliation(s)
- Joao Leote
- Faculdade de Ciências da Universidade de Lisboa, Instituto de Biofísica e Engenharia Biomédica, Lisboa, Portugal.,Department of Neurosurgery and Critical Care, Hospital Garcia de Orta EPE, Almada, Portugal
| | - Ricardo Loução
- Institute of Neurosciences and Medicine, INM 4, Julich, Nordrhein-Westfalen, Germany
| | - Catarina Viegas
- Department of Neurosurgery and Critical Care, Hospital Garcia de Orta EPE, Almada, Portugal
| | - Martin Lauterbach
- Department of Neuroradiology, Sociedade Portuguesa de Ressonância Magnética, Lisboa, Portugal
| | - António Perez-Hick
- Department of Neurosurgery and Critical Care, Hospital Garcia de Orta EPE, Almada, Portugal
| | - Joana Monteiro
- Department of Neurosurgery and Critical Care, Hospital Garcia de Orta EPE, Almada, Portugal
| | - Rita G Nunes
- Department of Bioengineering and Institute for Systems and Robotics (ISR/IST), LARSyS, Universidade de Lisboa Instituto Superior Técnico Campus Alameda, Lisboa, Lisboa, Portugal
| | - Hugo A Ferreira
- Faculdade de Ciências da Universidade de Lisboa, Instituto de Biofísica e Engenharia Biomédica, Lisboa, Portugal
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Martín-Monzón I, Rivero Ballagas Y, Arias-Sánchez S. Language mapping: A systematic review of protocols that evaluate linguistic functions in awake surgery. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:845-854. [PMID: 32543924 DOI: 10.1080/23279095.2020.1776287] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Nowadays, numerous neuropsychological tests are available for multidisciplinary teams to perform awake brain surgery but none-or very few-of them constitutes a mandatory prerequisite. No consensus has been reached about the choice of intraoperative tests, which can be relatively simple for certain primary functions, but can be much more difficult for high-level cognitive functions. This review aims to give an overview about the assessment of language during awake brain surgery in adults and focus on the analysis of the different language protocols that have been published, to compile the most used standardized tests that evaluate different linguistic cognitive processes. We performed a systematic review about awake brain surgery studies that mentioned a specific test or protocol for assessing language in adults from the last 15 years. The search yielded 3,504 articles. 120 studies reported a linguistic protocol or test. This review allowed to obtain a defined neuropsychological picture of the essential tasks that a linguistic protocol in awake surgery should compile. This review will help clinicians in selecting tasks for monitoring cognition during awake brain surgery as well as contributes to enlighten the efficacy of linguistics protocols in order to minimize language deficits in awake surgery.
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Affiliation(s)
- Isabel Martín-Monzón
- Laboratory of Psychobiology, Faculty of Psychology, Campus Santiago Ramón y Cajal, University of Sevilla, Sevilla, Spain
| | - Yudania Rivero Ballagas
- Department of Experimental Psychology, Faculty of Psychology, Campus, Santiago Ramón y Cajal, University of Sevilla, Sevilla, Spain
| | - Samuel Arias-Sánchez
- Department of Experimental Psychology, Faculty of Psychology, Campus, Santiago Ramón y Cajal, University of Sevilla, Sevilla, Spain
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