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Castellucci GA, Kovach CK, Tabasi F, Christianson D, Greenlee JDW, Long MA. Stimulation of caudal inferior and middle frontal gyri disrupts planning during spoken interaction. Curr Biol 2024; 34:2719-2727.e5. [PMID: 38823382 PMCID: PMC11187660 DOI: 10.1016/j.cub.2024.04.080] [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: 01/20/2024] [Revised: 03/06/2024] [Accepted: 04/30/2024] [Indexed: 06/03/2024]
Abstract
Turn-taking is a central feature of conversation across languages and cultures.1,2,3,4 This key social behavior requires numerous sensorimotor and cognitive operations1,5,6 that can be organized into three general phases: comprehension of a partner's turn, preparation of a speaker's own turn, and execution of that turn. Using intracranial electrocorticography, we recently demonstrated that neural activity related to these phases is functionally distinct during turn-taking.7 In particular, networks active during the perceptual and articulatory stages of turn-taking consisted of structures known to be important for speech-related sensory and motor processing,8,9,10,11,12,13,14,15,16,17 while putative planning dynamics were most regularly observed in the caudal inferior frontal gyrus (cIFG) and the middle frontal gyrus (cMFG). To test if these structures are necessary for planning during spoken interaction, we used direct electrical stimulation (DES) to transiently perturb cortical function in neurosurgical patient-volunteers performing a question-answer task.7,18,19 We found that stimulating the cIFG and cMFG led to various response errors9,13,20,21 but not gross articulatory deficits, which instead resulted from DES of structures involved in motor control8,13,20,22 (e.g., the precentral gyrus). Furthermore, perturbation of the cIFG and cMFG delayed inter-speaker timing-consistent with slowed planning-while faster responses could result from stimulation of sites located in other areas. Taken together, our findings suggest that the cIFG and cMFG contain critical preparatory circuits that are relevant for interactive language use.
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Affiliation(s)
- Gregg A Castellucci
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY 10016, USA; Center for Neural Science, New York University, New York, NY 10003, USA
| | - Christopher K Kovach
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - Farhad Tabasi
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - David Christianson
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA
| | - Jeremy D W Greenlee
- Department of Neurosurgery, University of Iowa Hospitals and Clinics, Iowa City, IA 52242, USA; Iowa Neuroscience Institute, Iowa City, IA 52242, USA
| | - Michael A Long
- NYU Neuroscience Institute and Department of Otolaryngology, New York University Langone Medical Center, New York, NY 10016, USA; Center for Neural Science, New York University, New York, NY 10003, USA.
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Matoba K, Matsumoto R, Shimotake A, Nakae T, Imamura H, Togo M, Yamao Y, Usami K, Kikuchi T, Yoshida K, Matsuhashi M, Kunieda T, Miyamoto S, Takahashi R, Ikeda A. Basal temporal language area revisited in Japanese language with a language function density map. Cereb Cortex 2024; 34:bhae218. [PMID: 38858838 DOI: 10.1093/cercor/bhae218] [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: 04/14/2023] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
We revisited the anatomo-functional characteristics of the basal temporal language area (BTLA), first described by Lüders et al. (1986), using electrical cortical stimulation (ECS) in the context of Japanese language and semantic networks. We recruited 11 patients with focal epilepsy who underwent chronic subdural electrode implantation and ECS mapping with multiple language tasks for presurgical evaluation. A semiquantitative language function density map delineated the anatomo-functional characteristics of the BTLA (66 electrodes, mean 3.8 cm from the temporal tip). The ECS-induced impairment probability was higher in the following tasks, listed in a descending order: spoken-word picture matching, picture naming, Kanji word reading, paragraph reading, spoken-verbal command, and Kana word reading. The anterior fusiform gyrus (FG), adjacent anterior inferior temporal gyrus (ITG), and the anterior end where FG and ITG fuse, were characterized by stimulation-induced impairment during visual and auditory tasks requiring verbal output or not, whereas the middle FG was characterized mainly by visual input. The parahippocampal gyrus was the least impaired of the three gyri in the basal temporal area. We propose that the BTLA has a functional gradient, with the anterior part involved in amodal semantic processing and the posterior part, especially the middle FG in unimodal semantic processing.
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Affiliation(s)
- Kento Matoba
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takuro Nakae
- Department of Neurosurgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga 524-0022, Japan
| | - Hisaji Imamura
- Department of Neurology, Fukui Red Cross Hospital, 2-4-1, Tsukimi, Fukui, 918-8011, Japan
| | - Masaya Togo
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kiyohide Usami
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Hageboutros K, Hewitt KC, Lee GP, Bansal A, Block C, Pedersen NP, Willie JT, Loring DW, Schoenberg MR, Smith KA, Giller CA, Gross RE, Drane DL. Comparison of minimally invasive to standard temporal lobectomy approaches to epilepsy surgery: Seizure relief and visual confrontation naming outcomes. Epilepsy Behav 2024; 155:109669. [PMID: 38663142 DOI: 10.1016/j.yebeh.2024.109669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/05/2024] [Accepted: 01/23/2024] [Indexed: 05/28/2024]
Abstract
The purpose of this study was to systematically examine three different surgical approaches in treating left medial temporal lobe epilepsy (mTLE) (viz., subtemporal selective amygdalohippocampectomy [subSAH], stereotactic laser amygdalohippocampotomy [SLAH], and anterior temporal lobectomy [ATL]), to determine which procedures are most favorable in terms of visual confrontation naming and seizure relief outcome. This was a retrospective study of 33 adults with intractable mTLE who underwent left temporal lobe surgery at three different epilepsy surgery centers who also underwent pre-, and at least 6-month post-surgical neuropsychological testing. Measures included the Boston Naming Test (BNT) and the Engel Epilepsy Surgery Outcome Scale. Fisher's exact tests revealed a statistically significant decline in naming in ATLs compared to SLAHs, but no other significant group differences. 82% of ATL and 36% of subSAH patients showed a significant naming decline whereas no SLAH patient (0%) had a significant naming decline. Significant postoperative naming improvement was seen in 36% of SLAH patients in contrast to 9% improvement in subSAH patients and 0% improvement in ATLs. Finally, there were no statistically significant differences between surgical approaches with regard to seizure freedom outcome, although there was a trend towards better seizure relief outcome among the ATL patients. Results support a possible benefit of SLAH in preserving visual confrontation naming after left TLE surgery. While result interpretation is limited by the small sample size, findings suggest outcome is likely to differ by surgical approach, and that further research on cognitive and seizure freedom outcomes is needed to inform patients and providers of potential risks and benefits with each.
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Affiliation(s)
- Karine Hageboutros
- Neuropsychology Department, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Kelsey C Hewitt
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Gregory P Lee
- Neuropsychology Department, Barrow Neurological Institute, Phoenix, AZ 85013, USA; Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Aastha Bansal
- Emory College of Arts and Sciences, Atlanta, GA 30322, USA
| | - Cady Block
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Nigel P Pedersen
- Department of Neurology, University of California Davis, Sacramento, CA 95816, USA
| | - Jon T Willie
- Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO 63110, USA
| | - David W Loring
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Mike R Schoenberg
- Department of Neurosurgery, University of South Florida, Tampa, FL 33606, USA
| | - Kris A Smith
- Department of Neurosurgery, Barrow Neurological Institute, Phoenix, AZ 85013, USA
| | - Cole A Giller
- Department of Neurosurgery, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Robert E Gross
- Department of Neurological Surgery, Emory University School of Medicine, Atlanta, GA 30322, USA
| | - Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA 30322, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA 30322, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA 98195, USA.
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Reecher HM, Bearden DJ, Koop JI, Berl MM, Patrick KE, Ailion AS. The changing landscape of electrical stimulation language mapping with subdural electrodes and stereoelectroencephalography for pediatric epilepsy: A literature review and commentary. Epilepsia 2024. [PMID: 38787551 DOI: 10.1111/epi.18009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 04/26/2024] [Accepted: 04/29/2024] [Indexed: 05/25/2024]
Abstract
Electrical stimulation mapping (ESM) is used to locate the brain areas supporting language directly within the human cortex to minimize the risk of functional decline following epilepsy surgery. ESM is completed by utilizing subdural grid or depth electrodes (stereo-electroencephalography [sEEG]) in combination with behavioral evaluation of language. Despite technological advances, there is no standardized method of assessing language during pediatric ESM. To identify current clinical practices for pediatric ESM of language, we surveyed neuropsychologists in the Pediatric Epilepsy Research Consortium. Results indicated that sEEG is used for functional mapping at >80% of participating epilepsy surgery centers (n = 13/16) in the United States. However, >65% of sites did not report a standardized protocol to map language. Survey results indicated a clear need for practice recommendations regarding ESM of language. We then utilized PubMed/Medline and PsychInfo to identify 42 articles that reported on ESM of language, of which 18 met inclusion criteria, which included use of ESM/signal recording to localize language regions in children (<21 years) and a detailed account of the procedure and language measures used, and region-specific language localization outcomes. Articles were grouped based on the language domain assessed, language measures used, and the brain regions involved. Our review revealed the need for evidence-based clinical guidelines for pediatric language paradigms during ESM and a standardized language mapping protocol as well as standardized reporting of brain regions in research. Relevant limitations and future directions are discussed with a focus on considerations for pediatric language mapping.
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Affiliation(s)
- Hope M Reecher
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Donald J Bearden
- Department of Neurology, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Neuropsychology, Children's Healthcare of Atlanta, Atlanta, Georgia, USA
| | - Jennifer I Koop
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
- Department of Neurology, Department of Neuropsychology, Children's Wisconsin, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Madison M Berl
- Department of Neuropsychology, Children's National Hospital, Washington, DC, USA
- Department of Psychiatry and Behavioral Sciences, George Washington University, Washington, DC, USA
| | - Kristina E Patrick
- Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA
- Department of Neuroscience, Seattle Children's Hospital, Seattle, Washington, USA
| | - Alyssa S Ailion
- Department of Neurology, Boston Children's Hospital, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
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Castellucci GA, Kovach CK, Tabasi F, Christianson D, Greenlee JD, Long MA. A frontal cortical network is critical for language planning during spoken interaction. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.08.26.554639. [PMID: 37693383 PMCID: PMC10491113 DOI: 10.1101/2023.08.26.554639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
Many brain areas exhibit activity correlated with language planning, but the impact of these dynamics on spoken interaction remains unclear. Here we use direct electrical stimulation to transiently perturb cortical function in neurosurgical patient-volunteers performing a question-answer task. Stimulating structures involved in speech motor function evoked diverse articulatory deficits, while perturbations of caudal inferior and middle frontal gyri - which exhibit preparatory activity during conversational turn-taking - led to response errors. Perturbation of the same planning-related frontal regions slowed inter-speaker timing, while faster responses could result from stimulation of sites located in other areas. Taken together, these findings further indicate that caudal inferior and middle frontal gyri constitute a critical planning network essential for interactive language use.
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Taussig D, Mazzola L, Petrescu AM, Aghakhani N, Bouilleret V, Dorfmüller G, Ferrand-Sorbets S, Herbrecht A, Isnard J. Deep retroinsular and parieto-opercular origin of vestibular symptoms: A stereoelectrocenphalography (SEEG) study. Epilepsy Behav 2023; 149:109509. [PMID: 37935078 DOI: 10.1016/j.yebeh.2023.109509] [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: 08/23/2023] [Revised: 10/20/2023] [Accepted: 10/22/2023] [Indexed: 11/09/2023]
Abstract
Several studies have shown that the retroinsular and posterior parietal operculum regions play a central role in vestibular processing. Electrical stimulations performed during stereoelectroencephalography (SEEG) in patients with focal drug-resistant epilepsy could contribute to the analysis of this area. Among the 264 SEEGs performed in both an adult and a paediatric epilepsy surgery centre, we retrospectively identified 24 patients (9%) reporting vertigo during electrical stimulations (ES). In seven of them (29% of patients experiencing vertigo during ES), it was evoked by stimulating the retroinsular region. The reported responses were mostly not rotatory sensations but actually illusions of body, limb or limb segment movement. The involved area is limited. Moreover, two patients reported having the same symptoms at the beginning of their seizures starting in the same region. Our case study confirms the pivotal role of the retroinsular and posterior parietal operculum areas in vestibular responses, and we therefore advise the exploration of this region when patients report an illusion of body movement at the beginning of their seizures.
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Affiliation(s)
- Delphine Taussig
- Université Paris Saclay-APHP, Neurophysiologie et Epileptologie, Le Kremlin Bicêtre, France.
| | - Laure Mazzola
- Neurology Department, University Hospital, Saint-Etienne, France; NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France
| | - Ana Maria Petrescu
- Université Paris Saclay-APHP, Neurophysiologie et Epileptologie, Le Kremlin Bicêtre, France
| | - Nozar Aghakhani
- Université Paris Saclay-APHP, Neurochirurgie, Le Kremlin Bicêtre, France
| | - Viviane Bouilleret
- Université Paris Saclay-APHP, Neurophysiologie et Epileptologie, Le Kremlin Bicêtre, France; Université Paris-Saclay, CEA, CNRS, Inserm, BioMaps, Orsay, France
| | - Georg Dorfmüller
- Hôpital Fondation Rothschild, Neurochirurgie Pédiatrique, Paris, France
| | | | - Anne Herbrecht
- Université Paris Saclay-APHP, Neurochirurgie, Le Kremlin Bicêtre, France
| | - Jean Isnard
- NeuroPain Lab, Lyon Neuroscience Research Centre, CRNL - INSERM U 1028/CNRS UMR 5292, University of Lyon, Lyon, France; Hospices Civils de Lyon, Neurological Hospital, Department of Functional Neurology and Epileptology, Lyon F - 69003, France
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Lawrence A, Carvajal M, Ormsby J. Beyond Broca's and Wernicke's: Functional Mapping of Ancillary Language Centers Prior to Brain Tumor Surgery. Tomography 2023; 9:1254-1275. [PMID: 37489468 PMCID: PMC10366753 DOI: 10.3390/tomography9040100] [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: 04/20/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 07/26/2023] Open
Abstract
Functional MRI is a well-established tool used for pre-surgical planning to help the neurosurgeon have a roadmap of critical functional areas that should be avoided, if possible, during surgery to minimize morbidity for patients with brain tumors (though this also has applications for surgical resection of epileptogenic tissue and vascular lesions). This article reviews the locations of secondary language centers within the brain along with imaging findings to help improve our confidence in our knowledge on language lateralization. Brief overviews of these language centers and their contributions to the language networks will be discussed. These language centers include primary language centers of "Broca's Area" and "Wernicke's Area". However, there are multiple secondary language centers such as the dorsal lateral prefrontal cortex (DLPFC), frontal eye fields, pre- supplemental motor area (pre-SMA), Basal Temporal Language Area (BTLA), along with other areas of activation. Knowing these foci helps to increase self-assurance when discussing the nature of laterality with the neurosurgeon. By knowing secondary language centers for language lateralization, via fMRI, one can feel confident on providing neurosurgeon colleagues with appropriate information on the laterality of language in preparation for surgery.
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Affiliation(s)
- Ashley Lawrence
- Center for Neuropsychological Services, University of New Mexico, MSC 10 5530 1 University of New Mexico, Albuquerque, NM 87131-5001, USA
| | - Michael Carvajal
- Center for Neuropsychological Services, University of New Mexico, MSC 10 5530 1 University of New Mexico, Albuquerque, NM 87131-5001, USA
| | - Jacob Ormsby
- Department of Radiology, University of New Mexico, MSC 10 5530 1 University of New Mexico, Albuquerque, NM 87131-5001, USA
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Burkhardt E, Zemmoura I, Hirsch F, Lemaitre AL, Deverdun J, Moritz-Gasser S, Duffau H, Herbet G. The central role of the left inferior longitudinal fasciculus in the face-name retrieval network. Hum Brain Mapp 2023; 44:3254-3270. [PMID: 37051699 PMCID: PMC10171495 DOI: 10.1002/hbm.26279] [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: 09/02/2022] [Revised: 02/18/2023] [Accepted: 03/06/2023] [Indexed: 04/14/2023] Open
Abstract
Unsuccessful retrieval of proper names (PNs) is commonly observed in patients suffering from neurological conditions such as stroke or epilepsy. While a large body of works has suggested that PN retrieval relies on a cortical network centered on the left anterior temporal lobe (ATL), much less is known about the white matter connections underpinning this process. Sparse studies provided evidence for a possible role of the uncinate fasciculus, but the inferior longitudinal fasciculus (ILF) might also contribute, since it mainly projects into the ATL, interconnects it with the posterior lexical interface and is engaged in common name (CN) retrieval. To ascertain this hypothesis, we assessed 58 patients having undergone a neurosurgery for a left low-grade glioma by means of a famous face naming (FFN) task. The behavioural data were processed following a multilevel lesion approach, including location-based analyses, voxel-based lesion-symptom mapping (VLSM) and disconnection-symptom mapping. Different statistical models were generated to control for sociodemographic data, familiarity, biographical knowledge and control cognitive performances (i.e., semantic and episodic memory and CN retrieval). Overall, VLSM analyses indicated that damage to the mid-to-anterior part of the ventro-basal temporal cortex was especially associated with PN retrieval deficits. As expected, tract-oriented analyses showed that the left ILF was the most strongly associated pathway. Our results provide evidence for the pivotal role of the ILF in the PN retrieval network. This novel finding paves the way for a better understanding of the pathophysiological bases underlying PN retrieval difficulties in the various neurological conditions marked by white matter abnormalities.
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Affiliation(s)
- Eléonor Burkhardt
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
| | - Ilyess Zemmoura
- UMR1253, iBrain, University of Tours, INSERM, Tours, France
- Department of Neurosurgery, Bretonneau Hospital, CHRU de Tours, Tours, France
| | - Fabrice Hirsch
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
| | - Anne-Laure Lemaitre
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Jeremy Deverdun
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Sylvie Moritz-Gasser
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Hugues Duffau
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Guillaume Herbet
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
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Avcu E, Hwang M, Brown KS, Gow DW. A tale of two lexica: Investigating computational pressures on word representation with neural networks. Front Artif Intell 2023; 6:1062230. [PMID: 37051161 PMCID: PMC10083378 DOI: 10.3389/frai.2023.1062230] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 03/10/2023] [Indexed: 03/28/2023] Open
Abstract
Introduction The notion of a single localized store of word representations has become increasingly less plausible as evidence has accumulated for the widely distributed neural representation of wordform grounded in motor, perceptual, and conceptual processes. Here, we attempt to combine machine learning methods and neurobiological frameworks to propose a computational model of brain systems potentially responsible for wordform representation. We tested the hypothesis that the functional specialization of word representation in the brain is driven partly by computational optimization. This hypothesis directly addresses the unique problem of mapping sound and articulation vs. mapping sound and meaning. Results We found that artificial neural networks trained on the mapping between sound and articulation performed poorly in recognizing the mapping between sound and meaning and vice versa. Moreover, a network trained on both tasks simultaneously could not discover the features required for efficient mapping between sound and higher-level cognitive states compared to the other two models. Furthermore, these networks developed internal representations reflecting specialized task-optimized functions without explicit training. Discussion Together, these findings demonstrate that different task-directed representations lead to more focused responses and better performance of a machine or algorithm and, hypothetically, the brain. Thus, we imply that the functional specialization of word representation mirrors a computational optimization strategy given the nature of the tasks that the human brain faces.
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Affiliation(s)
- Enes Avcu
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | | | - Kevin Scott Brown
- Department of Pharmaceutical Sciences and School of Chemical, Biological, and Environmental Engineering, Oregon State University, Corvallis, OR, United States
| | - David W. Gow
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
- Athinoula A. Martinos Center for Biomedical Imaging Massachusetts General Hospital, Charlestown, MA, United States
- Department of Psychology, Salem State University, Salem, MA, United States
- Harvard-MIT Division of Health Sciences and Technology, Boston, MA, United States
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Snyder KM, Forseth KJ, Donos C, Rollo PS, Fischer-Baum S, Breier J, Tandon N. Critical role of the ventral temporal lobe in naming. Epilepsia 2023; 64:1200-1213. [PMID: 36806185 DOI: 10.1111/epi.17555] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 02/16/2023] [Accepted: 02/17/2023] [Indexed: 02/22/2023]
Abstract
OBJECTIVE Lexical retrieval deficits are characteristic of a variety of different neurological disorders. However, the exact substrates responsible for this are not known. We studied a large cohort of patients undergoing surgery in the dominant temporal lobe for medically intractable epilepsy (n = 95) to localize brain regions that were associated with anomia. METHODS We performed a multivariate voxel-based lesion-symptom mapping analysis to correlate surgical lesions within the temporal lobe with changes in naming ability. Additionally, we used a surface-based mixed-effects multilevel analysis to estimate group-level broadband gamma activity during naming across a subset of patients with electrocorticographic recordings and integrated these results with lesion-deficit findings. RESULTS We observed that ventral temporal regions, centered around the middle fusiform gyrus, were significantly associated with a decline in naming. Furthermore, we found that the ventral aspect of temporal lobectomies was linearly correlated to a decline in naming, with a clinically significant decline occurring once the resection extended 6 cm from the anterior tip of the temporal lobe on the ventral surface. On electrocorticography, the majority of these cortical regions were functionally active following visual processing. These loci coincide with the sites of susceptibility artifacts during echoplanar imaging, which may explain why this region has been previously underappreciated as the locus responsible for postoperative naming deficits. SIGNIFICANCE Taken together, these data highlight the crucial contribution of the ventral temporal cortex in naming and its important role in the pathophysiology of anomia following temporal lobe resections. As such, surgical strategies should attempt to preserve this region to mitigate postoperative language deficits.
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Affiliation(s)
- Kathryn M Snyder
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Kiefer J Forseth
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Cristian Donos
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Faculty of Physics, University of Bucharest, Bucharest, Romania
| | - Patrick S Rollo
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA
| | - Simon Fischer-Baum
- Department of Psychological Sciences, Rice University, Houston, Texas, USA
| | - Joshua Breier
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, USA
| | - Nitin Tandon
- Vivian L. Smith Department of Neurosurgery, McGovern Medical School at UT Health Houston, Houston, Texas, USA.,Texas Institute for Restorative Neurotechnologies, University of Texas Health Science Center at Houston, Houston, Texas, USA.,Memorial Hermann Hospital, Texas Medical Center, Houston, Texas, USA
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11
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Samudra N, Armour E, Gonzalez H, Mattingly D, Haas K, Singh P, Sonmezturk H, Gallagher M, Crudele A, Nobis W, Reddy S, Jacobs M, Aulino JM, Bick S, Morgan V, Englot D, Abou-Khalil B. Epilepsy with anterior temporal encephaloceles: Baseline characteristics, post-surgical outcomes, and comparison to mesial temporal sclerosis. Epilepsy Behav 2023; 139:109061. [PMID: 36587487 DOI: 10.1016/j.yebeh.2022.109061] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 11/18/2022] [Accepted: 12/11/2022] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To review clinical and neuropsychological characteristics and natural history of a series of patients with temporal lobe epilepsy (TLE) and anterior temporal encephaloceles (ATE) and compare them to a similar series of TLE patients with mesial temporal sclerosis (MTS) to identify characteristics suggestive of ATE-related epilepsy. METHODS Patients with epilepsy and ATE were identified via clinic encounters and consensus epilepsy surgery conference at a Level 4 epilepsy center. The drug-resistant subset of these patients who underwent epilepsy surgery (twenty-two of thirty-five) were compared to age- and laterality-matched patients with MTS. Clinical, neuropsychological, electrophysiologic, and surgical data were abstracted through chart review. RESULTS In comparison with MTS, ATE patients were more often female, had significantly later onset of epilepsy, and did not have prior febrile seizures. In addition, ATE patients were more likely to have chronic headaches and other historical features consistent with idiopathic intracranial hypertension (IIH). Failure to identify ATE on initial imaging was common. Most patients had limited temporal cortical resections sparing mesial structures. Of the twenty ATE patients who had a long-term postsurgical follow-up, seventeen (85%) had International League Against Epilepsy (ILAE) Class 1 or 2 outcomes. SIGNIFICANCE A shorter duration of epilepsy, female gender, and lack of history of febrile seizures may suggest ATE as an etiology of refractory TLE in adults. Targeted encephalocele resections can result in seizure freedom, underscoring the importance of encephalocele identification.
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Affiliation(s)
- Niyatee Samudra
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Eric Armour
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hernan Gonzalez
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Danielle Mattingly
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Kevin Haas
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Pradumna Singh
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Hasan Sonmezturk
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Martin Gallagher
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Angela Crudele
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - William Nobis
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Shilpa Reddy
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Monica Jacobs
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Joseph M Aulino
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Sarah Bick
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Victoria Morgan
- Department of Radiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Dario Englot
- Department of Neurosurgery, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Bassel Abou-Khalil
- Department of Neurology, Vanderbilt University Medical Center, Nashville, TN, USA.
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12
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Mesulam MM. Temporopolar regions of the human brain. Brain 2023; 146:20-41. [PMID: 36331542 DOI: 10.1093/brain/awac339] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 07/26/2022] [Accepted: 08/29/2022] [Indexed: 11/06/2022] Open
Abstract
Following prolonged neglect during the formative decades of behavioural neurology, the temporopolar region has become a site of vibrant research on the neurobiology of cognition and conduct. This turnaround can be attributed to increasing recognition of neurodegenerative diseases that target temporopolar regions for peak destruction. The resultant syndromes include behavioural dementia, associative agnosia, semantic forms of primary progressive aphasia and semantic dementia. Clinicopathological correlations show that object naming and word comprehension are critically dependent on the language-dominant (usually left) temporopolar region, whereas behavioural control and non-verbal object recognition display a more bilateral representation with a rightward bias. Neuroanatomical experiments in macaques and neuroimaging in humans show that the temporoparietal region sits at the confluence of auditory, visual and limbic streams of processing at the downstream (deep) pole of the 'what' pathway. The functional neuroanatomy of this region revolves around three axes, an anterograde horizontal axis from unimodal to heteromodal and paralimbic cortex; a radial axis where visual (ventral), auditory (dorsal) and paralimbic (medial) territories encircle temporopolar cortex and display hemispheric asymmetry; and a vertical depth-of-processing axis for the associative elaboration of words, objects and interoceptive states. One function of this neural matrix is to support the transformation of object and word representations from unimodal percepts to multimodal concepts. The underlying process is likely to start at canonical gateways that successively lead to generic (superordinate), specific (basic) and unique levels of recognition. A first sign of left temporopolar dysfunction takes the form of taxonomic blurring where boundaries among categories are preserved but not boundaries among exemplars of a category. Semantic paraphasias and coordinate errors in word-picture verification tests are consequences of this phenomenon. Eventually, boundaries among categories are also blurred and comprehension impairments become more profound. The medial temporopolar region belongs to the amygdalocentric component of the limbic system and stands to integrate exteroceptive information with interoceptive states underlying social interactions. Review of the pertinent literature shows that word comprehension and conduct impairments caused by temporopolar strokes and temporal lobectomy are far less severe than those seen in temporopolar atrophies. One explanation for this unexpected discrepancy invokes the miswiring of residual temporopolar neurons during the many years of indolently progressive neurodegeneration. According to this hypothesis, the temporopolar regions become not only dysfunctional but also sources of aberrant outputs that interfere with the function of areas elsewhere in the language and paralimbic networks, a juxtaposition not seen in lobectomy or stroke.
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Affiliation(s)
- M Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL 60611, USA
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13
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Aron O, Krieg J, Brissart H, Abdallah C, Colnat-Coulbois S, Jonas J, Maillard L. Naming impairments evoked by focal cortical electrical stimulation in the ventral temporal cortex correlate with increased functional connectivity. Neurophysiol Clin 2022; 52:312-322. [PMID: 35777988 DOI: 10.1016/j.neucli.2022.06.002] [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: 03/03/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND High-frequency cortical electrical stimulations (HF-CES) are the gold standard for presurgical functional mapping. In the dominant ventral temporal cortex (VTC) HF-CES can elicit transient naming impairment (eloquent sites), defining a basal temporal language area (BTLA). OBJECTIVE Whether naming impairments induced by HF-CES within the VTC are related to a specific pattern of connectivity of the BTLA within the temporal lobe remains unknown. We addressed this issue by comparing the connectivity of eloquent and non-eloquent sites from the VTC using cortico-cortical evoked potentials (CCEP). METHODS Low frequency cortical electrical stimulations (LF-CES) were used to evoke CCEP in nine individual brains explored with Stereo-Electroencephalography. We compared the connectivity of eloquent versus non eloquent sites within the VTC using Pearson's correlation matrix. RESULTS Overall, within the VTC, eloquent sites were associated with increased functional connectivity compared to non-eloquent sites. Among the VTC structures, this pattern holds true for the inferior temporal gyrus and the parahippocampal gyrus while the fusiform gyrus specifically showed a high connectivity in both non eloquent and eloquent sites. CONCLUSIONS Our findings suggest that the cognitive effects of focal HF-CES are related to the functional connectivity properties of the stimulated sites, and therefore to the disturbance of a wide cortical network. They further suggest that functional specialization of a cortical region emerges from its specific pattern of functional connectivity. Cortical electrical stimulation functional mapping protocols including LF coupled to HF-CES could provide valuable data characterizing both local and distant functional architecture.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France.
| | - Julien Krieg
- Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Helene Brissart
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France
| | - Chifaou Abdallah
- Neurology and Neurosurgery Department, Montreal Neurological Institute (C.A.) McGill University, Montreal, Quebec, Canada
| | - Sophie Colnat-Coulbois
- Department of Neurosurgery, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Jacques Jonas
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Louis Maillard
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
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14
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Gkiatis K, Garganis K, Benjamin CF, Karanasiou I, Kondylidis N, Harushukuri J, Matsopoulos GK. Standardization of presurgical language fMRI in Greek population: Mapping of six critical regions. Brain Behav 2022; 12:e2609. [PMID: 35587046 PMCID: PMC9226851 DOI: 10.1002/brb3.2609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 04/04/2022] [Accepted: 04/12/2022] [Indexed: 11/11/2022] Open
Abstract
BACKGROUND Mapping the language system has been crucial in presurgical evaluation especially when the area to be resected is near relevant eloquent cortex. Functional magnetic resonance imaging (fMRI) proved to be a noninvasive alternative of Wada test that can account not only for language lateralization but also for localization when appropriate tasks and MRI sequences are being used. The tasks utilized during the fMRI acquisition are playing a crucial role as to which areas will be activated. Recent studies demonstrated that key language regions exist outside the classical model of "Wernicke-Lichtheim-Geschwind," but sensitive tasks must take place in order to be revealed. On top of that, the tasks should be in mother tongue for appropriate language mapping to be possible. METHODS For that reason, in this study, we adopted an English protocol that can reveal six language critical regions even in clinical setups and we translated it into Greek to prove its efficacy in Greek population. Twenty healthy right-handed volunteers were recruited and performed the fMRI acquisition in a standardized manner. RESULTS Results demonstrated that all six language critical regions were activated in all subjects as well as the group mean map. Furthermore, activations were found in the thalamus, the caudate, and the contralateral cerebellum. CONCLUSION In this study, we standardized an fMRI protocol in Greek and proved that it can reliably activate six language critical regions. We have validated its efficacy for presurgical language mapping in Greek patients capable to be adopted in clinical setup.
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Affiliation(s)
- Kostakis Gkiatis
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece.,Epilepsy Monitoring Unit, St. Luke's Hospital, Thessaloniki, Greece
| | | | - Christopher F Benjamin
- Department of Neurology, Comprehensive Epilepsy Center, Yale School of Medicine, New Haven, Connecticut, USA.,Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut, USA
| | - Irene Karanasiou
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | | | - Jean Harushukuri
- Epilepsy Monitoring Unit, St. Luke's Hospital, Thessaloniki, Greece
| | - George K Matsopoulos
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
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15
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Giampiccolo D, Duffau H. Controversy over the temporal cortical terminations of the left arcuate fasciculus: a reappraisal. Brain 2022; 145:1242-1256. [PMID: 35142842 DOI: 10.1093/brain/awac057] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Revised: 12/19/2021] [Accepted: 01/20/2022] [Indexed: 11/12/2022] Open
Abstract
The arcuate fasciculus has been considered a major dorsal fronto-temporal white matter pathway linking frontal language production regions with auditory perception in the superior temporal gyrus, the so-called Wernicke's area. In line with this tradition, both historical and contemporary models of language function have assigned primacy to superior temporal projections of the arcuate fasciculus. However, classical anatomical descriptions and emerging behavioural data are at odds with this assumption. On one hand, fronto-temporal projections to Wernicke's area may not be unique to the arcuate fasciculus. On the other hand, dorsal stream language deficits have been reported also for damage to middle, inferior and basal temporal gyri which may be linked to arcuate disconnection. These findings point to a reappraisal of arcuate projections in the temporal lobe. Here, we review anatomical and functional evidence regarding the temporal cortical terminations of the left arcuate fasciculus by incorporating dissection and tractography findings with stimulation data using cortico-cortical evoked potentials and direct electrical stimulation mapping in awake patients. Firstly, we discuss the fibers of the arcuate fasciculus projecting to the superior temporal gyrus and the functional rostro-caudal gradient in this region where both phonological encoding and auditory-motor transformation may be performed. Caudal regions within the temporoparietal junction may be involved in articulation and associated with temporoparietal projections of the third branch of the superior longitudinal fasciculus, while more rostral regions may support encoding of acoustic phonetic features, supported by arcuate fibres. We then move to examine clinical data showing that multimodal phonological encoding is facilitated by projections of the arcuate fasciculus to superior, but also middle, inferior and basal temporal regions. Hence, we discuss how projections of the arcuate fasciculus may contribute to acoustic (middle-posterior superior and middle temporal gyri), visual (posterior inferior temporal/fusiform gyri comprising the visual word form area) and lexical (anterior-middle inferior temporal/fusiform gyri in the basal temporal language area) information in the temporal lobe to be processed, encoded and translated into a dorsal phonological route to the frontal lobe. Finally, we point out surgical implications for this model in terms of the prediction and avoidance of neurological deficit.
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Affiliation(s)
- Davide Giampiccolo
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, Verona, Italy.,Institute of Neuroscience, Cleveland Clinic London, Grosvenor Place, London, UK.,Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK.,Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Team "Neuroplasticity, Stem Cells and Low-grade Gliomas," INSERM U1191, Institute of Genomics of Montpellier, University of Montpellier, Montpellier, France
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16
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Kaestner E, Wu X, Friedman D, Dugan P, Devinsky O, Carlson C, Doyle W, Thesen T, Halgren E. The Precentral Gyrus Contributions to the Early Time-Course of Grapheme-to-Phoneme Conversion. NEUROBIOLOGY OF LANGUAGE (CAMBRIDGE, MASS.) 2022; 3:18-45. [PMID: 37215328 PMCID: PMC10158576 DOI: 10.1162/nol_a_00047] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Accepted: 06/16/2021] [Indexed: 05/24/2023]
Abstract
As part of silent reading models, visual orthographic information is transduced into an auditory phonological code in a process of grapheme-to-phoneme conversion (GPC). This process is often identified with lateral temporal-parietal regions associated with auditory phoneme encoding. However, the role of articulatory phonemic representations and the precentral gyrus in GPC is ambiguous. Though the precentral gyrus is implicated in many functional MRI studies of reading, it is not clear if the time course of activity in this region is consistent with the precentral gyrus being involved in GPC. We recorded cortical electrophysiology during a bimodal match/mismatch task from eight patients with perisylvian subdural electrodes to examine the time course of neural activity during a task that necessitated GPC. Patients made a match/mismatch decision between a 3-letter string and the following auditory bi-phoneme. We characterized the distribution and timing of evoked broadband high gamma (70-170 Hz) as well as phase-locking between electrodes. The precentral gyrus emerged with a high concentration of broadband high gamma responses to visual and auditory language as well as mismatch effects. The pars opercularis, supramarginal gyrus, and superior temporal gyrus were also involved. The precentral gyrus showed strong phase-locking with the caudal fusiform gyrus during letter-string presentation and with surrounding perisylvian cortex during the bimodal visual-auditory comparison period. These findings hint at a role for precentral cortex in transducing visual into auditory codes during silent reading.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, USA
| | - Xiaojing Wu
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Daniel Friedman
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Patricia Dugan
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Orrin Devinsky
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Chad Carlson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, USA
| | - Werner Doyle
- Department of Neurology, NYU Langone School of Medicine, New York, USA
- Department of Neurosurgery, NYU Langone School of Medicine, New York, USA
| | - Thomas Thesen
- Department of Neurology, NYU Langone School of Medicine, New York, USA
| | - Eric Halgren
- Department of Neurosciences, University of California at San Diego, La Jolla, USA
- Department of Radiology, University of California at San Diego, La Jolla, USA
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17
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Kaestner E, Stasenko A, Ben-Haim S, Shih J, Paul BM, McDonald CR. The importance of basal-temporal white matter to pre- and post-surgical naming ability in temporal lobe epilepsy. Neuroimage Clin 2022; 34:102963. [PMID: 35220106 PMCID: PMC8888987 DOI: 10.1016/j.nicl.2022.102963] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 12/15/2021] [Accepted: 02/07/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Emerging research highlights the importance of basal-temporal cortex, centered on the fusiform gyrus, to both pre-surgical naming ability and post-surgical naming outcomes in temporal lobe epilepsy (TLE). In this study, we investigate whether integrity of the white matter network that interconnects this basal region to the distributed language network affects naming ability and risk for post-surgical naming decline. METHODS Patients with drug-resistant TLE were recruited from two epilepsy centers in a prospective longitudinal study. The pre-surgical dataset included 50 healthy controls, 47 left TLE (L-TLE), and 41 right TLE (R-TLE) patients. All participants completed pre-surgical T1- and diffusion-weighted MRI (dMRI), as well as neuropsychological tests of auditory and visual naming. Nineteen L-TLE and 18 R-TLE patients underwent anterior temporal lobectomy (ATL) and also completed post-surgical neuropsychological testing. Pre-surgical fractional anisotropy (FA) of the white matter directly beneath the fusiform neocortex (i.e., superficial white matter; SWM) and of deep white matter tracts with connections to the basal-temporal cortex [inferior longitudinal fasciculus (ILF) and inferior frontal occipital fasciculus (IFOF)] was calculated. Clinical variables, hippocampal volume, and FA of each white matter tract or region were examined in linear regressions with naming scores, or change in naming scores, as the primary outcomes. RESULTS Pre-surgically, higher FA in the bilateral ILF, bilateral IFOF, and left fusiform SWM was associated with better visual and auditory naming scores (all ps < 0.05 with FDR correction). In L-TLE, higher pre-surgical FA was also associated with less naming decline post-surgically, but results varied across tracts. When including only patients with typical language dominance, only integrity of the right fusiform SWM was associated with less visual naming decline (p = .0018). DISCUSSION Although a broad network of white matter network matter may contribute to naming ability pre-surgically, the reserve capacity of the contralateral (right) fusiform SWM may be important for mitigating visual naming decline following ATL in L-TLE. This shows that the study of the structural network interconnecting the basal-temporal region to the wider language network has implications for understanding both pre- and post-surgical naming in TLE.
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Affiliation(s)
- Erik Kaestner
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Alena Stasenko
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA
| | - Sharona Ben-Haim
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Jerry Shih
- Department of Neurosurgery, University of California, San Diego, CA, USA
| | - Brianna M Paul
- Department of Neurology, University of California -San Francisco, San Francisco, CA, USA
| | - Carrie R McDonald
- Center for Multimodal Imaging and Genetics, University of California, San Diego, CA, USA; Department of Psychiatry, University of California, San Diego, CA, USA; San Diego State University, University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
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18
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Resection of dominant fusiform gyrus is associated with decline of naming function when temporal lobe epilepsy manifests after the age of five: A voxel-based lesion-symptom mapping study. NEUROIMAGE: CLINICAL 2022; 35:103129. [PMID: 36002957 PMCID: PMC9421498 DOI: 10.1016/j.nicl.2022.103129] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 07/08/2022] [Accepted: 07/27/2022] [Indexed: 11/20/2022] Open
Abstract
Resection in the dominant fusiform gyrus is associated with an increased risk of postoperative decline in picture naming. More temporo-posterior resections in this area results in a greater degree of naming decline. Risk of significant naming decline after left temporal surgery increased by 5% with every year of later seizure onset.
Objective To determine patients’ characteristics and regions in the temporal lobe where resections lead to a decline in picture naming. Methods 311 patients with left hemispheric dominance for language were included who underwent epilepsy surgery at the Epilepsy Center of Erlangen and whose picture naming scores (Boston Naming Test, BNT) were available preoperatively and 6-months postoperatively. Surgical lesions were mapped to an averaged template based on preoperative and postoperative MRI using voxel-based lesion-symptom mapping (VBLSM). Postoperative brain shifts were corrected. The relationship between lesioned brain areas and the presence of a postoperative naming decline was examined voxel-wise while controlling for effects of overall lesion size at first in the total cohort and then restricted to temporal lobe resections. Results In VBLSM in the total sample, a decline in BNT score was significantly related to left temporal surgery. When only considering patients with left temporal lobe resections (n = 121), 40 (33.1%) significantly worsened in BNT postoperatively. VBLSM including all patients with left temporal resections generated no significant results within the temporal lobe. However, naming decline of patients with epilepsy onset after 5 years of age was significantly associated with resections in the left inferior temporal (extent of BNT decline range: 10.8− 14.4%) and fusiform gyrus (decline range: 12.1−18.4%). Significance Resections in the posterior part of the dominant fusiform and inferior temporal gyrus was associated with a risk of deterioration in naming performance at six months after surgery in patients with epilepsy onset after 5 years of age but not with earlier epilepsy onset.
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19
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Giampiccolo D, Nunes S, Cattaneo L, Sala F. Functional Approaches to the Surgery of Brain Gliomas. Adv Tech Stand Neurosurg 2022; 45:35-96. [PMID: 35976447 DOI: 10.1007/978-3-030-99166-1_2] [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] [Indexed: 06/15/2023]
Abstract
In the surgery of gliomas, recent years have witnessed unprecedented theoretical and technical development, which extensively increased indication to surgery. On one hand, it has been solidly demonstrated the impact of gross total resection on life expectancy. On the other hand, the paradigm shift from classical cortical localization of brain function towards connectomics caused by the resurgence of awake surgery and the advent of tractography has permitted safer surgeries focused on subcortical white matter tracts preservation and allowed for surgical resections within regions, such as Broca's area or the primary motor cortex, which were previously deemed inoperable. Furthermore, new asleep electrophysiological techniques have been developed whenever awake surgery is not an option, such as operating in situations of poor compliance (including paediatric patients) or pre-existing neurological deficits. One such strategy is the use of intraoperative neurophysiological monitoring (IONM), enabling the identification and preservation of functionally defined, but anatomically ambiguous, cortico-subcortical structures through mapping and monitoring techniques. These advances tie in with novel challenges, specifically risk prediction and the impact of neuroplasticity, the indication for tumour resection beyond visible borders, or supratotal resection, and most of all, a reappraisal of the importance of the right hemisphere from early psychosurgery to mapping and preservation of social behaviour, executive control, and decision making.Here we review current advances and future perspectives in a functional approach to glioma surgery.
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Affiliation(s)
- Davide Giampiccolo
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
- Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Institute of Neurosciences, Cleveland Clinic London, London, UK
| | - Sonia Nunes
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy
| | - Luigi Cattaneo
- Center for Mind and Brain Sciences (CIMeC) and Center for Medical Sciences (CISMed), University of Trento, Trento, Italy
| | - Francesco Sala
- Section of Neurosurgery, Department of Neurosciences, Biomedicine and Movement Sciences, University Hospital, University of Verona, Verona, Italy.
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20
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Catani M. The connectional anatomy of the temporal lobe. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:3-16. [PMID: 35964979 DOI: 10.1016/b978-0-12-823493-8.00001-8] [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: 06/15/2023]
Abstract
The idea of a temporal lobe separated from the rest of the hemisphere by reason of its unique structural and functional properties is a clinically useful artifact. While the temporal lobe can be safely defined as the portion of the cerebrum lodged in the middle cranial fossa, the pattern of its connections is a more revealing description of its functional subdivisions and specific contribution to higher cognitive functions. This chapter provides an historical overview of the anatomy of the temporal lobe and an updated framework of temporal lobe connections based on tractography studies of human and nonhuman primates and patients with brain disorders. Compared to monkeys, the human temporal lobe shows a relatively increased connectivity with perisylvian frontal and parietal regions and a set of unique intrinsic connections, which may have supported the evolution of working memory, semantic representation, and language in our species. Conversely, the decreased volume of the anterior (limbic) interhemispheric temporal connections in humans is related to a reduced reliance on olfaction and a partial transference of functions from the anterior commissure to the posterior corpus callosum. Overall the novel data from tractography suggest a revision of current dual stream models for visual and auditory processing.
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Affiliation(s)
- Marco Catani
- Natbrainlab, Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom; Department of Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, London, United Kingdom.
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21
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Frazzini V, Cousyn L, Navarro V. Semiology, EEG, and neuroimaging findings in temporal lobe epilepsies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:489-518. [PMID: 35964989 DOI: 10.1016/b978-0-12-823493-8.00021-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Temporal lobe epilepsy (TLE) is the most common type of focal epilepsy. First descriptions of TLE date back in time and detailed portraits of epileptic seizures of temporal origin can be found in early medical reports as well as in the works of various artists and dramatists. Depending on the seizure onset zone, several subtypes of TLE have been identified, each one associated with peculiar ictal semiology. TLE can result from multiple etiological causes, ranging from genetic to lesional ones. While the diagnosis of TLE relies on detailed analysis of clinical as well as electroencephalographic (EEG) features, the lesions responsible for seizure generation can be highlighted by multiple brain imaging modalities or, in selected cases, by genetic investigations. TLE is the most common cause of refractory epilepsy and despite the great advances in diagnostic tools, no lesion is found in around one-third of patients. Surgical treatment is a safe and effective option, requiring presurgical investigations to accurately identify the seizure onset zone (SOZ). In selected cases, presurgical investigations need intracerebral investigations (such as stereoelectroencephalography) or dedicated metabolic imaging techniques (interictal PET and ictal SPECT) to correctly identify the brain structures to be removed.
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Affiliation(s)
- Valerio Frazzini
- AP-HP, Department of Neurology and Department of Clinical Neurophysiology, Epilepsy and EEG Unit, Reference Center for Rare Epilepsies, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, Paris Brain Institute, Team "Dynamics of Neuronal Networks and Neuronal Excitability", Paris, France
| | - Louis Cousyn
- AP-HP, Department of Neurology and Department of Clinical Neurophysiology, Epilepsy and EEG Unit, Reference Center for Rare Epilepsies, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, Paris Brain Institute, Team "Dynamics of Neuronal Networks and Neuronal Excitability", Paris, France
| | - Vincent Navarro
- AP-HP, Department of Neurology and Department of Clinical Neurophysiology, Epilepsy and EEG Unit, Reference Center for Rare Epilepsies, Pitié-Salpêtrière Hospital, Paris, France; Sorbonne Université, Paris Brain Institute, Team "Dynamics of Neuronal Networks and Neuronal Excitability", Paris, France.
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22
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McDonald CR. Removing Basal Temporal Language Cortex in Epilepsy Surgery: Short-Term Disruption or Long-Lasting Problem? Epilepsy Curr 2021; 21:329-331. [PMID: 34924825 PMCID: PMC8655261 DOI: 10.1177/15357597211025134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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23
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Kwon H, Kronemer SI, Christison-Lagay KL, Khalaf A, Li J, Ding JZ, Freedman NC, Blumenfeld H. Early cortical signals in visual stimulus detection. Neuroimage 2021; 244:118608. [PMID: 34560270 DOI: 10.1016/j.neuroimage.2021.118608] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Revised: 08/19/2021] [Accepted: 09/20/2021] [Indexed: 11/16/2022] Open
Abstract
During visual conscious perception, the earliest responses linked to signal detection are little known. The current study aims to reveal the cortical neural activity changes in the earliest stages of conscious perception using recordings from intracranial electrodes. Epilepsy patients (N=158) were recruited from a multi-center collaboration and completed a visual word recall task. Broadband gamma activity (40-115Hz) was extracted with a band-pass filter and gamma power was calculated across subjects on a common brain surface. Our results show early gamma power increases within 0-50ms after stimulus onset in bilateral visual processing cortex, right frontal cortex (frontal eye fields, ventral medial/frontopolar, orbital frontal) and bilateral medial temporal cortex regardless of whether the word was later recalled. At the same early times, decreases were seen in the left rostral middle frontal gyrus. At later times after stimulus onset, gamma power changes developed in multiple cortical regions. These included sustained changes in visual and other association cortical networks, and transient decreases in the default mode network most prominently at 300-650ms. In agreement with prior work in this verbal memory task, we also saw greater increases in visual and medial temporal regions as well as prominent later (> 300ms) increases in left hemisphere language areas for recalled versus not recalled stimuli. These results suggest an early signal detection network in the frontal, medial temporal, and visual cortex is engaged at the earliest stages of conscious visual perception.
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Affiliation(s)
- Hunki Kwon
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA
| | - Sharif I Kronemer
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA; Interdepartmental Neuroscience Program, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA
| | - Kate L Christison-Lagay
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA
| | - Aya Khalaf
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA; Biomedical Engineering and Systems, Faculty of Engineering, Cairo University, Giza, Egypt
| | - Jiajia Li
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA; School of Information and Control Engineering, Xian University of Architecture and Technology, Xi'an 710055, China
| | - Julia Z Ding
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA
| | - Noah C Freedman
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA
| | - Hal Blumenfeld
- Department of Neurology, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520-8018, USA; Neuroscience, Yale University School of Medicine, 333 Cedar Street, New Haven, CT 06520, USA; Neurosurgery, Yale University School of Medicine, 333 Cedar Street, New Haven, Connecticut 06520, USA.
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Longo A, Houot M, Herlin B, Méré M, Denos M, Samson S, Dupont S. Distinctive neuropsychological profiles of lateral temporal lobe epilepsy. Epilepsy Behav 2021; 125:108411. [PMID: 34794011 DOI: 10.1016/j.yebeh.2021.108411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 09/07/2021] [Accepted: 10/25/2021] [Indexed: 10/19/2022]
Abstract
OBJECTIVE Lateral temporal lobe epilepsies (LTLE) are poorly characterized heterogeneous epilepsies. As the lateral temporal lobe supports distinct functions, we hypothesized that neuropsychological profiles could differ according to the localization of the seizure focus within the lateral temporal lobe. METHODS We retrospectively examined the neuropsychological characteristics of 74 consecutive patients with refractory LTLE assessed in the context of a presurgical investigation at the Pitié-Salpêtrière Hospital in Paris between 1998 and 2018. Precise localization of the epileptic focus was correlated with scores on tests of intelligence (Global, Verbal and Performance IQ), working memory, episodic memory (verbal and visual learning and forgetting), executive functions, and language abilities. RESULTS We demonstrated an impact of the localization of the epileptic focus within the lateral temporal lobe with worse learning and/or executive performances depicted in the infero-basal and pure pole LTLE groups and greater language difficulties in the posterior LTLE group, Antiepileptic drugs had a greater effect than parameters related to the epilepsy itself as the lesion or the disease duration, and finally as in medial TLE, the age, education, and sex influenced some cognitive performances. CONCLUSION Our findings show that the lateral temporal neocortex is also part of the neural substrate for memory processing and executive functions and suggest that this involvement could be related to functions devoted to specific subregions of the temporal lobe (i.e., temporal pole, inferior and basal regions) that support language and semantic processing.
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Affiliation(s)
- Alessia Longo
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Neurosciences Department, Area Del Farmaco E Salute Del Bambino, Firenze, Italy
| | - Marion Houot
- Clinical Investigation Centre, Institut du Cerveau et de la Moelle épinière (ICM), Pitié-Salpêtrière Hospital Paris, France; Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Centre of Excellence of Neurodegenerative Disease (CoEN), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Bastien Herlin
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marie Méré
- Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Marisa Denos
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France
| | - Séverine Samson
- Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Univ. Lille, ULR 4072 - PSITEC - Psychologie : Interactions Temps Émotions Cognition, F-59000 Lille, France
| | - Sophie Dupont
- Rehabilitation Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Epilepsy Unit, AP-HP, Pitié-Salpêtrière Hospital, Paris, France; Université Paris Sorbonne, Paris, France; Centre de recherche de l'Institut du cerveau et de la moelle épinière (ICM), UMPC-UMR 7225 CNRS-UMRS 975 Inserm, Paris, France.
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Sone D, Ahmad M, Thompson PJ, Baxendale S, Vos SB, Xiao F, de Tisi J, McEvoy AW, Miserocchi A, Duncan JS, Koepp MJ, Galovic M. Optimal Surgical Extent for Memory and Seizure Outcome in Temporal Lobe Epilepsy. Ann Neurol 2021; 91:131-144. [PMID: 34741484 PMCID: PMC8916104 DOI: 10.1002/ana.26266] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 10/21/2021] [Accepted: 10/31/2021] [Indexed: 12/28/2022]
Abstract
OBJECTIVE Postoperative memory decline is an important consequence of anterior temporal lobe resection (ATLR) for temporal lobe epilepsy (TLE), and the extent of resection may be a modifiable factor. This study aimed to define optimal resection margins for cognitive outcome while maintaining a high rate of postoperative seizure freedom. METHODS This cohort study evaluated the resection extent on postoperative structural MRI using automated voxel-based methods and manual measurements in 142 consecutive patients with unilateral drug refractory TLE (74 left, 68 right TLE) who underwent standard ATLR. RESULTS Voxel-wise analyses revealed that postsurgical verbal memory decline correlated with resections of the posterior hippocampus and inferior temporal gyrus, whereas larger resections of the fusiform gyrus were associated with worsening of visual memory in left TLE. Limiting the posterior extent of left hippocampal resection to 55% reduced the odds of significant postoperative verbal memory decline by a factor of 8.1 (95% CI 1.5-44.4, p = 0.02). Seizure freedom was not related to posterior resection extent, but to the piriform cortex removal after left ATLR. In right TLE, variability of the posterior extent of resection was not associated with verbal and visual memory decline or seizures after surgery. INTERPRETATION The extent of surgical resection is an independent and modifiable risk factor for cognitive decline and seizures after left ATLR. Adapting the posterior extent of left ATLR might optimize postoperative outcome, with reduced risk of memory impairment while maintaining comparable seizure-freedom rates. The current, more lenient, approach might be appropriate for right ATLR. ANN NEUROL 2021.
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Affiliation(s)
- Daichi Sone
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Psychiatry, The Jikei University School of Medicine, Tokyo, Japan
| | - Maria Ahmad
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Pamela J Thompson
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Sallie Baxendale
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Sjoerd B Vos
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Centre for Medical Image Computing (CMIC), University College London, London, UK.,Neuroradiological Academic Unit, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Fenglai Xiao
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Jane de Tisi
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Andrew W McEvoy
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - Anna Miserocchi
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK
| | - John S Duncan
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Marian Galovic
- Department of Clinical and Experimental Epilepsy, University College London Queen Square Institute of Neurology, London, UK.,Magnetic Resonance Imaging Unit, Epilepsy Society, Chalfont St Peter, UK.,Department of Neurology, Clinical Neuroscience Center, University Hospital Zurich, Zurich, Switzerland
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26
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Cloppenborg T, Mertens M, Hopf JL, Kalbhenn T, Bien CG, Woermann FG, Polster T. Reading and the visual word form area (VWFA) - Management and clinical experience at one epilepsy surgery center. Epilepsy Behav 2021; 124:108274. [PMID: 34536734 DOI: 10.1016/j.yebeh.2021.108274] [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: 05/18/2021] [Revised: 08/12/2021] [Accepted: 08/14/2021] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Presurgical evaluation has no established routine to assess reading competence and to identify essential "not to resect" reading areas. Functional models describe a visual word form area (VWFA) located in the midfusiform gyrus in the dominant ventral occipito-temporal cortex (vOTC) as essential for reading. We demonstrate the relevance and feasibility of invasive VWFA-mapping. METHODS Four patients with epilepsy received invasive VWFA-mapping via left temporo-basal strip-electrodes. Co-registration of the results and additional data from the literature led to the definition of a region of interest (ROI) for a retrospective assessment of postoperative reading deficits by a standardized telephone-interview in patients with resections in this ROI between 2004 and 2018. RESULTS Electrical cortical stimulation disturbed whole word recognition and reading in four patients with structural epilepsy. Stimulation results showed distribution in the basal temporal lobe (dorsal mesencephalon to preoccipital notch). We identified 34 patients with resections in the ROI of the dominant hemisphere. Of these, 15 (44.1%) showed a postoperative reading deficit with a mean duration of 18.2 months (+/-32.4, 0.5-122). Six patients suffered from letter-by-letter (LBL) reading. Two patients had permanent LBL reading after resection in the ROI. SIGNIFICANCE We present evidence on the functional relevance of the vOTC for reading by (1) extra-operative cortical stimulation of the VWFA and by (2) a retrospective case study of reading deficits in patients operated in this area. Reading assessments and data concerning essential reading structures should be included in the presurgical evaluation of patients with lesions in the left vOTC.
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Affiliation(s)
- Thomas Cloppenborg
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Bielefeld, Germany.
| | - Markus Mertens
- Society of Epilepsy Research, Bethel Epilepsy Centre, Bielefeld, Germany
| | - Johanna L Hopf
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Bielefeld, Germany
| | - Thilo Kalbhenn
- Bielefeld University, Medical School, Department of Neurosurgery (Evangelisches Klinikum Bethel), Bielefeld, Germany
| | - Christian G Bien
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Bielefeld, Germany
| | - Friedrich G Woermann
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Bielefeld, Germany
| | - Tilman Polster
- Bielefeld University, Medical School, Department of Epileptology (Krankenhaus Mara), Bielefeld, Germany
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27
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Mesulam MM, Coventry CA, Rader BM, Kuang A, Sridhar J, Martersteck A, Zhang H, Thompson CK, Weintraub S, Rogalski EJ. Modularity and granularity across the language network-A primary progressive aphasia perspective. Cortex 2021; 141:482-496. [PMID: 34153680 PMCID: PMC8319115 DOI: 10.1016/j.cortex.2021.05.002] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 03/22/2021] [Accepted: 05/05/2021] [Indexed: 11/16/2022]
Abstract
Tests of grammar, repetition and semantics were administered to 62 prospectively enrolled right-handed participants with primary progressive aphasia (PPA). Structural brain images were obtained at the time of testing. Regression analyses uncovered 3 clearly delineated non-overlapping left hemisphere clusters where cortical thinning (atrophy) was significantly correlated with impaired performance. A morphosyntactic cluster associated with the grammaticality of sentence construction was located predominantly within the middle and inferior frontal gyri; a phonolexical cluster associated with language repetition was located in the temporoparietal junction; a lexicosemantic cluster associated with object naming and single word comprehension was located within the middle and anterior parts of the temporal lobe and extended into insular, orbitofrontal, and mediotemporal cortices. Commonality analyses were undertaken to explore whether these three clusters were as modular as indicated by the regression analyses or whether some underlying functional granularity could be uncovered. Modularity was defined as the exclusive association of an anatomical cluster with a single type of language task whereas granularity was defined as the association of a single anatomical cluster with more than one type of language task. The commonality analyses revealed a predominantly modular organization with quantitatively minor instances of inter-cluster granularity. The results also reconfirmed previous work on PPA which had shown that Wernicke's area is not essential for word comprehension, that naming impairments can be based either on deficits of lexical retrieval or word comprehension, and that the essential substrates of word comprehension encompass much wider areas of the temporal lobe than the temporal pole. The anatomy of the language network has traditionally been explored through patients with focal cerebrovascular accidents and experiments based on functional activation. Investigations on PPA are showing that focal neurodegenerations can add new perspectives to existing models of the language network.
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Affiliation(s)
- M-Marsel Mesulam
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Davee Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
| | - Christina A Coventry
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | | | - Alan Kuang
- Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
| | - Jaiashre Sridhar
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Adam Martersteck
- Helen Wills Neuroscience Institute, University of California, Berkeley, CA, USA
| | - Hui Zhang
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Preventive Medicine, Chicago, IL, USA
| | - Cynthia K Thompson
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University School of Communication, Evanston, IL, USA
| | - Sandra Weintraub
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
| | - Emily J Rogalski
- Mesulam Center for Cognitive Neurology and Alzheimer's Disease, Northwestern University Feinberg School of Medicine, Chicago, IL, USA; Northwestern University Feinberg School of Medicine, Department of Psychiatry and Behavioral Sciences, Chicago, IL, USA
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Drane DL, Pedersen NP, Sabsevitz DS, Block C, Dickey AS, Alwaki A, Kheder A. Cognitive and Emotional Mapping With SEEG. Front Neurol 2021; 12:627981. [PMID: 33912122 PMCID: PMC8072290 DOI: 10.3389/fneur.2021.627981] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Accepted: 03/04/2021] [Indexed: 02/05/2023] Open
Abstract
Mapping of cortical functions is critical for the best clinical care of patients undergoing epilepsy and tumor surgery, but also to better understand human brain function and connectivity. The purpose of this review is to explore existing and potential means of mapping higher cortical functions, including stimulation mapping, passive mapping, and connectivity analyses. We examine the history of mapping, differences between subdural and stereoelectroencephalographic approaches, and some risks and safety aspects, before examining different types of functional mapping. Much of this review explores the prospects for new mapping approaches to better understand other components of language, memory, spatial skills, executive, and socio-emotional functions. We also touch on brain-machine interfaces, philosophical aspects of aligning tasks to brain circuits, and the study of consciousness. We end by discussing multi-modal testing and virtual reality approaches to mapping higher cortical functions.
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Affiliation(s)
- Daniel L. Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Emory Epilepsy Center, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
- Department of Neurology, University of Washington School of Medicine, Seattle, WA, United States
| | - Nigel P. Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Emory Epilepsy Center, Atlanta, GA, United States
- Department of Biomedical Engineering, Georgia Institute of Technology and Emory University, Atlanta, GA, United States
| | - David S. Sabsevitz
- Department of Psychology and Psychiatry, Mayo Clinic, Jacksonville, FL, United States
- Department of Neurological Surgery, Mayo Clinic, Jacksonville, FL, United States
| | - Cady Block
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Adam S. Dickey
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Abdulrahman Alwaki
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
| | - Ammar Kheder
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, United States
- Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, United States
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Aron O, Jonas J, Colnat-Coulbois S, Maillard L. Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion. Front Hum Neurosci 2021; 15:619521. [PMID: 33776668 PMCID: PMC7987679 DOI: 10.3389/fnhum.2021.619521] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Stereo-electroencephalography (sEEG) is a method that uses stereotactically implanted depth electrodes for extra-operative mapping of epileptogenic and functional networks. sEEG derived functional mapping is achieved using electrical cortical stimulations (ECS) that are currently the gold standard for delineating eloquent cortex. As this stands true especially for primary cortices (e.g., visual, sensitive, motor, etc.), ECS applied to higher order brain areas determine more subtle behavioral responses. While anterior and posterior language areas in the dorsal language stream seem to share characteristics with primary cortices, basal temporal language area (BTLA) in the ventral temporal cortex (VTC) behaves as a highly associative cortex. After a short introduction and considerations about methodological aspects of ECS using sEEG, we review the sEEG language mapping literature in this perspective. We first establish the validity of this technique to map indispensable language cortices in the dorsal language stream. Second, we highlight the contrast between the growing empirical ECS experience and the lack of understanding regarding the fundamental mechanisms underlying ECS behavioral effects, especially concerning the dispensable language cortex in the VTC. Evidences for considering network architecture as determinant for ECS behavioral response complexities are discussed. Further, we address the importance of designing new research in network organization of language as this could enhance ECS ability to map interindividual variability, pathology driven reorganization, and ultimately identify network resilience markers in order to better predict post-operative language deficit. Finally, based on a whole body of available studies, we believe there is strong evidence to consider sEEG as a valid, safe and reliable method for defining eloquent language cortices although there have been no proper comparisons between surgical resections with or without extra-operative or intra-operative language mapping.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | - Jacques Jonas
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | | | - Louis Maillard
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
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Shinozuka K, Niioka K, Tokuda T, Kyutoku Y, Okuno K, Takahashi T, Dan I. Language Familiarity and Proficiency Leads to Differential Cortical Processing During Translation Between Distantly Related Languages. Front Hum Neurosci 2021; 15:593108. [PMID: 33716689 PMCID: PMC7952452 DOI: 10.3389/fnhum.2021.593108] [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: 08/09/2020] [Accepted: 01/12/2021] [Indexed: 01/29/2023] Open
Abstract
In the midst of globalization, English is regarded as an international language, or Lingua Franca, but learning it as a second language (L2) remains still difficult to speakers of other languages. This is true especially for the speakers of languages distantly related to English such as Japanese. In this sense, exploring neural basis for translation between the first language (L1) and L2 is of great interest. There have been relatively many previous researches revealing brain activation patterns during translations between L1 and English as L2. These studies, which focused on language translation with close or moderate linguistic distance (LD), have suggested that the Broca area (BA 44/45) and the dorsolateral prefrontal cortex (DLPFC; BA 46) may play an important role on translation. However, the neural mechanism of language translation between Japanese and English, having large LD, has not been clarified. Thus, we used functional near infrared spectroscopy (fNIRS) to investigate the brain activation patterns during word translation between Japanese and English. We also assessed the effects of translation directions and word familiarity. All participants’ first language was Japanese and they were learning English. Their English proficiency was advanced or elementary. We selected English and Japanese words as stimuli based on the familiarity for Japanese people. Our results showed that the brain activation patterns during word translation largely differed depending on their English proficiency. The advanced group elicited greater activation on the left prefrontal cortex around the Broca’s area while translating words with low familiarity, but no activation was observed while translating words with high familiarity. On the other hand, the elementary group evoked greater activation on the left temporal area including the superior temporal gyrus (STG) irrespective of the word familiarity. These results suggested that different cognitive process could be involved in word translation corresponding to English proficiency in Japanese learners of English. These difference on the brain activation patterns between the advanced and elementary group may reflect the difference on the cognitive loads depending on the levels of automatization in one’s language processing.
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Affiliation(s)
- Katsumasa Shinozuka
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Kiyomitsu Niioka
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Tatsuya Tokuda
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Yasushi Kyutoku
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Koki Okuno
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Tomoki Takahashi
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
| | - Ippeita Dan
- Research and Development Initiatives, Applied Cognitive Neuroscience Laboratory, Chuo University, Tokyo, Japan
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Abdallah C, Brissart H, Colnat-Coulbois S, Pierson L, Aron O, Forthoffer N, Vignal JP, Tyvaert L, Jonas J, Maillard L. Stereoelectroencephalographic language mapping of the basal temporal cortex predicts postoperative naming outcome. J Neurosurg 2021; 135:1466-1476. [PMID: 33636700 DOI: 10.3171/2020.8.jns202431] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/31/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In drug-resistant temporal lobe epilepsy (TLE) patients, the authors evaluated early and late outcomes for decline in visual object naming after dominant temporal lobe resection (TLR) according to the resection status of the basal temporal language area (BTLA) identified by cortical stimulation during stereoelectroencephalography (SEEG). METHODS Twenty patients who underwent SEEG for drug-resistant TLE met the inclusion criteria. During language mapping, a site was considered positive when stimulation of two contiguous contacts elicited at least one naming impairment during two remote sessions. After TLR ipsilateral to their BTLA, patients were classified as BTLA+ when at least one positive language site was resected and as BTLA- when all positive language sites were preserved. Outcomes in naming and verbal fluency tests were assessed using pre- and postoperative (means of 7 and 25 months after surgery) scores at the group level and reliable change indices (RCIs) for clinically meaningful changes at the individual level. RESULTS BTLA+ patients (n = 7) had significantly worse naming scores than BTLA- patients (n = 13) within 1 year after surgery but not at the long-term evaluation. No difference in verbal fluency tests was observed. When RCIs were used, 5 of 18 patients (28%) had naming decline within 1 year postoperatively (corresponding to 57% of BTLA+ and 9% of BTLA- patients). A significant correlation was found between BTLA resection and naming decline. CONCLUSIONS BTLA resection is associated with a specific and early naming decline. Even if this decline is transient, naming scores in BTLA+ patients tend to remain lower compared to their baseline. SEEG mapping helps to predict postoperative language outcome after dominant TLR.
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Affiliation(s)
- Chifaou Abdallah
- Departments of1Neurology and
- 4Neurology and Neurosurgery Department, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | | | | | | | | | | | | | - Louise Tyvaert
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
| | - Jacques Jonas
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
| | - Louis Maillard
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
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How does inattention affect written and spoken language processing? Cortex 2021; 138:212-227. [PMID: 33713968 DOI: 10.1016/j.cortex.2021.02.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Revised: 12/20/2020] [Accepted: 02/02/2021] [Indexed: 11/22/2022]
Abstract
The classic cocktail party effect suggests that some, but probably not all levels of language processing can proceed without attention. We used whole-brain functional MRI to investigate how modality-specific and modality-independent language areas are modulated by the withdrawal of attention to another sensory modality (e.g., attending to vision during the presentation of auditory sentences, or vice-versa). We tested the hypotheses that inattention may abolish sentence-level integration and eliminate top-down effects. In both written and spoken modalities, language processing was strongly modulated by the distraction of attention, but this inattention effect varied considerably depending on the area and hierarchical level of language processing. Under inattention, a bottom-up activation remained in early modality-specific areas, particularly in superior temporal spoken-language areas, but the difference between sentences and words lists vanished. Under both attended and unattended conditions, ventral temporal cortices were activated in a top-down manner by spoken language more than by control stimuli, reaching posteriorily the Visual Word Form Area. We conclude that inattention prevents sentence-level syntactic and semantic integration, but preserves some top-down crossmodal processing, plus a large degree of bottom-up modality-specific processing, including a ventral occipito-temporal specialization for letter strings in a known alphabet.
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Trébuchon A, Liégeois-Chauvel C, Gonzalez-Martinez JA, Alario FX. Contributions of electrophysiology for identifying cortical language systems in patients with epilepsy. Epilepsy Behav 2020; 112:107407. [PMID: 33181892 DOI: 10.1016/j.yebeh.2020.107407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/10/2020] [Indexed: 11/26/2022]
Abstract
A crucial element of the surgical treatment of medically refractory epilepsy is to delineate cortical areas that must be spared in order to avoid clinically relevant neurological and neuropsychological deficits postoperatively. For each patient, this typically necessitates determining the language lateralization between hemispheres and language localization within hemisphere. Understanding cortical language systems is complicated by two primary challenges: the extent of the neural tissue involved and the substantial variability across individuals, especially in pathological populations. We review the contributions made through the study of electrophysiological activity to address these challenges. These contributions are based on the techniques of magnetoencephalography (MEG), intracerebral recordings, electrical-cortical stimulation (ECS), and the electrovideo analyses of seizures and their semiology. We highlight why no single modality alone is adequate to identify cortical language systems and suggest avenues for improving current practice.
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Affiliation(s)
- Agnès Trébuchon
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France
| | - Catherine Liégeois-Chauvel
- Aix-Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA
| | | | - F-Xavier Alario
- Department of Neurological Surgery, School of Medicine, University of Pittsburgh (PA), USA; Aix-Marseille Univ, CNRS, LPC, Marseille, France.
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Binder JR, Tong JQ, Pillay SB, Conant LL, Humphries CJ, Raghavan M, Mueller WM, Busch RM, Allen L, Gross WL, Anderson CT, Carlson CE, Lowe MJ, Langfitt JT, Tivarus ME, Drane DL, Loring DW, Jacobs M, Morgan VL, Allendorfer JB, Szaflarski JP, Bonilha L, Bookheimer S, Grabowski T, Vannest J, Swanson SJ. Temporal lobe regions essential for preserved picture naming after left temporal epilepsy surgery. Epilepsia 2020; 61:1939-1948. [PMID: 32780878 DOI: 10.1111/epi.16643] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To define left temporal lobe regions where surgical resection produces a persistent postoperative decline in naming visual objects. METHODS Pre- and postoperative brain magnetic resonance imaging data and picture naming (Boston Naming Test) scores were obtained prospectively from 59 people with drug-resistant left temporal lobe epilepsy. All patients had left hemisphere language dominance at baseline and underwent surgical resection or ablation in the left temporal lobe. Postoperative naming assessment occurred approximately 7 months after surgery. Surgical lesions were mapped to a standard template, and the relationship between presence or absence of a lesion and the degree of naming decline was tested at each template voxel while controlling for effects of overall lesion size. RESULTS Patients declined by an average of 15% in their naming score, with wide variation across individuals. Decline was significantly related to damage in a cluster of voxels in the ventral temporal lobe, located mainly in the fusiform gyrus approximately 4-6 cm posterior to the temporal tip. Extent of damage to this region explained roughly 50% of the variance in outcome. Picture naming decline was not related to hippocampal or temporal pole damage. SIGNIFICANCE The results provide the first statistical map relating lesion location in left temporal lobe epilepsy surgery to picture naming decline, and they support previous observations of transient naming deficits from electrical stimulation in the basal temporal cortex. The critical lesion is relatively posterior and could be avoided in many patients undergoing left temporal lobe surgery for intractable epilepsy.
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Affiliation(s)
- Jeffrey R Binder
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jia-Qing Tong
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sara B Pillay
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lisa L Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colin J Humphries
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Wade M Mueller
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Robyn M Busch
- Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Linda Allen
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - William L Gross
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Chad E Carlson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mark J Lowe
- Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - John T Langfitt
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Madalina E Tivarus
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Daniel L Drane
- Department of Neurology and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - David W Loring
- Department of Neurology and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Monica Jacobs
- Department of Psychology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victoria L Morgan
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Susan Bookheimer
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Thomas Grabowski
- Department of Neurology, University of Washington, Seattle, Washington, USA
| | - Jennifer Vannest
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Sara J Swanson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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Caruana F, Avanzini P, Pelliccia V, Mariani V, Zauli F, Sartori I, Del Vecchio M, Lo Russo G, Rizzolatti G. Mirroring other's laughter. Cingulate, opercular and temporal contributions to laughter expression and observation. Cortex 2020; 128:35-48. [DOI: 10.1016/j.cortex.2020.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/29/2020] [Accepted: 02/25/2020] [Indexed: 01/19/2023]
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Bobilev AM, Perez JM, Tamminga CA. Molecular alterations in the medial temporal lobe in schizophrenia. Schizophr Res 2020; 217:71-85. [PMID: 31227207 DOI: 10.1016/j.schres.2019.06.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/29/2019] [Accepted: 06/01/2019] [Indexed: 11/30/2022]
Abstract
The medial temporal lobe (MTL) and its individual structures have been extensively implicated in schizophrenia pathophysiology, with considerable efforts aimed at identifying structural and functional differences in this brain region. The major structures of the MTL for which prominent differences have been revealed include the hippocampus, the amygdala and the superior temporal gyrus (STG). The different functions of each of these regions have been comprehensively characterized, and likely contribute differently to schizophrenia. While neuroimaging studies provide an essential framework for understanding the role of these MTL structures in various aspects of the disease, ongoing efforts have sought to employ molecular measurements in order to elucidate the biology underlying these macroscopic differences. This review provides a summary of the molecular findings in three major MTL structures, and discusses convergent findings in cellular architecture and inter-and intra-cellular networks. The findings of this effort have uncovered cell-type, network and gene-level specificity largely unique to each brain region, indicating distinct molecular origins of disease etiology. Future studies should test the functional implications of these molecular changes at the circuit level, and leverage new advances in sequencing technology to further refine our understanding of the differential contribution of MTL structures to schizophrenia.
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Affiliation(s)
- Anastasia M Bobilev
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, United States of America.
| | - Jessica M Perez
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, United States of America.
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, 5323 Harry Hines Blvd., Dallas, TX, United States of America.
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Faulkner JW, Wilshire CE. Mapping eloquent cortex: A voxel-based lesion-symptom mapping study of core speech production capacities in brain tumour patients. BRAIN AND LANGUAGE 2020; 200:104710. [PMID: 31739187 DOI: 10.1016/j.bandl.2019.104710] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/21/2019] [Accepted: 10/09/2019] [Indexed: 06/10/2023]
Abstract
This study used voxel-based lesion-symptom mapping to examine the cortical and white matter regions associated with language production impairments in a sample of 63 preoperative tumour patients. We identified four cognitive functions considered crucial for spoken language production: semantic-to-lexical mapping (selecting the appropriate lexical label for the intended concept); phonological encoding (retrieving the word's phonological form); articulatory-motor planning (programming the articulatory motor movements); and goal-driven language selection (exerting top-down control over the words selected for production). Each participant received a score estimating their competence on each function. We then mapped the region(s) where pathology was significantly associated with low scores. For semantic-to-lexical mapping, the critical map encompassed portions of the left posterior middle and inferior temporal gyri, extending into posterior fusiform gyrus, overlapping substantially with the territory of the inferior longitudinal fasciculus. For phonological encoding, the map encompassed the left inferior parietal lobe and posterior middle temporal gyrus, overlapping with the territory of the inferior longitudinal and posterior arcuate fasciculi. For articulatory-motor planning, the map encompassed parts of the left frontal pole, frontal operculum, and inferior frontal gyrus, and overlapped with the territory of the frontal aslant tract. Finally, the map for goal-driven language selection encompassed the left frontal pole and the anterior cingulate cortex. We compare our findings with those from other neuropsychological samples, and conclude that the study of tumour patients offers evidence that complements that available from other populations.
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Affiliation(s)
- Josh W Faulkner
- School of Psychology, Victoria University of Wellington, New Zealand
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38
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Bruffaerts R, Schaeverbeke J, De Weer AS, Nelissen N, Dries E, Van Bouwel K, Sieben A, Bergmans B, Swinnen C, Pijnenburg Y, Sunaert S, Vandenbulcke M, Vandenberghe R. Multivariate analysis reveals anatomical correlates of naming errors in primary progressive aphasia. Neurobiol Aging 2019; 88:71-82. [PMID: 31955981 DOI: 10.1016/j.neurobiolaging.2019.12.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 12/10/2019] [Accepted: 12/15/2019] [Indexed: 12/30/2022]
Abstract
Primary progressive aphasia (PPA) is an overarching term for a heterogeneous group of neurodegenerative diseases which affect language processing. Impaired picture naming has been linked to atrophy of the anterior temporal lobe in the semantic variant of PPA. Although atrophy of the anterior temporal lobe proposedly impairs picture naming by undermining access to semantic knowledge, picture naming also entails object recognition and lexical retrieval. Using multivariate analysis, we investigated whether cortical atrophy relates to different types of naming errors generated during picture naming in 43 PPA patients (13 semantic, 9 logopenic, 11 nonfluent, and 10 mixed variant). Omissions were associated with atrophy of the anterior temporal lobes. Semantic errors, for example, mistaking a rhinoceros for a hippopotamus, were associated with atrophy of the left mid and posterior fusiform cortex and the posterior middle and inferior temporal gyrus. Semantic errors and atrophy in these regions occurred in each PPA subtype, without major between-subtype differences. We propose that pathological changes to neural mechanisms associated with semantic errors occur across the PPA spectrum.
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Affiliation(s)
- Rose Bruffaerts
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Department, University Hospitals Leuven, Leuven, Belgium.
| | - Jolien Schaeverbeke
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - An-Sofie De Weer
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Natalie Nelissen
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Eva Dries
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Karen Van Bouwel
- Neurology Department, University Hospitals Leuven, Leuven, Belgium
| | - Anne Sieben
- Neurology Department, University Hospital Ghent, Ghent, Belgium
| | - Bruno Bergmans
- Neurology Department, University Hospital Ghent, Ghent, Belgium; Neurology Department, AZ Sint-Jan Brugge-Oostende AV, Bruges, Belgium
| | | | - Yolande Pijnenburg
- Neurology Department, Alzheimer Center Amsterdam, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Stefan Sunaert
- Radiology Department, University Hospitals Leuven, Leuven, Belgium
| | | | - Rik Vandenberghe
- Laboratory for Cognitive Neurology, Department of Neurosciences, KU Leuven, Leuven, Belgium; Neurology Department, University Hospitals Leuven, Leuven, Belgium
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Kinney MO, Kovac S, Diehl B. Structured testing during seizures: A practical guide for assessing and interpreting ictal and postictal signs during video EEG long term monitoring. Seizure 2019; 72:13-22. [PMID: 31546090 DOI: 10.1016/j.seizure.2019.08.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2019] [Revised: 08/01/2019] [Accepted: 08/17/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Ictal and postictal testing carried out in long-term epilepsy monitoring units is often sub-optimal. Recently, a European consensus protocol for testing patients during and after seizures was developed by a joint taskforce of the International League Against Epilepsy - Commission on European Affairs and the European Epilepsy Monitoring Unit Association. AIM Using this recently developed standardised assessment battery as a framework, the goal of this narrative review is to outline the proposed testing procedure in detail and explain the rationale for each individual component, focusing on the underlying neurobiology. This is intended to serve as an educational resource for staff working in epilepsy monitoring units. METHODS A literature review of PubMed was performed; using the search terms "seizure", "ictal", "postictal", "testing", "examination", and "interview". Relevant literature was reviewed and relevant references were chosen. The work is presented as a narrative review. RESULTS The proposed standardised assessment battery provides a comprehensive and user-friendly format for ictal-postictal testing, and examines consciousness, language, motor, sensory, and visual function. CONCLUSION The standardised approach proposed has the potential to make full use of data recorded during video EEG increasing the diagnostic yield with regards to lateralisation and localisation, aiding both presurgical and diagnostic studies.
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Affiliation(s)
- Michael Owen Kinney
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK.
| | - Stjepana Kovac
- Department of Neurology, University of Münster, Münster, Germany
| | - Beate Diehl
- Department of Clinical Neurophysiology, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK; Department of Clinical and Experimental Epilepsy, National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
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Forseth KJ, Kadipasaoglu CM, Conner CR, Hickok G, Knight RT, Tandon N. A lexical semantic hub for heteromodal naming in middle fusiform gyrus. Brain 2019; 141:2112-2126. [PMID: 29860298 DOI: 10.1093/brain/awy120] [Citation(s) in RCA: 86] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Accepted: 03/23/2018] [Indexed: 11/13/2022] Open
Abstract
Semantic memory underpins our understanding of objects, people, places, and ideas. Anomia, a disruption of semantic memory access, is the most common residual language disturbance and is seen in dementia and following injury to temporal cortex. While such anomia has been well characterized by lesion symptom mapping studies, its pathophysiology is not well understood. We hypothesize that inputs to the semantic memory system engage a specific heteromodal network hub that integrates lexical retrieval with the appropriate semantic content. Such a network hub has been proposed by others, but has thus far eluded precise spatiotemporal delineation. This limitation in our understanding of semantic memory has impeded progress in the treatment of anomia. We evaluated the cortical structure and dynamics of the lexical semantic network in driving speech production in a large cohort of patients with epilepsy using electrocorticography (n = 64), functional MRI (n = 36), and direct cortical stimulation (n = 30) during two generative language processes that rely on semantic knowledge: visual picture naming and auditory naming to definition. Each task also featured a non-semantic control condition: scrambled pictures and reversed speech, respectively. These large-scale data of the left, language-dominant hemisphere uniquely enable convergent, high-resolution analyses of neural mechanisms characterized by rapid, transient dynamics with strong interactions between distributed cortical substrates. We observed three stages of activity during both visual picture naming and auditory naming to definition that were serially organized: sensory processing, lexical semantic processing, and articulation. Critically, the second stage was absent in both the visual and auditory control conditions. Group activity maps from both electrocorticography and functional MRI identified heteromodal responses in middle fusiform gyrus, intraparietal sulcus, and inferior frontal gyrus; furthermore, the spectrotemporal profiles of these three regions revealed coincident activity preceding articulation. Only in the middle fusiform gyrus did direct cortical stimulation disrupt both naming tasks while still preserving the ability to repeat sentences. These convergent data strongly support a model in which a distinct neuroanatomical substrate in middle fusiform gyrus provides access to object semantic information. This under-appreciated locus of semantic processing is at risk in resections for temporal lobe epilepsy as well as in trauma and strokes that affect the inferior temporal cortex-it may explain the range of anomic states seen in these conditions. Further characterization of brain network behaviour engaging this region in both healthy and diseased states will expand our understanding of semantic memory and further development of therapies directed at anomia.
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Affiliation(s)
- Kiefer James Forseth
- Vivian L Smith Department of Neurosurgery, McGovern Medical School, Houston, TX, USA
| | | | | | - Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | | | - Nitin Tandon
- Vivian L Smith Department of Neurosurgery, McGovern Medical School, Houston, TX, USA.,Memorial Hermann Hospital, Texas Medical Center, Houston, TX, USA
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Rolinski R, Austermuehle A, Wiggs E, Agrawal S, Sepeta L, Gaillard WD, Zaghloul K, Inati SK, Theodore WH. Functional MRI and direct cortical stimulation: Prediction of postoperative language decline. Epilepsia 2019; 60:560-570. [PMID: 30740700 PMCID: PMC6467056 DOI: 10.1111/epi.14666] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2018] [Revised: 01/16/2019] [Accepted: 01/16/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE To assess the ability of functional MRI (fMRI) to predict postoperative language decline compared to direct cortical stimulation (DCS) in epilepsy surgery patients. METHODS In this prospective case series, 17 patients with drug-resistant epilepsy had intracranial monitoring and resection from 2012 to 2016 with 1-year follow-up. All patients completed preoperative language fMRI, mapping with DCS of subdural electrodes, pre- and postoperative neuropsychological testing for language function, and resection. Changes in language function before and after surgery were assessed. fMRI activation and DCS electrodes in the resection were evaluated as potential predictors of language decline. RESULTS Four of 17 patients (12 female; median [range] age, 43 [23-59] years) experienced postoperative language decline 1 year after surgery. Two of 4 patients had overlap of fMRI activation, language-positive electrodes in basal temporal regions (within 1 cm), and resection. Two had overlap between resection volume and fMRI activation, but not DCS. fMRI demonstrated 100% sensitivity and 46% specificity for outcome compared to DCS (50% and 85%, respectively). When fMRI and DCS language findings were concordant, the combined tests showed 100% sensitivity and 75% specificity for language outcome. Seizure-onset age, resection side, type, volume, or 1 year seizure outcome did not predict language decline. SIGNIFICANCE Language localization overlap of fMRI and direct cortical stimulation in the resection influences postoperative language performance. Our preliminary study suggests that fMRI may be more sensitive and less specific than direct cortical stimulation. Together they may predict outcome better than either test alone.
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Affiliation(s)
- Rachel Rolinski
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Alison Austermuehle
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Edythe Wiggs
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Shubhi Agrawal
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Berman Brain & Spine Institute, Baltimore, MD
| | - Leigh Sepeta
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Department of Neurology Children’s National Medical
Center, Washington, D.C
| | - William D Gaillard
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
- Department of Neurology Children’s National Medical
Center, Washington, D.C
| | - Kareem Zaghloul
- Surgical Neurology Branch, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - Sara K Inati
- Electroencephalography Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
| | - William H Theodore
- Clinical Epilepsy Section, National Institute of
Neurological Disorders and Stroke, Bethesda, MD
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Drane DL, Pedersen NP. Knowledge of language function and underlying neural networks gained from focal seizures and epilepsy surgery. BRAIN AND LANGUAGE 2019; 189:20-33. [PMID: 30615986 PMCID: PMC7183240 DOI: 10.1016/j.bandl.2018.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/22/2016] [Revised: 09/05/2018] [Accepted: 12/19/2018] [Indexed: 05/09/2023]
Abstract
The effects of epilepsy and its treatments have contributed significantly to language models. The setting of epilepsy surgery, which allows for careful pre- and postsurgical evaluation of patients with cognitive testing and neuroimaging, has produced a wealth of language findings. Moreover, a new wave of surgical interventions, including stereotactic laser ablation and radio frequency ablation, have contributed new insights and corrections to language models as they can make extremely precise, focal lesions. This review covers the common language deficits observed in focal dyscognitive seizure syndromes. It also addresses the effects of surgical interventions on language, and highlights insights gained from unique epilepsy assessment methods (e.g., cortical stimulation mapping, Wada evaluation). Emergent findings are covered including a lack of involvement of the hippocampus in confrontation word retrieval, possible roles for key white matter tracts in language, and the often-overlooked basal temporal language area. The relationship between language and semantic memory networks is also explored, with brief consideration given to the prevailing models of semantic processing, including the amodal Hub and distributed, multi-modal processing models.
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Affiliation(s)
- Daniel L Drane
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA; Department of Pediatrics, Emory University School of Medicine, Atlanta, GA, USA; Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA.
| | - Nigel P Pedersen
- Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA
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Katyal R, De Sousa E, Sultan F. A Rare Case of Prolonged Ictal Aphasia. Neurodiagn J 2019; 59:104-111. [PMID: 31210608 DOI: 10.1080/21646821.2019.1616960] [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: 02/11/2019] [Accepted: 05/07/2019] [Indexed: 06/09/2023]
Abstract
Aphasia is commonly seen in focal brain lesions. Prolonged aphasia from an ictal state is rarely reported. We report the case of a 62-year-old man with focal motor status epilepticus manifested initially as episodic right cheiro-oral clonic movements with preserved awareness and expressive aphasia for 48 hours. EEG showed left frontal and central lateralized periodic discharges (LPDs) without plus features (rhythmicity, overlying fast) and electrographic seizures that correlated with right clonic movements. Treatment with two seizure medications (levetiracetam and lacosamide) resulted in complete electrographic and clinical resolution of his symptoms, including aphasia. In this case, aphasia was determined to be an ictal semiology, as patient had complete resolution of his symptoms supported by a normal EEG after receiving seizure medications. We suggest keeping high suspicion for an ictal process in patients with sudden-onset aphasia supported by EEG findings of LPDs.
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Affiliation(s)
- Roohi Katyal
- a University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
| | - Eduardo De Sousa
- b Mercy Neurology Neuroscience Institute , Oklahoma City , Oklahoma
| | - Fahd Sultan
- a University of Oklahoma Health Sciences Center , Oklahoma City , Oklahoma
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Wang L, Kuperberg G, Jensen O. Specific lexico-semantic predictions are associated with unique spatial and temporal patterns of neural activity. eLife 2018; 7:e39061. [PMID: 30575521 PMCID: PMC6322859 DOI: 10.7554/elife.39061] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/20/2018] [Indexed: 11/13/2022] Open
Abstract
We used Magnetoencephalography (MEG) in combination with Representational Similarity Analysis to probe neural activity associated with distinct, item-specific lexico-semantic predictions during language comprehension. MEG activity was measured as participants read highly constraining sentences in which the final words could be predicted. Before the onset of the predicted words, both the spatial and temporal patterns of brain activity were more similar when the same words were predicted than when different words were predicted. The temporal patterns localized to the left inferior and medial temporal lobe. These findings provide evidence that unique spatial and temporal patterns of neural activity are associated with item-specific lexico-semantic predictions. We suggest that the unique spatial patterns reflected the prediction of spatially distributed semantic features associated with the predicted word, and that the left inferior/medial temporal lobe played a role in temporally 'binding' these features, giving rise to unique lexico-semantic predictions.
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Affiliation(s)
- Lin Wang
- Department of PsychiatryHarvard Medical SchoolBostonUnited States
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownUnited States
- Department of PsychologyTufts UniversityMedfordUnited States
| | - Gina Kuperberg
- Department of PsychiatryHarvard Medical SchoolBostonUnited States
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownUnited States
- Department of PsychologyTufts UniversityMedfordUnited States
| | - Ole Jensen
- School of PsychologyCentre for Human Brain Health, University of BirminghamBirminghamUnited Kingdom
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Vogt VL, Delev D, Grote A, Schramm J, von Lehe M, Elger CE, Witt JA, Helmstaedter C. Neuropsychological outcome after subtemporal versus transsylvian approach for selective amygdalohippocampectomy in patients with mesial temporal lobe epilepsy: a randomised prospective clinical trial. J Neurol Neurosurg Psychiatry 2018; 89:1057-1063. [PMID: 29273691 DOI: 10.1136/jnnp-2017-316311] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Revised: 08/29/2017] [Accepted: 11/20/2017] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To compare the effects of different surgical approaches for selective amygdalohippocampectomy in patients with pharmacoresistant mesial temporal lobe epilepsy with regard to the neuropsychological outcome and to replicate an earlier study employing a matched-pair design. METHOD 47 patients were randomised to subtemporal versus transsylvian approaches. Memory, language, attentional and executive functions were assessed before and 1 year after surgery. Multivariate analyses of variance (MANOVAs) with presurgical and postsurgical assessments as within-subject variables and approach and side of surgery as between-subject factors were calculated. Additionally, the frequencies of individual performance changes based on reliable change indices were analysed. RESULTS Seizure freedom International League Against Epilepsy (ILAE) 1a, was achieved in 62% of all patients without group difference. MANOVAs revealed no significant effects of approach on cognition. Tested separately for each parameter, verbal recognition memory declined irrespective of approach. Post hoc tests revealed that on group level, the subtemporal approach was associated with a worse outcome for verbal learning and delayed free recall as well as for semantic fluency. Accordingly, on individual level, more patients in the subtemporal group declined in verbal learning. Left side of surgery was associated with decline in naming regardless of approach. CONCLUSION The main analysis did not confirm the effects of approach on memory outcome seen in our previous study. Post hoc testing, however, showed greater memory losses with the subtemporal approach. Previous findings were replicated for semantic fluency. The discrepant results are discussed on the background of the different study designs.
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Affiliation(s)
- Viola Lara Vogt
- Department of Epileptology, University of Bonn-Medical Center, Bonn, Germany
| | - Daniel Delev
- Department of Neurosurgery, University of Bonn-Medical Center, Bonn, Germany.,Department of Neurosurgery, University Medical Center, Freiburg, Germany
| | - Alexander Grote
- Department of Neurosurgery, University of Bonn-Medical Center, Bonn, Germany
| | - Johannes Schramm
- Department of Neurosurgery, University of Bonn-Medical Center, Bonn, Germany
| | - Marec von Lehe
- Department of Neurosurgery, Knappschaftskrankenhaus Bochum, Bonn, Germany
| | | | - Juri-Alexander Witt
- Department of Epileptology, University of Bonn-Medical Center, Bonn, Germany
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Tatum W, Rubboli G, Kaplan P, Mirsatari S, Radhakrishnan K, Gloss D, Caboclo L, Drislane F, Koutroumanidis M, Schomer D, Kasteleijn-Nolst Trenite D, Cook M, Beniczky S. Clinical utility of EEG in diagnosing and monitoring epilepsy in adults. Clin Neurophysiol 2018; 129:1056-1082. [DOI: 10.1016/j.clinph.2018.01.019] [Citation(s) in RCA: 76] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2017] [Revised: 12/28/2017] [Accepted: 01/09/2018] [Indexed: 12/20/2022]
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Herbet G, Moritz-Gasser S, Boiseau M, Duvaux S, Cochereau J, Duffau H. Converging evidence for a cortico-subcortical network mediating lexical retrieval. Brain 2018; 139:3007-3021. [PMID: 27604309 DOI: 10.1093/brain/aww220] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 07/13/2016] [Indexed: 11/12/2022] Open
Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France.,Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Morgane Boiseau
- Department of Neurology, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Sophie Duvaux
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Jérôme Cochereau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34295, Montpellier, France.,Institute for Neuroscience of Montpellier (INM), INSERM-1051, Team 4, Saint-Eloi Hospital, Montpellier University Medical Center, F-34091, Montpellier, France
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Trebuchon A, Lambert I, Guisiano B, McGonigal A, Perot C, Bonini F, Carron R, Liegeois-Chauvel C, Chauvel P, Bartolomei F. The different patterns of seizure-induced aphasia in temporal lobe epilepsies. Epilepsy Behav 2018; 78:256-264. [PMID: 29128469 DOI: 10.1016/j.yebeh.2017.08.022] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2017] [Revised: 08/05/2017] [Accepted: 08/14/2017] [Indexed: 10/18/2022]
Abstract
OBJECTIVES Ictal language disturbances may occur in dominant hemisphere temporal lobe epilepsy (TLE), but little is known about the precise anatomoelectroclinical correlations. This study investigated the different facets of ictal aphasia in intracerebrally recorded TLE. METHODS Video-stereoelectroencephalography (SEEG) recordings of 37 seizures in 17 right-handed patients with drug-resistant TLE were analyzed; SEEG electroclinical correlations between language disturbance and involvement of temporal lobe structures were assessed. In the clinical analysis, we separated speech disturbance from loss of consciousness. RESULTS According to the region involved, different patterns of ictal aphasia in TLE were identified. Impaired speech comprehension was associated with posterior lateral involvement, anomia and reduced verbal fluency with anterior mediobasal structures, and jargonaphasia with basal temporal involvement. The language production deficits, such as anomia and low fluency, cannot be simply explained by an involvement of Broca's area, since this region was not affected by seizure discharge. SIGNIFICANCE Assessment of language function in the early ictal state can be successfully performed and provides valuable information on seizure localization within the temporal lobe as well as potentially useful information for guiding surgery.
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Affiliation(s)
- Agnès Trebuchon
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France.
| | - Isabelle Lambert
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Bernard Guisiano
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Aileen McGonigal
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Charline Perot
- APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Francesca Bonini
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Romain Carron
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | | | - Patrick Chauvel
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
| | - Fabrice Bartolomei
- Aix Marseille Univ, INSERM, INS, Inst Neurosci Syst, Marseille, France; APHM, Hôpital de la Timone, Service de Neurophysiologie Clinique, Marseille, France
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Ives-Deliperi VL, Butler JT. Localizing the Language Network with fMRI and Functional Connectivity: Implications for Pre-Surgical Planning. ACTA ACUST UNITED AC 2018. [DOI: 10.4236/ojmn.2018.82015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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