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Young JS, Morshed RA, Andrews JP, Cha S, Berger MS. Prosopagnosia following nonlanguage dominant inferior temporal lobe low-grade glioma resection in which the inferior longitudinal fasciculus was disrupted preoperatively: illustrative case. JOURNAL OF NEUROSURGERY: CASE LESSONS 2021; 2:CASE21277. [PMID: 35855186 PMCID: PMC9265231 DOI: 10.3171/case21277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 05/24/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND
Prosopagnosia is a rare neurological condition characterized by the impairment of face perception with preserved visual processing and cognitive functioning and is associated with injury to the fusiform gyrus and inferior longitudinal fasciculus (ILF). Reports of this clinical impairment following resection of right temporal lobe diffuse gliomas in the absence of contralateral injury are exceedingly scarce and not expected as a complication of surgery.
OBSERVATIONS
The authors describe the case of a young female patient found to have an incidental diffuse glioma in the right inferior temporal lobe despite evidence of preoperative ILF disruption by the tumor. Following resection of the lesion, despite the preoperative disruption to the ILF by the tumor, the patient developed prosopagnosia. There was no evidence of contralateral, left-sided ILF injury.
LESSONS
Given the significant functional impairment associated with prosopagnosia, neurosurgeons should be aware of the exceedingly rare possibility of a visual-processing deficit following unilateral and, in this case, right-sided inferior temporal lobe glioma resections. More investigation is needed to determine whether preoperative testing can determine dominance of facial-processing networks for patients with lesions in the right inferior posterior temporooccipital lobe and whether intraoperative mapping could help prevent this complication.
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Affiliation(s)
| | | | | | - Soonmee Cha
- Radiology, University of California, San Francisco, California
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Sanada T, Kapeller C, Jordan M, Grünwald J, Mitsuhashi T, Ogawa H, Anei R, Guger C. Multi-modal Mapping of the Face Selective Ventral Temporal Cortex-A Group Study With Clinical Implications for ECS, ECoG, and fMRI. Front Hum Neurosci 2021; 15:616591. [PMID: 33828468 PMCID: PMC8020907 DOI: 10.3389/fnhum.2021.616591] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/22/2021] [Indexed: 12/29/2022] Open
Abstract
Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation (ECS), electrocorticography (ECoG), and functional magnetic resonance imagining (fMRI). This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest (ROI), which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations.
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Affiliation(s)
- Takahiro Sanada
- Department of Neurosurgery, Nayoro City General Hospital, Nayoro, Japan.,Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Christoph Kapeller
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Michael Jordan
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Johannes Grünwald
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Takumi Mitsuhashi
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, United States
| | - Hiroshi Ogawa
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ryogo Anei
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Christoph Guger
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
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Dulla CG, Coulter DA, Ziburkus J. From Molecular Circuit Dysfunction to Disease: Case Studies in Epilepsy, Traumatic Brain Injury, and Alzheimer's Disease. Neuroscientist 2016; 22:295-312. [PMID: 25948650 PMCID: PMC4641826 DOI: 10.1177/1073858415585108] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Complex circuitry with feed-forward and feed-back systems regulate neuronal activity throughout the brain. Cell biological, electrical, and neurotransmitter systems enable neural networks to process and drive the entire spectrum of cognitive, behavioral, and motor functions. Simultaneous orchestration of distinct cells and interconnected neural circuits relies on hundreds, if not thousands, of unique molecular interactions. Even single molecule dysfunctions can be disrupting to neural circuit activity, leading to neurological pathology. Here, we sample our current understanding of how molecular aberrations lead to disruptions in networks using three neurological pathologies as exemplars: epilepsy, traumatic brain injury (TBI), and Alzheimer's disease (AD). Epilepsy provides a window into how total destabilization of network balance can occur. TBI is an abrupt physical disruption that manifests in both acute and chronic neurological deficits. Last, in AD progressive cell loss leads to devastating cognitive consequences. Interestingly, all three of these neurological diseases are interrelated. The goal of this review, therefore, is to identify molecular changes that may lead to network dysfunction, elaborate on how altered network activity and circuit structure can contribute to neurological disease, and suggest common threads that may lie at the heart of molecular circuit dysfunction.
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Affiliation(s)
- Chris G Dulla
- Department of Neuroscience, Tufts University School of Medicine, Boston, MA, USA
| | - Douglas A Coulter
- Department of Pediatrics and Neuroscience, University of Pennsylvania Perleman School of Medicine, Philadelphia, PA, USA Division of Neurology and the Research Institute of Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Jokubas Ziburkus
- Department of Biology and Biochemistry, University of Houston, Houston, TX, USA
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Dulay MF, Busch RM. Prediction of neuropsychological outcome after resection of temporal and extratemporal seizure foci. Neurosurg Focus 2012; 32:E4. [DOI: 10.3171/2012.1.focus11340] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Resection of seizure foci is an effective treatment for the control of medically intractable epilepsy. However, cognitive morbidity can occur as a result of surgical intervention. This morbidity is dependent on several factors, including location and extent of resection, disease characteristics, patient demographic characteristics, and functional status of the tissue to be resected. In this review article, the authors provide a summary of the neurocognitive outcomes of epilepsy surgery with an emphasis on presurgical predictors of postsurgical cognitive decline.
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Affiliation(s)
- Mario F. Dulay
- 1Comprehensive Epilepsy Program and Department of Neurosurgery, The Methodist Hospital Neurological Institute, Houston, Texas; and
| | - Robyn M. Busch
- 2Epilepsy Center, Neurological Institute, Cleveland Clinic, Cleveland, Ohio
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Danchaivijitr C, Kennard C. Chapter 14 Cortical Visual Disorders—Functional Localization and Pathophysiology. Neuroophthalmology 2008. [DOI: 10.1016/s1877-184x(09)70044-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Godinho F, Magnin M, Frot M, Perchet C, Garcia-Larrea L. Emotional modulation of pain: is it the sensation or what we recall? J Neurosci 2006; 26:11454-61. [PMID: 17079675 PMCID: PMC6674534 DOI: 10.1523/jneurosci.2260-06.2006] [Citation(s) in RCA: 105] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2006] [Revised: 08/30/2006] [Accepted: 08/30/2006] [Indexed: 11/21/2022] Open
Abstract
Emotions modulate pain perception, although the mechanisms underlying this phenomenon remain unclear. In this study, we show that intensity reports significantly increased when painful stimuli were concomitant to images showing human pain, whereas pictures with identical emotional values but without somatic content failed to modulate pain. Early somatosensory responses (<200 ms) remained unmodified by emotions. Conversely, late responses showed a significant enhancement associated with increased pain ratings, localized to the right prefrontal, right temporo-occipital junction, and right temporal pole. In contrast to selective attention, which enhances pain ratings by increasing sensory gain, emotions triggered by seeing other people's pain did not alter processing in SI-SII (primary and second somatosensory areas), but may have biased the transfer to, and the representation of pain in short-term memory buffers (prefrontal), as well as the affective assignment to this representation (temporal pole). Memory encoding and recall, rather than sensory processing, appear to be modulated by empathy with others' physical suffering.
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Affiliation(s)
- Fabio Godinho
- Equipe Mixte INSERM 342, Central Integration of Pain, Hôpital Neurologique Pierre Wertheimer, 69003 Lyon, France.
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Devinsky O. The myth of silent cortex and the morbidity of epileptogenic tissue: implications for temporal lobectomy. Epilepsy Behav 2005; 7:383-9. [PMID: 16198151 DOI: 10.1016/j.yebeh.2005.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2005] [Revised: 07/27/2005] [Accepted: 07/28/2005] [Indexed: 11/21/2022]
Abstract
This article reviews two commonly held myths regarding temporal lobe epilepsy-it is a static disorder with minimal morbidity and mortality, and epileptogenic tissue impairs only the functions of the seizure focus-and one myth concerning temporal lobe functions-they contain areas of nonfunctional, "silent" cortex. Chronic temporal lobe epilepsy can cause progressive structural, cognitive, and behavioral changes. Aside from the seizure focus, primary epileptogenic cortex may have a deleterious influence on distant brain areas. Removing this "nociferous" cortex and reducing the antiepileptic drug burden can improve cognitive or behavioral and metabolic function in areas remote from the resection. Anterior temporal lobectomy often removes functional tissue that may or may not be epileptogenic. Because normal brain does not contain functionless, "silent" areas, the procedure can have negative as well as positive cognitive or behavioral consequences. To improve the outcomes of focal cortical resections for seizure control, we need to better define functional and nociferous cortex and more clearly understand their boundaries and interactions.
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Affiliation(s)
- Orrin Devinsky
- Department of Neurology, New York University School of Medicine, 403 East 34th Street, 4th Floor, New York, NY 10016, USA.
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Bouvier SE, Engel SA. Behavioral Deficits and Cortical Damage Loci in Cerebral Achromatopsia. Cereb Cortex 2005; 16:183-91. [PMID: 15858161 DOI: 10.1093/cercor/bhi096] [Citation(s) in RCA: 199] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Lesions to ventral occipital cortex can produce severe deficits in color vision, a syndrome known as cerebral achromatopsia. Because most studies examine relatively few cases, however, uncertainty remains about precisely which cortical loci, when damaged, produce the syndrome. In addition, the extents of the associated perceptual deficits remain unclear. To address these issues, we performed a meta-analysis of 92 case reports from the literature. The severity of color vision deficits of the cases varied greatly, although nearly all showed some deficit in color discrimination. Almost all cases tested also showed some loss of spatial vision. Lesion overlap analyses revealed a relatively small region of high overlap in ventral occipital cortex. The region of high overlap was located near areas identified by neuroimaging studies as important for color perception. For comparison, we performed a similar analysis of prosopagnosia, a disorder of face perception, and found several regions of high lesion overlap adjacent to the region associated with achromatopsia. Because the behavioral deficits in achromatopsia are often incomplete and never restricted to color vision, the region of high lesion overlap may be one critical stage within a stream of many visual areas that participate nonexclusively in color perception.
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Affiliation(s)
- Seth E Bouvier
- Interdepartmental Program in Neuroscience, University of California at Los Angeles, Los Angeles, CA 90095, USA
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