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Whitworth A. Elizabeth Usher memorial lecture. Models, mind maps, and metacognition: How theory is the true hero. INTERNATIONAL JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2024; 26:304-316. [PMID: 38982689 DOI: 10.1080/17549507.2024.2369146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2024]
Abstract
Within the educational context of identifying the critical ingredients of an effective speech-language pathologist, this paper highlights the centrality of theory in underpinning every level of our practice. A spotlight is placed on us knowing how language and communication work, what makes our interventions work, how we can make the most difference through our choices in therapy, and what makes both us and our clients respond. So, what are the critical ingredients of an effective speech-language pathologist, of an effective therapy, of an effective therapeutic alliance, and why is this so important? While there are many foundational and guiding habits upon which new graduates, early career, and experienced clinicians shape their practice, no one habit is regarded as more important than us exploring the theoretical underpinnings of what we are doing and why. To underscore the role of theory in our everyday practice, a discourse level intervention for people with aphasia is used as an exemplar to track the complex contribution of different theories to a single intervention. Discourse level interventions are relatively new on the scene in the area of acquired language disorders. Child language interventions, on the other hand, have frequently revolved around the story, aiming to bridge the oral-literate divide through the development of narrative structure. This paper will aim to weave its own story around discourse level interventions, combining the narrative genre with the everyday genres used by adults in conversation. I will highlight how this approach taps into lexical theories, sentence processing theories, discourse organisation, and the cognitive underpinnings of language, and closely examine how this multilayering of language in context may hold some of the answers to questions around generalisation, impact, and making the greatest difference to individuals.
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Affiliation(s)
- Anne Whitworth
- Speech Pathology, School of Health Sciences, University of Tasmania, Launceston, Australia
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Rofes A, Piai V. Introduction to the special issue on cognitive neurosurgery. J Neuropsychol 2024; 18 Suppl 1:1-6. [PMID: 38375989 DOI: 10.1111/jnp.12358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2023] [Accepted: 12/26/2023] [Indexed: 02/21/2024]
Affiliation(s)
- Adrià Rofes
- Center for Language and Cognition (CLCG), University of Groningen, Groningen, The Netherlands
- Research School of Behavioral and Cognitive Neurosciences (BCN), University of Groningen, Groningen, The Netherlands
| | - Vitória Piai
- Donders Institute for Brain, Cognition and Behavior, Radboud University, Nijmegen, The Netherlands
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Mettler HM, Alt M, Gray S, Hogan T, Green S, Cowan N. Phonological Working Memory and Sentence Production in School-Age Children with Typical Language, Dyslexia, and Comorbid Dyslexia and Developmental Language Disorder. JOURNAL OF CHILD LANGUAGE 2024; 51:56-90. [PMID: 36259454 PMCID: PMC11290596 DOI: 10.1017/s0305000922000435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
PURPOSE Little is known about the relationship between sentence production and phonological working memory in school-age children. To fill this gap, we examined how strongly these constructs correlate. We also compared diagnostic groups' working memory abilities to see if differences co-occurred with qualitative differences in their sentences. METHOD We conducted Bayesian analyses on data from seven- to nine-year-old children (n = 165 typical language, n = 81 dyslexia-only, n = 43 comorbid dyslexia and developmental language disorder). We correlated sentence production and working memory scores and conducted t tests between groups' working memory scores and sentence length, lexical diversity, and complexity. RESULTS Correlations were positive but weak. The dyslexic and typical groups had dissimilar working memory and comparable sentence quality. The dyslexic and comorbid groups had comparable working memory but dissimilar sentence quality. CONCLUSION Contrary to literature-based predictions, phonological working memory and sentence production are weakly related in school-age children.
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Wang Z, Ficek BN, Webster KT, Herrmann O, Frangakis CE, Desmond JE, Onyike CU, Caffo B, Hillis AE, Tsapkini K. Specificity in Generalization Effects of Transcranial Direct Current Stimulation Over the Left Inferior Frontal Gyrus in Primary Progressive Aphasia. Neuromodulation 2023; 26:850-860. [PMID: 37287321 PMCID: PMC10250817 DOI: 10.1016/j.neurom.2022.09.004] [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: 05/11/2022] [Revised: 08/30/2022] [Accepted: 09/01/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Generalization (or near-transfer) effects of an intervention to tasks not explicitly trained are the most desirable intervention outcomes. However, they are rarely reported and even more rarely explained. One hypothesis for generalization effects is that the tasks improved share the same brain function/computation with the intervention task. We tested this hypothesis in this study of transcranial direct current stimulation (tDCS) over the left inferior frontal gyrus (IFG) that is claimed to be involved in selective semantic retrieval of information from the temporal lobes. MATERIALS AND METHODS In this study, we examined whether tDCS over the left IFG in a group of patients with primary progressive aphasia (PPA), paired with a lexical/semantic retrieval intervention (oral and written naming), may specifically improve semantic fluency, a nontrained near-transfer task that relies on selective semantic retrieval, in patients with PPA. RESULTS Semantic fluency improved significantly more in the active tDCS than in the sham tDCS condition immediately after and two weeks after treatment. This improvement was marginally significant two months after treatment. We also found that the active tDCS effect was specific to tasks that require this IFG computation (selective semantic retrieval) but not to other tasks that may require different computations of the frontal lobes. CONCLUSIONS We provided interventional evidence that the left IFG is critical for selective semantic retrieval, and tDCS over the left IFG may have a near-transfer effect on tasks that depend on the same computation, even if they are not specifically trained. CLINICAL TRIAL REGISTRATION The Clinicaltrials.gov registration number for the study is NCT02606422.
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Affiliation(s)
- Zeyi Wang
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Bronte N Ficek
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Kimberly T Webster
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Olivia Herrmann
- Department of Neurology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Constantine E Frangakis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Radiology, Johns Hopkins Medicine, Baltimore, MD, USA
| | - John E Desmond
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Neuroscience Program, Johns Hopkins University, Baltimore, MD, USA
| | - Chiadi U Onyike
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Brian Caffo
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA
| | - Argye E Hillis
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins Medicine, Baltimore, MD, USA; Department of Physical Medicine & Rehabilitation, Johns Hopkins Medicine, Baltimore, MD, USA
| | - Kyrana Tsapkini
- Department of Biostatistics, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Cognitive Science, Johns Hopkins Medicine, Baltimore, MD, USA.
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Wang Y, Guo S, Wang N, Liu J, Chen F, Zhai Y, Wang Y, Jiao Y, Zhao W, Fan C, Xue Y, Gao G, Ji P, Wang L. The clinical and neurocognitive functional changes with awake brain mapping for gliomas invading eloquent areas: Institutional experience and the utility of The Montreal Cognitive Assessment. Front Oncol 2023; 13:1086118. [PMID: 36910631 PMCID: PMC9992726 DOI: 10.3389/fonc.2023.1086118] [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: 11/01/2022] [Accepted: 02/09/2023] [Indexed: 02/24/2023] Open
Abstract
Objective Awake craniotomy with intraoperative brain functional mapping effectively reduces the potential risk of neurological deficits in patients with glioma invading the eloquent areas. However, glioma patients frequently present with impaired neurocognitive function. The present study aimed to investigate the neurocognitive and functional outcomes of glioma patients after awake brain mapping and assess the experience of a tertiary neurosurgical center in China over eight years. Methods This retrospective study included 80 patients who underwent awake brain mapping for gliomas invading the eloquent cortex between January 2013 and December 2021. Clinical and surgical factors, such as the extent of resection (EOR), perioperative Karnofsky Performance Score (KPS), progression-free survival (PFS), and overall survival (OS), were evaluated. We also used the Montreal Cognitive Assessment (MoCA) to assess the neurocognitive status changes. Results The most frequently observed location of glioma was the frontal lobe (33/80, 41.25%), whereas the tumor primarily invaded the language-related cortex (36/80, 45%). Most patients had supratotal resection (11/80, 13.75%) and total resection (45/80, 56.25%). The median PFS was 43.2 months, and the median OS was 48.9 months in our cohort. The transient (less than seven days) neurological deficit rate was 17.5%, whereas the rate of persistent deficit (lasting for three months) was 15%. At three months of follow-up, most patients (72/80, 90%) had KPS scores > 80. Meanwhile, compared to the preoperative baseline tests, the changes in MoCA scores presented significant improvements at discharge and three months follow-up tests. Conclusion Awake brain mapping is a feasible and safe method for treating glioma invading the eloquent cortex, with the benefit of minimizing neurological deficits, increasing EOR, and extending survival time. The results of MoCA test indicated that brain mapping plays a critical role in preserving neurocognitive function during tumor resection.
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Affiliation(s)
- Yuan Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Shaochun Guo
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Na Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Jinghui Liu
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Fan Chen
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yulong Zhai
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yue Wang
- Department of Health Statistics, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yang Jiao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Wenjian Zhao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Chao Fan
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Yanrong Xue
- National Time Service Center, Chinese Academy of Sciences, Xi'an, Shaanxi, China.,School of Optoelectronics, University of Chinese Academy of Sciences, Beijing, China
| | - GuoDong Gao
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Peigang Ji
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
| | - Liang Wang
- Department of Neurosurgery, Tangdu Hospital, Fourth Military Medical University, Xi'an, Shaanxi, China
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Le Lann F, Cristante J, De Schlichting E, Quehan R, Réhault E, Lotterie JA, Roux FE. Variability of Intraoperative Electrostimulation Parameters in Conscious Individuals: Language Fasciculi. World Neurosurg 2022; 164:e194-e202. [PMID: 35472645 DOI: 10.1016/j.wneu.2022.04.066] [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: 02/17/2022] [Accepted: 04/18/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The authors analyzed the current-intensity thresholds for electrostimulation of language fasciculi and the possible consequences of threshold variability on brain mapping. METHODS A prospective protocol of subcortical electrostimulation was used in 50 patients undergoing brain mapping, directly stimulating presumed language fasciculi identified by diffusion tensor imaging. RESULTS The stimulation-intensity thresholds for identification of language fasciculi varied among patients (mean minimum current intensity of 4.4 mA, range = 1.5-10 mA, standard deviation = 1.1 mA), and 23% of fascicular interferences were detected only above 5 mA. Repeated stimulation of the same site with the same intensity led to different types of interferences in 20% of patients, and a higher current intensity led to changes in the type of response in 27%. The mean minimum stimulation intensities did not differ significantly between different fasciculi, between the different types of interference obtained, or with age, sex, or type of tumor. Positive results on cortical mapping were significantly associated with positive results on subcortical mapping (P < 0.001). Subcortical intensity thresholds were slightly lower than cortical ones (mean = 4.43 vs. 5.25 mA, P = 0.034). In 23 of 50 subcortical mappings, fascicular stimulation produced no language interference. CONCLUSIONS Individual variability of minimum stimulation-intensity thresholds for identification of language fasciculi is frequent. Nevertheless, even when a high current intensity was used, many stimulations on language fasciculi remained negative for various hypothetic reasons. Finding the optimal current intensity for identifying language fasciculi is of paramount importance to refine the clinical results and scientific data derived from brain mapping.
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Affiliation(s)
- Florian Le Lann
- Pole Neurosciences (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Université de Toulouse, UPS, Toulouse, France.
| | | | - Emmanuel De Schlichting
- Université Grenoble Alpes, Faculté de Médecine, Grenoble, France; Neurochirurgie, Centre Hospitalo-Universitaire de Grenoble, Toulouse, France
| | - Romain Quehan
- Pole Neurosciences (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Université de Toulouse, UPS, Toulouse, France
| | - Emilie Réhault
- Pole Neurosciences (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse, Toulouse, France
| | - Jean-Albert Lotterie
- Pole Neurosciences (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Université de Toulouse, UPS, Toulouse, France
| | - Franck-Emmanuel Roux
- Pole Neurosciences (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse, Toulouse, France; Université de Toulouse, UPS, Toulouse, France; Centre de Recherche Cerveau et Cognition (CNRS; CerCo), Toulouse, France
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Elin K, Malyutina S, Bronov O, Stupina E, Marinets A, Zhuravleva A, Dragoy O. A New Functional Magnetic Resonance Imaging Localizer for Preoperative Language Mapping Using a Sentence Completion Task: Validity, Choice of Baseline Condition, and Test–Retest Reliability. Front Hum Neurosci 2022; 16:791577. [PMID: 35431846 PMCID: PMC9006995 DOI: 10.3389/fnhum.2022.791577] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
To avoid post-neurosurgical language deficits, intraoperative mapping of the language function in the brain can be complemented with preoperative mapping with functional magnetic resonance imaging (fMRI). The validity of an fMRI “language localizer” paradigm crucially depends on the choice of an optimal language task and baseline condition. This study presents a new fMRI “language localizer” in Russian using overt sentence completion, a task that comprehensively engages the language function by involving both production and comprehension at the word and sentence level. The paradigm was validated in 18 neurologically healthy volunteers who participated in two scanning sessions, for estimating test–retest reliability. For the first time, two baseline conditions for the sentence completion task were compared. At the group level, the paradigm significantly activated both anterior and posterior language-related regions. Individual-level analysis showed that activation was elicited most consistently in the inferior frontal regions, followed by posterior temporal regions and the angular gyrus. Test–retest reliability of activation location, as measured by Dice coefficients, was moderate and thus comparable to previous studies. Test–retest reliability was higher in the frontal than temporo-parietal region and with the most liberal statistical thresholding compared to two more conservative thresholding methods. Lateralization indices were expectedly left-hemispheric, with greater lateralization in the frontal than temporo-parietal region, and showed moderate test-retest reliability. Finally, the pseudoword baseline elicited more extensive and more reliable activation, although the syllable baseline appears more feasible for future clinical use. Overall, the study demonstrated the validity and reliability of the sentence completion task for mapping the language function in the brain. The paradigm needs further validation in a clinical sample of neurosurgical patients. Additionally, the study contributes to general evidence on test–retest reliability of fMRI.
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Affiliation(s)
- Kirill Elin
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Svetlana Malyutina
- Center for Language and Brain, HSE University, Moscow, Russia
- *Correspondence: Svetlana Malyutina,
| | - Oleg Bronov
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | | | - Aleksei Marinets
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | - Anna Zhuravleva
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russia
- Institute of Linguistics, Russian Academy of Sciences, Moscow, Russia
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Tackling the Complexity of Lesion-Symptoms Mapping: How to Bridge the Gap Between Data Scientists and Clinicians? ACTA NEUROCHIRURGICA. SUPPLEMENT 2021; 134:195-203. [PMID: 34862543 DOI: 10.1007/978-3-030-85292-4_23] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Accurate and predictive lesion-symptoms mapping is a major goal in the field of clinical neurosciences. Recent studies have called for a reappraisal of the results given by the standard univariate voxel-based lesion-symptom mapping technique, emphasizing the need of developing multivariate methods. While the organization of large datasets and their analysis with machine learning (ML) approaches represents an opportunity to increase prediction accuracy, the complexity and dimensionality of the problem remain a major obstacle. Acknowledging the difficulty of inferring individual outcomes from the observation of spatial patterns of lesions, we propose here to base prediction on new individuals on models of brain connectivity, whereby the disruption of a given network predicts the occurrence of selective deficits. Well-suited ML tools are necessary to capture the relevant information from limited datasets and perform reliable inference.
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Aabedi AA, Kakaizada S, Young JS, Ahn E, Weissman DH, Berger MS, Brang D, Hervey-Jumper SL. Balancing task sensitivity with reliability for multimodal language assessments. J Neurosurg 2021; 135:1817-1824. [PMID: 34049284 PMCID: PMC10404475 DOI: 10.3171/2020.10.jns202947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 10/21/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Intraoperative tasks for awake language mapping are typically selected based on the language tracts that will likely be encountered during tumor resection. However, diminished attention and arousal secondary to perioperative sedatives may reduce a task's usefulness for identifying eloquent cortex. For instance, accuracy in performing select language tasks may be high preoperatively but decline in the operating room. In the present study, the authors sought to identify language tasks that can be performed with high accuracy in both situational contexts so the neurosurgical team can be confident that speech errors committed during awake language mapping result from direct cortical stimulation to eloquent cortex, rather than from poor performance in general. METHODS We administered five language tasks to 44 patients: picture naming (PN), text reading (TR), auditory object naming (AN), repetition of 4-syllable words (4SYL), and production of syntactically intact sentences (SYNTAX). Performance was assessed using the 4-point scale of the quick aphasia battery 24 hours preoperatively and intraoperatively. We next determined whether or not accuracy on each task was higher preoperatively than intraoperatively. We also determined whether 1) intraoperative accuracy on a given task predicted intraoperative performance on the other tasks and 2) low preoperative accuracy on a task predicted a decrease in accuracy intraoperatively. RESULTS Relative to preoperative accuracy, intraoperative accuracy declined on PN (3.90 vs 3.82, p = 0.0001), 4SYL (3.96 vs 3.91, p = 0.0006), and SYNTAX (3.85 vs 3.67, p = 0.0001) but not on TR (3.96 vs 3.94, p = 0.13) or AN (3.70 vs 3.58, p = 0.058). Intraoperative accuracy on PN and AN independently predicted intraoperative accuracy on the remaining language tasks (p < 0.001 and p < 0.01, respectively). Finally, low preoperative accuracy on SYNTAX predicted a decrease in accuracy on this task intraoperatively (R2 = 0.36, p = 0.00002). CONCLUSIONS While TR lacks sensitivity in identifying language deficits at baseline, accuracy on TR is stable across testing settings. Baseline accuracy on the other four of our five language tasks was not predictive of intraoperative performance, signifying the need to repeat language tests prior to stimulation mapping to confirm reliability.
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Affiliation(s)
- Alexander A. Aabedi
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Sofia Kakaizada
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Jacob S. Young
- Department of Neurological Surgery, University of California, San Francisco, California
| | - EunSeon Ahn
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
| | | | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, California
| | - David Brang
- Department of Psychology, University of Michigan, Ann Arbor, Michigan
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Ntemou E, Ohlerth AK, Ille S, Krieg SM, Bastiaanse R, Rofes A. Mapping Verb Retrieval With nTMS: The Role of Transitivity. Front Hum Neurosci 2021; 15:719461. [PMID: 34539364 PMCID: PMC8442843 DOI: 10.3389/fnhum.2021.719461] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 07/31/2021] [Indexed: 11/25/2022] Open
Abstract
Navigated Transcranial Magnetic Stimulation (nTMS) is used to understand the cortical organization of language in preparation for the surgical removal of a brain tumor. Action naming with finite verbs can be employed for that purpose, providing additional information to object naming. However, little research has focused on the properties of the verbs that are used in action naming tasks, such as their status as transitive (taking an object; e.g., to read) or intransitive (not taking an object; e.g., to wink). Previous neuroimaging data show higher activation for transitive compared to intransitive verbs in posterior perisylvian regions bilaterally. In the present study, we employed nTMS and production of finite verbs to investigate the cortical underpinnings of transitivity. Twenty neurologically healthy native speakers of German participated in the study. They underwent language mapping in both hemispheres with nTMS. The action naming task with finite verbs consisted of transitive (e.g., The man reads the book) and intransitive verbs (e.g., The woman winks) and was controlled for relevant psycholinguistic variables. Errors were classified in four different error categories (i.e., non-linguistic errors, grammatical errors, lexico-semantic errors and, errors at the sound level) and were analyzed quantitatively. We found more nTMS-positive points in the left hemisphere, particularly in the left parietal lobe for the production of transitive compared to intransitive verbs. These positive points most commonly corresponded to lexico-semantic errors. Our findings are in line with previous aphasia and neuroimaging studies, suggesting that a more widespread network is used for the production of verbs with a larger number of arguments (i.e., transitives). The higher number of lexico-semantic errors with transitive compared to intransitive verbs in the left parietal lobe supports previous claims for the role of left posterior areas in the retrieval of argument structure information.
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Affiliation(s)
- Effrosyni Ntemou
- International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, Trento and Macquarie University), Sydney, NSW, Australia.,Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
| | - Ann-Katrin Ohlerth
- International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, Trento and Macquarie University), Sydney, NSW, Australia.,Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum Rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Roelien Bastiaanse
- Center for Language and Brain, National Research University Higher School of Economics, Moscow, Russia
| | - Adrià Rofes
- Centre for Language and Cognition Groningen (CLCG), University of Groningen, Groningen, Netherlands
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van der Linden SD, Rutten GJM, Dirven L, Taphoorn MJB, Satoer DD, Dirven CMF, Sitskoorn MM, Gehring K. eHealth cognitive rehabilitation for brain tumor patients: results of a randomized controlled trial. J Neurooncol 2021; 154:315-326. [PMID: 34487313 PMCID: PMC8484142 DOI: 10.1007/s11060-021-03828-1] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 08/12/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Evidence-based cognitive rehabilitation programs for brain tumor patients are not widely available, despite the high need. We aimed to evaluate the effects of a tablet-based cognitive rehabilitation program on cognitive performance, cognitive complaints, fatigue, and psychological distress in primary brain tumor patients following neurosurgery. Also, attrition, adherence and patient satisfaction with the program were evaluated. METHODS Adults with presumed low-grade glioma and meningioma were recruited before surgery. Three months thereafter, participants were allocated to the intervention group or waiting-list control group using minimization. The 10-week eHealth app ReMind, based on the effective face-to-face intervention, consisted of psychoeducation, strategy-training and attention retraining. Performance-based cognitive outcomes and patient-reported outcomes were assessed before surgery and 3, 6 and 12 months thereafter. Mean scores, percentages of cognitively impaired individuals and reliable change indices (RCIs) were compared between groups. RESULTS Sixty-two out of 183 eligible patients were randomized. Of the people who declined, 56% reported that participation would to be too burdensome. All participants found a tablet-app suitable for delivery of cognitive rehabilitation and 90% rated the program as "good" or "excellent". Performance-based cognitive outcomes and patient-reported outcomes did not significantly differ in group means over time nor RCIs between the intervention (final n = 20) and control group (final n = 25). CONCLUSIONS Recruitment at this early stage was difficult, resulting in limited statistical power. No significant effects were demonstrated, while adherence and satisfaction with the eHealth program were good. In clinical practice, ReMind may be helpful, if timing would be adapted to patients' needs.
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Affiliation(s)
- Sophie D van der Linden
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands.,Department of Cognitive Neuropsychology, Tilburg University, Room S219, P.O. Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Geert-Jan M Rutten
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands
| | - Linda Dirven
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Martin J B Taphoorn
- Department of Neurology, Leiden University Medical Center, Leiden, the Netherlands.,Department of Neurology, Haaglanden Medical Center, The Hague, the Netherlands
| | - Djaina D Satoer
- Department of Neurosurgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Clemens M F Dirven
- Department of Neurosurgery, Erasmus Medical Center, Rotterdam, the Netherlands
| | - Margriet M Sitskoorn
- Department of Cognitive Neuropsychology, Tilburg University, Room S219, P.O. Box 90153, 5000 LE, Tilburg, the Netherlands
| | - Karin Gehring
- Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, the Netherlands. .,Department of Cognitive Neuropsychology, Tilburg University, Room S219, P.O. Box 90153, 5000 LE, Tilburg, the Netherlands.
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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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13
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Baro V, Caliri S, Sartori L, Facchini S, Guarrera B, Zangrossi P, Anglani M, Denaro L, d’Avella D, Ferreri F, Landi A. Preoperative Repetitive Navigated TMS and Functional White Matter Tractography in a Bilingual Patient with a Brain Tumor in Wernike Area. Brain Sci 2021; 11:brainsci11050557. [PMID: 33924964 PMCID: PMC8145512 DOI: 10.3390/brainsci11050557] [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: 03/15/2021] [Revised: 04/23/2021] [Accepted: 04/26/2021] [Indexed: 01/10/2023] Open
Abstract
Awake surgery and intraoperative neuromonitoring represent the gold standard for surgery of lesion located in language-eloquent areas of the dominant hemisphere, enabling the maximal safe resection while preserving language function. Nevertheless, this functional mapping is invasive; it can be executed only during surgery and in selected patients. Moreover, the number of neuro-oncological bilingual patients is constantly growing, and performing awake surgery in this group of patients can be difficult. In this scenario, the application of accurate, repeatable and non-invasive preoperative mapping procedures is needed, in order to define the anatomical distribution of both languages. Repetitive navigated transcranial magnetic stimulation (rnTMS) associated with functional subcortical fiber tracking (nTMS-based DTI-FT) represents a promising and comprehensive mapping tool to display language pathway and function reorganization in neurosurgical patients. Herein we report a case of a bilingual patient affected by brain tumor in the left temporal lobe, who underwent rnTMS mapping for both languages (Romanian and Italian), disclosing the true eloquence of the anterior part of the lesion in both tests. After surgery, language abilities were intact at follow-up in both languages. This case represents a preliminary application of nTMS-based DTI-FT in neurosurgery for brain tumor in eloquent areas in a bilingual patient.
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Affiliation(s)
- Valentina Baro
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
- Correspondence:
| | - Samuel Caliri
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | - Luca Sartori
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | - Silvia Facchini
- Department of Neuroscience DNS, University of Padova, 35128 Padova, Italy;
| | - Brando Guarrera
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | - Pietro Zangrossi
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | | | - Luca Denaro
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | - Domenico d’Avella
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
| | - Florinda Ferreri
- Unit of Neurology and Neurophysiology, Department of Neuroscience, University of Padova, 35128 Padova, Italy;
| | - Andrea Landi
- Academic Neurosurgery, Department of Neuroscience, University of Padova, 35128 Padova, Italy; (S.C.); (L.S.); (B.G.); (P.Z.); (L.D.); (D.d.); (A.L.)
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14
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Gobbo M, De Pellegrin S, Bonaudo C, Semenza C, Della Puppa A, Salillas E. Two dissociable semantic mechanisms predict naming errors and their responsive brain sites in awake surgery. DO80 revisited. Neuropsychologia 2020; 151:107727. [PMID: 33338472 DOI: 10.1016/j.neuropsychologia.2020.107727] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 11/29/2022]
Abstract
How do we choose words, and what affects the selection of a specific term? Naming tests such as the DO80 are frequently used to assess language function during brain mapping in awake surgery. The present study aimed to explore whether specific semantic errors become more probable under the stimulation of specific brain areas. Moreover, it meant to determine whether specific semantic characteristics of the items may evoke specific types of error. A corpus-based qualitative semantic analysis of the DO80 items, and the emitted naming errors to those items during direct cortical electrostimulation (DCE) revealed that the number of hyperonyms (i.e. 'vehicle' for car') of an item predicted the emission of a synonym ('automobile' for 'car'). This association occurred mainly in frontal tumor patients, which was corroborated by behavior to lesion analyses. In contrast, the emission of co-hyponyms was associated with tumors located in temporal areas. These two behavior-lesion associations thus dissociated, and were also dependent on item semantic characteristics. Co-hyponym errors might generate from the disruption in a temporal semantic-to-lexical process, and the production of synonyms could be the result of an impairment in a frontal lexical-selection mechanism. A hypothesis on the lexical selection mechanisms exerted by the inferior frontal gyrus is proposed. Crucially, the present data suggest the need for more restrictive naming tasks, with items conditioned by tumor location.
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Affiliation(s)
- Marika Gobbo
- UOC Neurologic Clinic, University Hospital of Padova, Padova, Italy.
| | | | - Camilla Bonaudo
- Neurosurgery, Department of NEUROFARBA, University Hospital of Careggi, University of Florence, Florence, Italy
| | - Carlo Semenza
- Department of Neurosciences, University of Padova, Padova, Italy; IRCCS San Camillo Hospital, Venice, Italy
| | - Alessandro Della Puppa
- Neurosurgery, Department of NEUROFARBA, University Hospital of Careggi, University of Florence, Florence, Italy
| | - Elena Salillas
- Department of Neurosciences, University of Padova, Padova, Italy.
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15
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Ehlen F, Roepke S, Klostermann F, Baskow I, Geise P, Belica C, Tiedt HO, Behnia B. Small Semantic Networks in Individuals with Autism Spectrum Disorder Without Intellectual Impairment: A Verbal Fluency Approach. J Autism Dev Disord 2020; 50:3967-3987. [PMID: 32198662 PMCID: PMC7560923 DOI: 10.1007/s10803-020-04457-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Individuals with Autism Spectrum Disorder (ASD) experience a variety of symptoms sometimes including atypicalities in language use. The study explored differences in semantic network organisation of adults with ASD without intellectual impairment. We assessed clusters and switches in verbal fluency tasks ('animals', 'human feature', 'verbs', 'r-words') via curve fitting in combination with corpus-driven analysis of semantic relatedness and evaluated socio-emotional and motor action related content. Compared to participants without ASD (n = 39), participants with ASD (n = 32) tended to produce smaller clusters, longer switches, and fewer words in semantic conditions (no p values survived Bonferroni-correction), whereas relatedness and content were similar. In ASD, semantic networks underlying cluster formation appeared comparably small without affecting strength of associations or content.
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Affiliation(s)
- Felicitas Ehlen
- Department of Neurology, Motor and Cognition Group, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany.
- Department of Psychiatry, Jüdisches Krankenhaus Berlin, Heinz-Galinski-Straße 1, 13347, Berlin, Germany.
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany.
| | - Stefan Roepke
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
| | - Fabian Klostermann
- Department of Neurology, Motor and Cognition Group, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität Zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Irina Baskow
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
- Department of Psychology, Humboldt-Universität Zu Berlin, Unter den Linden 6, 10099, Berlin, Germany
| | - Pia Geise
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
- Universität Potsdam, Am Neuen Palais 10, 14469, Potsdam, Germany
| | - Cyril Belica
- Department of Digital Linguistics, Leibniz-Institut für Deutsche Sprache, R5, 6-13, 68161, Mannheim, Germany
| | - Hannes Ole Tiedt
- Department of Neurology, Motor and Cognition Group, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
| | - Behnoush Behnia
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Campus Benjamin Franklin (CBF), Hindenburgdamm 30, 12203, Berlin, Germany
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16
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Jeltema HR, Ohlerth AK, de Wit A, Wagemakers M, Rofes A, Bastiaanse R, Drost G. Comparing navigated transcranial magnetic stimulation mapping and "gold standard" direct cortical stimulation mapping in neurosurgery: a systematic review. Neurosurg Rev 2020; 44:1903-1920. [PMID: 33009990 PMCID: PMC8338816 DOI: 10.1007/s10143-020-01397-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/05/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
The objective of this systematic review is to create an overview of the literature on the comparison of navigated transcranial magnetic stimulation (nTMS) as a mapping tool to the current gold standard, which is (intraoperative) direct cortical stimulation (DCS) mapping. A search in the databases of PubMed, EMBASE, and Web of Science was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendations were used. Thirty-five publications were included in the review, describing a total of 552 patients. All studies concerned either mapping of motor or language function. No comparative data for nTMS and DCS for other neurological functions were found. For motor mapping, the distances between the cortical representation of the different muscle groups identified by nTMS and DCS varied between 2 and 16 mm. Regarding mapping of language function, solely an object naming task was performed in the comparative studies on nTMS and DCS. Sensitivity and specificity ranged from 10 to 100% and 13.3–98%, respectively, when nTMS language mapping was compared with DCS mapping. The positive predictive value (PPV) and negative predictive value (NPV) ranged from 17 to 75% and 57–100% respectively. The available evidence for nTMS as a mapping modality for motor and language function is discussed.
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Affiliation(s)
- Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Aranka de Wit
- Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Adrià Rofes
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands.,Center for Language and Brain, National Research University, Higher School of Economics, Moscow, Russian Federation
| | - Gea Drost
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
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17
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Fromm O, Klostermann F, Ehlen F. A Vector Space Model for Neural Network Functions: Inspirations From Similarities Between the Theory of Connectivity and the Logarithmic Time Course of Word Production. Front Syst Neurosci 2020; 14:58. [PMID: 32982704 PMCID: PMC7485382 DOI: 10.3389/fnsys.2020.00058] [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: 04/27/2020] [Accepted: 07/21/2020] [Indexed: 11/13/2022] Open
Abstract
The present report examines the coinciding results of two study groups each presenting a power-of-two function to describe network structures underlying perceptual processes in one case and word production during verbal fluency tasks in the other. The former is theorized as neural cliques organized according to the function N = 2 i - 1, whereas the latter assumes word conglomerations thinkable as tuples following the function N = 2 i . Both theories assume the innate optimization of energy efficiency to cause the specific connectivity structure. The vast resemblance between both formulae motivated the development of a common formulation. This was obtained by using a vector space model, in which the configuration of neural cliques or connected words is represented by a N-dimensional state vector. A further analysis of the model showed that the entire time course of word production could be derived using basically one single minimal transformation-matrix. This again seems in line with the principle of maximum energy efficiency.
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Affiliation(s)
- Ortwin Fromm
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Fabian Klostermann
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Felicitas Ehlen
- Motor and Cognition Group, Department of Neurology, Charité - Universitätsmedizin Berlin, Berlin, Germany.,Department of Psychiatry, Jüdisches Krankenhaus Berlin, Berlin, Germany
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18
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Perrone-Bertolotti M, Alexandre S, Jobb AS, De Palma L, Baciu M, Mairesse MP, Hoffmann D, Minotti L, Kahane P, David O. Probabilistic mapping of language networks from high frequency activity induced by direct electrical stimulation. Hum Brain Mapp 2020; 41:4113-4126. [PMID: 32697353 PMCID: PMC7469846 DOI: 10.1002/hbm.25112] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 05/28/2020] [Accepted: 06/02/2020] [Indexed: 11/29/2022] Open
Abstract
Direct electrical stimulation (DES) at 50 Hz is used as a gold standard to map cognitive functions but little is known about its ability to map large‐scale networks and specific subnetwork. In the present study, we aim to propose a new methodological approach to evaluate the specific hypothesis suggesting that language errors/dysfunction induced by DES are the result of large‐scale network modification rather than of a single cortical region, which explains that similar language symptoms may be observed after stimulation of different cortical regions belonging to this network. We retrospectively examined 29 patients suffering from focal drug‐resistant epilepsy who benefitted from stereo‐electroencephalographic (SEEG) exploration and exhibited language symptoms during a naming task following 50 Hz DES. We assessed the large‐scale language network correlated with behavioral DES‐induced responses (naming errors) by quantifying DES‐induced changes in high frequency activity (HFA, 70–150 Hz) outside the stimulated cortical region. We developed a probabilistic approach to report the spatial pattern of HFA modulations during DES‐induced language errors. Similarly, we mapped the pattern of after‐discharges (3–35 Hz) occurring after DES. HFA modulations concurrent to language symptoms revealed a brain network similar to our current knowledge of language gathered from standard brain mapping. In addition, specific subnetworks could be identified within the global language network, related to different language processes, generally described in relation to the classical language regions. Spatial patterns of after‐discharges were similar to HFA induced during DES. Our results suggest that this new methodological DES‐HFA mapping is a relevant approach to map functional networks during SEEG explorations, which would allow to shift from “local” to “network” perspectives.
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Affiliation(s)
- Marcela Perrone-Bertolotti
- CNRC, Laboratoire de Psychologie et NeuroCognition, University of Grenoble Alpes, University of Savoie Mont Blanc, Grenoble, France.,Institut Universitaire de, Paris, France
| | - Sarah Alexandre
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France
| | - Anne-Sophie Jobb
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Luca De Palma
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France
| | - Monica Baciu
- CNRC, Laboratoire de Psychologie et NeuroCognition, University of Grenoble Alpes, University of Savoie Mont Blanc, Grenoble, France.,Institut Universitaire de, Paris, France
| | | | | | - Lorella Minotti
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Philippe Kahane
- CHU Grenoble Alpes, Pôle Neurologie Psychiatrie, Grenoble, France.,University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
| | - Olivier David
- University of Grenoble Alpes, Grenoble Institut Neurosciences, GIN, Grenoble, France.,Inserm, Grenoble, France
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19
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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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20
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Chernoff BL, Sims MH, Smith SO, Pilcher WH, Mahon BZ. Direct electrical stimulation of the left frontal aslant tract disrupts sentence planning without affecting articulation. Cogn Neuropsychol 2019; 36:178-192. [PMID: 31210568 PMCID: PMC6744286 DOI: 10.1080/02643294.2019.1619544] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2018] [Revised: 02/22/2019] [Accepted: 04/26/2019] [Indexed: 10/26/2022]
Abstract
Sentence production involves mapping from deep structures that specify meaning and thematic roles to surface structures that specify the order and sequencing of production ready elements. We propose that the frontal aslant tract is a key pathway for sequencing complex actions with deep hierarchical structure. In the domain of language, and primarily with respect to the left FAT, we refer to this as the 'Syntagmatic Constraints On Positional Elements' (SCOPE) hypothesis. One prediction made by the SCOPE hypothesis is that disruption of the frontal aslant tract should disrupt sentence production at grammatical phrase boundaries, with no disruption of articulatory processes. We test this prediction in a patient undergoing direct electrical stimulation mapping of the frontal aslant tract during an awake craniotomy to remove a left frontal brain tumor. We found that stimulation of the left FAT prolonged inter-word durations at the start of grammatical phrases, while inter-word durations internal to noun phrases were unaffected, and there was no effect on intra-word articulatory duration. These results provide initial support for the SCOPE hypothesis, and motivate novel directions for future research to explore the functions of this recently discovered component of the language system.
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Affiliation(s)
| | - Max H. Sims
- Department of Neurology, University of Rochester, USA
| | - Susan O. Smith
- Department of Neurosurgery, University of Rochester Medical Center, USA
| | | | - Bradford Z. Mahon
- Department of Psychology, Carnegie Mellon University, USA
- Department of Neurology, University of Rochester, USA
- Department of Neurosurgery, University of Rochester Medical Center, USA
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21
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Mahon BZ, Miozzo M, Pilcher WH. Direct electrical stimulation mapping of cognitive functions in the human brain. Cogn Neuropsychol 2019; 36:97-102. [PMID: 31514643 DOI: 10.1080/02643294.2019.1630375] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 05/30/2019] [Accepted: 06/05/2019] [Indexed: 10/26/2022]
Abstract
Direct electrical stimulation (DES) is a well-established clinical tool for mapping cognitive functions while patients are undergoing awake neurosurgery or invasive long-term monitoring to identify epileptogenic tissue. Despite the proliferation of a range of invasive and noninvasive methods for mapping sensory, motor and cognitive processes in the human brain, DES remains the clinical gold standard for establishing the margins of brain tissue that can be safely removed while avoiding long-term neurological deficits. In parallel, and principally over the last two decades, DES has emerged as a powerful scientific tool for testing hypotheses of brain organization and mechanistic hypotheses of cognitive function. DES can cause transient "lesions" and thus can support causal inferences about the necessity of stimulated brain regions for specific functions, as well as the separability of sensory, motor and cognitive processes. This Special Issue of Cognitive Neuropsychology emphasizes the use of DES as a research tool to advance understanding of normal brain organization and function.
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Affiliation(s)
- Bradford Z Mahon
- Department of Psychology, Carnegie Mellon University , Pittsburgh , PA , USA
- Department of Neurosurgery, University of Rochester Medical Center , Rochester , NY , USA
- Department of Neurology, University of Rochester Medical Center , Rochester , NY , USA
- Carnegie Mellon Neuroscience Institute, Carnegie Mellon University , Pittsburgh , PA , USA
- Department of Neurological Surgery, University of Pittsburgh Medical Center , Pittsburgh , PA , USA
| | - Michele Miozzo
- Department of Psychology, The New School , New York , NY , USA
| | - Webster H Pilcher
- Department of Neurosurgery, University of Rochester Medical Center , Rochester , NY , USA
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22
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Mazurek KA, Schieber MH. How is electrical stimulation of the brain experienced, and how can we tell? Selected considerations on sensorimotor function and speech. Cogn Neuropsychol 2019; 36:103-116. [PMID: 31076014 PMCID: PMC6744321 DOI: 10.1080/02643294.2019.1609918] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2018] [Revised: 04/14/2019] [Accepted: 04/15/2019] [Indexed: 01/05/2023]
Abstract
Electrical stimulation of the nervous system is a powerful tool for localizing and examining the function of numerous brain regions. Delivered to certain regions of the cerebral cortex, electrical stimulation can evoke a variety of first-order effects, including observable movements or an urge to move, or somatosensory, visual, or auditory percepts. In still other regions the subject may be oblivious to the stimulation. Often overlooked, however, is whether the subject is aware of the stimulation, and if so, how the stimulation is experienced by the subject. In this review of how electrical stimulation has been used to study selected aspects of sensorimotor and language function, we raise questions that future studies might address concerning the subjects' second-order experiences of intention and agency regarding evoked movements, of the naturalness of evoked sensory percepts, and of other qualia that might be evoked in the absence of an overt first-order experience.
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Affiliation(s)
- Kevin A. Mazurek
- Department of Neurology, University of Rochester, Rochester, NY
- Del Monte Institute for Neuroscience, University of Rochester, Rochester, NY
| | - Marc H. Schieber
- Department of Neurology, University of Rochester, Rochester, NY
- Department of Neuroscience, University of Rochester, Rochester, NY
- Department of Biomedical Engineering, University of Rochester, Rochester, NY
- Del Monte Institute for Neuroscience, University of Rochester, Rochester, NY
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