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Hong Y, Ryun S, Chung CK. Evoking artificial speech perception through invasive brain stimulation for brain-computer interfaces: current challenges and future perspectives. Front Neurosci 2024; 18:1428256. [PMID: 38988764 PMCID: PMC11234843 DOI: 10.3389/fnins.2024.1428256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Accepted: 06/10/2024] [Indexed: 07/12/2024] Open
Abstract
Encoding artificial perceptions through brain stimulation, especially that of higher cognitive functions such as speech perception, is one of the most formidable challenges in brain-computer interfaces (BCI). Brain stimulation has been used for functional mapping in clinical practices for the last 70 years to treat various disorders affecting the nervous system, including epilepsy, Parkinson's disease, essential tremors, and dystonia. Recently, direct electrical stimulation has been used to evoke various forms of perception in humans, ranging from sensorimotor, auditory, and visual to speech cognition. Successfully evoking and fine-tuning artificial perceptions could revolutionize communication for individuals with speech disorders and significantly enhance the capabilities of brain-computer interface technologies. However, despite the extensive literature on encoding various perceptions and the rising popularity of speech BCIs, inducing artificial speech perception is still largely unexplored, and its potential has yet to be determined. In this paper, we examine the various stimulation techniques used to evoke complex percepts and the target brain areas for the input of speech-like information. Finally, we discuss strategies to address the challenges of speech encoding and discuss the prospects of these approaches.
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Affiliation(s)
- Yirye Hong
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, Republic of Korea
| | - Seokyun Ryun
- Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
| | - Chun Kee Chung
- Neuroscience Research Institute, Seoul National University Medical Research Center, Seoul, Republic of Korea
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2
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Brem S, Hoch MJ. Commentary: Resting State Functional Networks in Gliomas: Validation With Direct Electrical Stimulation Using a New Tool for Planning Brain Resections. Neurosurgery 2024:00006123-990000000-01215. [PMID: 38869302 DOI: 10.1227/neu.0000000000003065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2024] [Accepted: 05/14/2024] [Indexed: 06/14/2024] Open
Affiliation(s)
- Steven Brem
- Department of Neurosurgery, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Glioblastoma Translational Center of Excellence (TCE), Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael J Hoch
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Diao Y, Xie H, Wang Y, Zhao B, Yang A, Hlavnicka J, Zhang J. Acoustic assessment in mandarin-speaking Parkinson's disease patients and disease progression monitoring and brain impairment within the speech subsystem. NPJ Parkinsons Dis 2024; 10:115. [PMID: 38866758 PMCID: PMC11169641 DOI: 10.1038/s41531-024-00720-3] [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: 12/05/2023] [Accepted: 05/10/2024] [Indexed: 06/14/2024] Open
Abstract
Approximately 90% of Parkinson's patients (PD) suffer from dysarthria. However, there is currently a lack of research on acoustic measurements and speech impairment patterns among Mandarin-speaking individuals with PD. This study aims to assess the diagnosis and disease monitoring possibility in Mandarin-speaking PD patients through the recommended speech paradigm for non-tonal languages, and to explore the anatomical and functional substrates. We examined total of 160 native Mandarin-speaking Chinese participants consisting of 80 PD patients, 40 healthy controls (HC), and 40 MRI controls. We screened the optimal acoustic metric combination for PD diagnosis. Finally, we used the objective metrics to predict the patient's motor status using the Naïve Bayes model and analyzed the correlations between cortical thickness, subcortical volumes, functional connectivity, and network properties. Comprehensive acoustic screening based on prosodic, articulation, and phonation abnormalities allows differentiation between HC and PD with an area under the curve of 0.931. Patients with slowed reading exhibited atrophy of the fusiform gyrus (FDR p = 0.010, R = 0.391), reduced functional connectivity between the fusiform gyrus and motor cortex, and increased nodal local efficiency (NLE) and nodal efficiency (NE) in bilateral pallidum. Patients with prolonged pauses demonstrated atrophy in the left hippocampus, along with decreased NLE and NE. The acoustic assessment in Mandarin proves effective in diagnosis and disease monitoring for Mandarin-speaking PD patients, generalizing standardized acoustic guidelines beyond non-tonal languages. The speech impairment in Mandarin-speaking PD patients not only involves motor aspects of speech but also encompasses the cognitive processes underlying language generation.
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Affiliation(s)
- Yu Diao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hutao Xie
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanwen Wang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Baotian Zhao
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Anchao Yang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Neurostimulation, Beijing, China
| | - Jan Hlavnicka
- Centre of Clinical Neuroscience, 1st Faculty of Medicine, Charles University in Prague, Prague, Czech Republic.
- Department of Circuit Theory, Faculty of Electrical Engineering, Czech Technical University in Prague, Prague, Czech Republic.
| | - Jianguo Zhang
- Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
- Beijing Key Laboratory of Neurostimulation, Beijing, China.
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Tomasino B, Weis L, Maieron M, Pauletto G, Verriello L, Budai R, Ius T, D'Agostini S, Fadiga L, Skrap M. Motor or non-motor speech interference? A multimodal fMRI and direct cortical stimulation mapping study. Neuropsychologia 2024; 198:108876. [PMID: 38555064 DOI: 10.1016/j.neuropsychologia.2024.108876] [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: 01/27/2024] [Revised: 03/21/2024] [Accepted: 03/22/2024] [Indexed: 04/02/2024]
Abstract
We retrospectively analyzed data from 15 patients, with a normal pre-operative cognitive performance, undergoing awake surgery for left fronto-temporal low-grade glioma. We combined a pre-surgical measure (fMRI maps of motor- and language-related centers) with intra-surgical measures (MNI-registered cortical sites data obtained during intra-operative direct electrical stimulation, DES, while they performed the two most common language tasks: number counting and picture naming). Selective DES effects along the precentral gyrus/inferior frontal gyrus (and/or the connected speech articulation network) were obtained. DES of the precentral gyrus evoked the motor speech arrest, i.e., anarthria (with apparent mentalis muscle movements). We calculated the number of shared voxels between the lip-tongue and overt counting related- and silent naming-related fMRI maps and the Volumes of Interest (VOIs) obtained by merging together the MNI sites at which a given speech disturbance was observed, normalized on their mean the values (i.e., Z score). Both tongue- and lips-related movements fMRI maps maximally overlapped (Z = 1.05 and Z = 0.94 for lips and tongue vs. 0.16 and -1.003 for counting and naming) with the motor speech arrest seed. DES of the inferior frontal gyrus, pars opercularis and the rolandic operculum induced speech arrest proper (without apparent mentalis muscle movements). This area maximally overlapped with overt counting-related fMRI map (Z = -0.11 and Z = 0.09 for lips and tongue vs. 0.9 and 0.0006 for counting and naming). Interestingly, our fMRI maps indicated reduced Broca's area activity during silent speech compared to overt speech. Lastly, DES of the inferior frontal gyrus, pars opercularis and triangularis evoked variations of the output, i.e., dysarthria, a motor speech disorder occurring when patients cannot control the muscles used to produce articulated sounds (phonemes). Silent object naming-related fMRI map maximally overlapped (Z = -0.93 and Z = -1.04 for lips and tongue vs. -1.07 and 0.99 for counting and naming) with this seed. Speech disturbances evoked by DES may be thought of as selective interferences with specific recruitment of left inferior frontal gyrus and precentral cortex which are differentiable in terms of the specific interference induced.
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Affiliation(s)
| | - Luca Weis
- Istituto Italiano di Tecnologia, Genova, Italy
| | - Marta Maieron
- Fisica Medica, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Giada Pauletto
- Neurologia, Dipartimento "Testa, Collo e Neuroscienze", Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Lorenzo Verriello
- Neurologia, Dipartimento "Testa, Collo e Neuroscienze", Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Riccardo Budai
- Neurologia, Dipartimento "Testa, Collo e Neuroscienze", Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Tamara Ius
- Neurochirurgia, Dipartimento "Testa, Collo e Neuroscienze", Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Serena D'Agostini
- Neuroradiologia, Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
| | - Luciano Fadiga
- Istituto Italiano di Tecnologia, Genova, Italy; Dipartimento di Neuroscienze e Riabilitazione, Università di Ferrara, Italy
| | - Miran Skrap
- Neurochirurgia, Dipartimento "Testa, Collo e Neuroscienze", Azienda Sanitaria Universitaria Friuli Centrale ASU FC, Italy
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Yu L, Dugan P, Doyle W, Devinsky O, Friedman D, Flinker A. A left-lateralized dorsolateral prefrontal network for naming. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.15.594403. [PMID: 38798614 PMCID: PMC11118423 DOI: 10.1101/2024.05.15.594403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/29/2024]
Abstract
The ability to connect the form and meaning of a concept, known as word retrieval, is fundamental to human communication. While various input modalities could lead to identical word retrieval, the exact neural dynamics supporting this convergence relevant to daily auditory discourse remain poorly understood. Here, we leveraged neurosurgical electrocorticographic (ECoG) recordings from 48 patients and dissociated two key language networks that highly overlap in time and space integral to word retrieval. Using unsupervised temporal clustering techniques, we found a semantic processing network located in the middle and inferior frontal gyri. This network was distinct from an articulatory planning network in the inferior frontal and precentral gyri, which was agnostic to input modalities. Functionally, we confirmed that the semantic processing network encodes word surprisal during sentence perception. Our findings characterize how humans integrate ongoing auditory semantic information over time, a critical linguistic function from passive comprehension to daily discourse.
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Affiliation(s)
- Leyao Yu
- Department of Biomedical Engineering, New York University, New York, 10016, New York, the United States
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Patricia Dugan
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Werner Doyle
- Department of Neurosurgery, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Orrin Devinsky
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Daniel Friedman
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
| | - Adeen Flinker
- Department of Biomedical Engineering, New York University, New York, 10016, New York, the United States
- Department of Neurology, School of Medicine, New York University, New York, 10016, New York, the United States
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Veljanoski D, Ng XY, Hill CS, Jamjoom AAB. Theory and evidence-base for a digital platform for the delivery of language tests during awake craniotomy and collaborative brain mapping. BMJ SURGERY, INTERVENTIONS, & HEALTH TECHNOLOGIES 2024; 6:e000234. [PMID: 38756704 PMCID: PMC11097893 DOI: 10.1136/bmjsit-2023-000234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Accepted: 03/20/2024] [Indexed: 05/18/2024] Open
Abstract
Objectives Build the theoretical and evidence-base for a digital platform (map-OR) which delivers intraoperative language tests during awake craniotomy and facilitates collaborative sharing of brain mapping data. Design Mixed methodology study including two scoping reviews, international survey, synthesis of development guiding principles and a risk assessment using failure modes and effects analysis. Setting The two scoping reviews examined the literature published in the English language. International survey was completed by members of awake craniotomy teams from 14 countries. Main outcome measures Scoping review 1: number of technologies described for language mapping during awake craniotomy. Scoping review 2: barriers and facilitators to adopting novel technology in surgery. International survey: degree of language mapping technology penetration into clinical practice. Results A total of 12 research articles describing 6 technologies were included. The technologies required a range of hardware components including portable devices, virtual reality headsets and large integrated multiscreen stacks. The facilitators and barriers of technology adoption in surgery were extracted from 11 studies and mapped onto the 4 Unified Theory of Acceptance and Use of Technology constructs. A total of 37 awake craniotomy teams from 14 countries completed the survey. Of the responses, 20 (54.1%) delivered their language tests digitally, 10 (27.0%) delivered tests using cards and 7 (18.9%) used a combination of both. The most commonly used devices were tablet computers (67.7%; n=21) and the most common software used was Microsoft PowerPoint (60.6%; n=20). Four key risks for the proposed digital platform were identified, the highest risk being a software and internet connectivity failure during surgery. Conclusions This work represents a rigorous and structured approach to the development of a digital platform for standardized intraoperative language testing during awake craniotomy and for collaborative sharing of brain mapping data. Trial registration number Scoping review protocol registrations in OSF registries (scoping review 1: osf.io/su9xm; scoping review 2: osf.io/x4wsc).
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Affiliation(s)
| | - Xin Yi Ng
- Department of Medicine, Arrowe Park Hospital, Wirral, UK
| | - Ciaran Scott Hill
- Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK
| | - Aimun A B Jamjoom
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Department of Neurosurgery, Barking Havering and Redbridge Hospitals NHS Trust, Romford, UK
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Matchin W, Mollasaraei ZK, Bonilha L, Rorden C, Hickok G, den Ouden D, Fridriksson J. Verbal working memory and syntactic comprehension segregate into the dorsal and ventral streams. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2024.05.05.592577. [PMID: 38746328 PMCID: PMC11092776 DOI: 10.1101/2024.05.05.592577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2024]
Abstract
Syntactic processing and verbal working memory are both essential components to sentence comprehension. Nonetheless, the separability of these systems in the brain remains unclear. To address this issue, we performed causal-inference analyses based on lesion and connectome network mapping using MRI and behavioral testing in 103 individuals with chronic post-stroke aphasia. We employed a rhyme judgment task with heavy working memory load without articulatory confounds, controlling for the overall ability to match auditory words to pictures and to perform a metalinguistic rhyme judgment, isolating the effect of working memory load. We assessed noncanonical sentence comprehension, isolating syntactic processing by incorporating residual rhyme judgment performance as a covariate for working memory load. Voxel-based lesion analyses and structural connectome-based lesion symptom mapping controlling for total lesion volume were performed, with permutation testing to correct for multiple comparisons (4,000 permutations). We observed that effects of working memory load localized to dorsal stream damage: posterior temporal-parietal lesions and frontal-parietal white matter disconnections. These effects were differentiated from syntactic comprehension deficits, which were primarily associated with ventral stream damage: lesions to temporal lobe and temporal-parietal white matter disconnections, particularly when incorporating the residual measure of working memory load as a covariate. Our results support the conclusion that working memory and syntactic processing are associated with distinct brain networks, largely loading onto dorsal and ventral streams, respectively.
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Chen Y, Zekelman LR, Zhang C, Xue T, Song Y, Makris N, Rathi Y, Golby AJ, Cai W, Zhang F, O'Donnell LJ. TractGeoNet: A geometric deep learning framework for pointwise analysis of tract microstructure to predict language assessment performance. Med Image Anal 2024; 94:103120. [PMID: 38458095 PMCID: PMC11016451 DOI: 10.1016/j.media.2024.103120] [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: 07/09/2023] [Revised: 11/30/2023] [Accepted: 02/21/2024] [Indexed: 03/10/2024]
Abstract
We propose a geometric deep-learning-based framework, TractGeoNet, for performing regression using diffusion magnetic resonance imaging (dMRI) tractography and associated pointwise tissue microstructure measurements. By employing a point cloud representation, TractGeoNet can directly utilize tissue microstructure and positional information from all points within a fiber tract without the need to average or bin data along the streamline as traditionally required by dMRI tractometry methods. To improve regression performance, we propose a novel loss function, the Paired-Siamese Regression loss, which encourages the model to focus on accurately predicting the relative differences between regression label scores rather than just their absolute values. In addition, to gain insight into the brain regions that contribute most strongly to the prediction results, we propose a Critical Region Localization algorithm. This algorithm identifies highly predictive anatomical regions within the white matter fiber tracts for the regression task. We evaluate the effectiveness of the proposed method by predicting individual performance on two neuropsychological assessments of language using a dataset of 20 association white matter fiber tracts from 806 subjects from the Human Connectome Project Young Adult dataset. The results demonstrate superior prediction performance of TractGeoNet compared to several popular regression models that have been applied to predict individual cognitive performance based on neuroimaging features. Of the twenty tracts studied, we find that the left arcuate fasciculus tract is the most highly predictive of the two studied language performance assessments. Within each tract, we localize critical regions whose microstructure and point information are highly and consistently predictive of language performance across different subjects and across multiple independently trained models. These critical regions are widespread and distributed across both hemispheres and all cerebral lobes, including areas of the brain considered important for language function such as superior and anterior temporal regions, pars opercularis, and precentral gyrus. Overall, TractGeoNet demonstrates the potential of geometric deep learning to enhance the study of the brain's white matter fiber tracts and to relate their structure to human traits such as language performance.
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Affiliation(s)
- Yuqian Chen
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Leo R Zekelman
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Speech and Hearing Bioscience and Technology, Harvard Medical School, Boston, MA, USA
| | - Chaoyi Zhang
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Tengfei Xue
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Yang Song
- School of Computer Science and Engineering, University of New South Wales, Sydney, NSW, Australia
| | - Nikos Makris
- Departments of Psychiatry and Neurology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yogesh Rathi
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexandra J Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Weidong Cai
- School of Computer Science, The University of Sydney, Sydney, NSW, Australia
| | - Fan Zhang
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA; University of Electronic Science and Technology of China, Chengdu, Sichuan, China.
| | - Lauren J O'Donnell
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Chiang H, Mudar RA, Dugas CS, Motes MA, Kraut MA, Hart J. A modified neural circuit framework for semantic memory retrieval with implications for circuit modulation to treat verbal retrieval deficits. Brain Behav 2024; 14:e3490. [PMID: 38680077 PMCID: PMC11056716 DOI: 10.1002/brb3.3490] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Revised: 01/23/2024] [Accepted: 04/03/2024] [Indexed: 05/01/2024] Open
Abstract
Word finding difficulty is a frequent complaint in older age and disease states, but treatment options are lacking for such verbal retrieval deficits. Better understanding of the neurophysiological and neuroanatomical basis of verbal retrieval function may inform effective interventions. In this article, we review the current evidence of a neural retrieval circuit central to verbal production, including words and semantic memory, that involves the pre-supplementary motor area (pre-SMA), striatum (particularly caudate nucleus), and thalamus. We aim to offer a modified neural circuit framework expanded upon a memory retrieval model proposed in 2013 by Hart et al., as evidence from electrophysiological, functional brain imaging, and noninvasive electrical brain stimulation studies have provided additional pieces of information that converge on a shared neural circuit for retrieval of memory and words. We propose that both the left inferior frontal gyrus and fronto-polar regions should be included in the expanded circuit. All these regions have their respective functional roles during verbal retrieval, such as selection and inhibition during search, initiation and termination of search, maintenance of co-activation across cortical regions, as well as final activation of the retrieved information. We will also highlight the structural connectivity from and to the pre-SMA (e.g., frontal aslant tract and fronto-striatal tract) that facilitates communication between the regions within this circuit. Finally, we will discuss how this circuit and its correlated activity may be affected by disease states and how this circuit may serve as a novel target engagement for neuromodulatory treatment of verbal retrieval deficits.
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Affiliation(s)
- Hsueh‐Sheng Chiang
- Department of NeurologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- School of Behavioral and Brain SciencesThe University of Texas at DallasRichardsonTexasUSA
| | - Raksha A. Mudar
- Department of Speech and Hearing ScienceUniversity of Illinois Urbana‐ChampaignChampaignIllinoisUSA
| | - Christine S. Dugas
- School of Behavioral and Brain SciencesThe University of Texas at DallasRichardsonTexasUSA
| | - Michael A. Motes
- School of Behavioral and Brain SciencesThe University of Texas at DallasRichardsonTexasUSA
| | - Michael A. Kraut
- Department of Radiology and Radiological ScienceJohns Hopkins UniversityBaltimoreMarylandUSA
| | - John Hart
- Department of NeurologyUniversity of Texas Southwestern Medical CenterDallasTexasUSA
- School of Behavioral and Brain SciencesThe University of Texas at DallasRichardsonTexasUSA
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Ille S, Zhang H, Stassen N, Schwendner M, Schröder A, Wiestler B, Meyer B, Krieg SM. Noninvasive- and invasive mapping reveals similar language network centralities - A function-based connectome analysis. Cortex 2024; 174:189-200. [PMID: 38569257 DOI: 10.1016/j.cortex.2024.01.013] [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: 06/14/2023] [Revised: 09/11/2023] [Accepted: 01/23/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Former comparisons between direct cortical stimulation (DCS) and navigated transcranial magnetic stimulation (nTMS) only focused on cortical mapping. While both can be combined with diffusion tensor imaging, their differences in the visualization of subcortical and even network levels remain unclear. Network centrality is an essential parameter in network analysis to measure the importance of nodes identified by mapping. Those include Degree centrality, Eigenvector centrality, Closeness centrality, Betweenness centrality, and PageRank centrality. While DCS and nTMS have repeatedly been compared on the cortical level, the underlying network identified by both has not been investigated yet. METHOD 27 patients with brain lesions necessitating preoperative nTMS and intraoperative DCS language mapping during awake craniotomy were enrolled. Function-based connectome analysis was performed based on the cortical nodes obtained through the two mapping methods, and language-related network centralities were compared. RESULTS Compared with DCS language mapping, the positive predictive value of cortical nTMS language mapping is 74.1%, with good consistency of tractography for the arcuate fascicle and superior longitudinal fascicle. Moreover, network centralities did not differ between the two mapping methods. However, ventral stream tracts can be better traced based on nTMS mappings, demonstrating its strengths in acquiring language-related networks. In addition, it showed lower centralities than other brain areas, with decentralization as an indicator of language function loss. CONCLUSION This study deepens the understanding of language-related functional anatomy and proves that non-invasive mapping-based network analysis is comparable to the language network identified via invasive cortical mapping.
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Affiliation(s)
- Sebastian Ille
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Haosu Zhang
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Nina Stassen
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Maximilian Schwendner
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Axel Schröder
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Munich, Germany.
| | - Bernhard Meyer
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
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Tagliaferri M, Amorosino G, Voltolini L, Giampiccolo D, Avesani P, Cattaneo L. A revision of the dorsal origin of the frontal aslant tract (FAT) in the superior frontal gyrus: a DWI-tractographic study. Brain Struct Funct 2024; 229:987-999. [PMID: 38502328 DOI: 10.1007/s00429-024-02778-4] [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: 08/08/2023] [Accepted: 02/19/2024] [Indexed: 03/21/2024]
Abstract
The frontal aslant tract (FAT) is a white matter tract connecting the superior frontal gyrus (SFG) to the inferior frontal gyrus (IFG). Its dorsal origin is identified in humans in the medial wall of the SFG, in the supplementary motor complex (SM-complex). However, empirical observation shows that many FAT fibres appear to originate from the dorsal, rather than medial, portion of the SFG. We quantitatively investigated the actual origin of FAT fibres in the SFG, specifically discriminating between terminations in the medial wall and in the convexity of the SFG. We analysed data from 105 subjects obtained from the Human Connectome Project (HCP) database. We parcelled the cortex of the IFG, dorsal SFG and medial SFG in several regions of interest (ROIs) ordered in a caudal-rostral direction, which served as seed locations for the generation of streamlines. Diffusion imaging data (DWI) was processed using a multi-shell multi-tissue CSD-based algorithm. Results showed that the number of streamlines originating from the dorsal wall of the SFG significantly exceeds those from the medial wall of the SFG. Connectivity patterns between ROIs indicated that FAT sub-bundles are segregated in parallel circuits ordered in a caudal-rostral direction. Such high degree of coherence in the streamline trajectory allows to establish pairs of homologous cortical parcels in the SFG and IFG. We conclude that the frontal origin of the FAT is found in both dorsal and medial surfaces of the superior frontal gyrus.
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Affiliation(s)
- Marco Tagliaferri
- Centro Interdipartimentale Mente e Cervello (CIMeC), University of Trento, Trento, Italy
| | - Gabriele Amorosino
- Centro Interdipartimentale Mente e Cervello (CIMeC), University of Trento, Trento, Italy
- Neuroinformatics Laboratory, Center for Digital Health & Well Being, Fondazione Bruno Kessler, Trento, Italy
| | - Linda Voltolini
- Centro Interdipartimentale Mente e Cervello (CIMeC), University of Trento, Trento, Italy
| | - Davide Giampiccolo
- 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 Neuroscience, Cleveland Clinic London, Grosvenor Place, London, UK
| | - Paolo Avesani
- Centro Interdipartimentale Mente e Cervello (CIMeC), University of Trento, Trento, Italy
- Neuroinformatics Laboratory, Center for Digital Health & Well Being, Fondazione Bruno Kessler, Trento, Italy
| | - Luigi Cattaneo
- Centro Interdipartimentale Mente e Cervello (CIMeC), University of Trento, Trento, Italy.
- Centro Interdipartimentale di Scienze Mediche (CISMed) - University of Trento, Trento, Italy.
- Center for Mind/Brain Sciences (CIMeC) - Center for Medical Sciences (CISMed), University of Trento Center for Medical Sciences (CISMed), Via delle Regole 101, Trento, 38123, Italy.
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12
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Roelofs A. Wernicke's functional neuroanatomy model of language turns 150: what became of its psychological reflex arcs? Brain Struct Funct 2024:10.1007/s00429-024-02785-5. [PMID: 38581582 DOI: 10.1007/s00429-024-02785-5] [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: 08/25/2023] [Accepted: 03/05/2024] [Indexed: 04/08/2024]
Abstract
Wernicke (Der aphasische Symptomencomplex: Eine psychologische Studie auf anatomischer Basis. Cohn und Weigert, Breslau. https://wellcomecollection.org/works/dwv5w9rw , 1874) proposed a model of the functional neuroanatomy of spoken word repetition, production, and comprehension. At the heart of this epoch-making model are psychological reflex arcs underpinned by fiber tracts connecting sensory to motor areas. Here, I evaluate the central assumption of psychological reflex arcs in light of what we have learned about language in the brain during the past 150 years. I first describe Wernicke's 1874 model and the evidence he presented for it. Next, I discuss his updates of the model published in 1886 and posthumously in 1906. Although the model had an enormous immediate impact, it lost influence after the First World War. Unresolved issues included the anatomical underpinnings of the psychological reflex arcs, the role of auditory images in word production, and the sufficiency of psychological reflex arcs, which was questioned by Wundt (Grundzüge der physiologischen Psychologie. Engelmann, Leipzig. http://vlp.mpiwg-berlin.mpg.de/references?id=lit46 , 1874; Grundzüge der physiologischen Psychologie (Vol. 1, 5th ed.). Engelmann, Leipzig. http://vlp.mpiwg-berlin.mpg.de/references?id=lit806 , 1902). After a long dormant period, Wernicke's model was revived by Geschwind (Science 170:940-944. https://doi.org/10.1126/science.170.3961.940 , 1970; Selected papers on language and the brain. Reidel, Dordrecht, 1974), who proposed a version of it that differed in several important respects from Wernicke's original. Finally, I describe how new evidence from modern research has led to a novel view on language in the brain, supplementing contemporary equivalents of psychological reflex arcs by other mechanisms such as attentional control and assuming different neuroanatomical underpinnings. In support of this novel view, I report new analyses of patient data and computer simulations using the WEAVER++/ARC model (Roelofs 2014, 2022) that incorporates attentional control and integrates the new evidence.
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Affiliation(s)
- Ardi Roelofs
- Donders Institute for Brain, Cognition and Behaviour, Centre for Cognition, Radboud University, Thomas van Aquinostraat 4, 6525 GD, Nijmegen, The Netherlands.
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13
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Kabakoff H, Yu L, Friedman D, Dugan P, Doyle WK, Devinsky O, Flinker A. Timing and location of speech errors induced by direct cortical stimulation. Brain Commun 2024; 6:fcae053. [PMID: 38505231 PMCID: PMC10948744 DOI: 10.1093/braincomms/fcae053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 11/30/2023] [Accepted: 02/22/2024] [Indexed: 03/21/2024] Open
Abstract
Cortical regions supporting speech production are commonly established using neuroimaging techniques in both research and clinical settings. However, for neurosurgical purposes, structural function is routinely mapped peri-operatively using direct electrocortical stimulation. While this method is the gold standard for identification of eloquent cortical regions to preserve in neurosurgical patients, there is lack of specificity of the actual underlying cognitive processes being interrupted. To address this, we propose mapping the temporal dynamics of speech arrest across peri-sylvian cortices by quantifying the latency between stimulation and speech deficits. In doing so, we are able to substantiate hypotheses about distinct region-specific functional roles (e.g. planning versus motor execution). In this retrospective observational study, we analysed 20 patients (12 female; age range 14-43) with refractory epilepsy who underwent continuous extra-operative intracranial EEG monitoring of an automatic speech task during clinical bedside language mapping. Latency to speech arrest was calculated as time from stimulation onset to speech arrest onset, controlling for individual speech rate. Most instances of motor-based arrest (87.5% of 96 instances) were in sensorimotor cortex with mid-range latencies to speech arrest with a distributional peak at 0.47 s. Speech arrest occurred in numerous regions, with relatively short latencies in supramarginal gyrus (0.46 s), superior temporal gyrus (0.51 s) and middle temporal gyrus (0.54 s), followed by relatively long latencies in sensorimotor cortex (0.72 s) and especially long latencies in inferior frontal gyrus (0.95 s). Non-parametric testing for speech arrest revealed that region predicted latency; latencies in supramarginal gyrus and in superior temporal gyrus were shorter than in sensorimotor cortex and in inferior frontal gyrus. Sensorimotor cortex is primarily responsible for motor-based arrest. Latencies to speech arrest in supramarginal gyrus and superior temporal gyrus (and to a lesser extent middle temporal gyrus) align with latencies to motor-based arrest in sensorimotor cortex. This pattern of relatively quick cessation of speech suggests that stimulating these regions interferes with the outgoing motor execution. In contrast, the latencies to speech arrest in inferior frontal gyrus and in ventral regions of sensorimotor cortex were significantly longer than those in temporoparietal regions. Longer latencies in the more frontal areas (including inferior frontal gyrus and ventral areas of precentral gyrus and postcentral gyrus) suggest that stimulating these areas interrupts a higher-level speech production process involved in planning. These results implicate the ventral specialization of sensorimotor cortex (including both precentral and postcentral gyri) for speech planning above and beyond motor execution.
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Affiliation(s)
- Heather Kabakoff
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA
| | - Leyao Yu
- Department of Biomedical Engineering, New York University School of Engineering, Brooklyn, NY 11201, USA
| | - Daniel Friedman
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA
| | - Patricia Dugan
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA
| | - Werner K Doyle
- Department of Neurosurgery, New York University School of Medicine, New York, NY 10016, USA
| | - Orrin Devinsky
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA
| | - Adeen Flinker
- Department of Neurology, New York University School of Medicine, New York, NY 10016, USA
- Department of Biomedical Engineering, New York University School of Engineering, Brooklyn, NY 11201, USA
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14
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Coletta L, Avesani P, Zigiotto L, Venturini M, Annicchiarico L, Vavassori L, Ng S, Duffau H, Sarubbo S. Integrating direct electrical brain stimulation with the human connectome. Brain 2024; 147:1100-1111. [PMID: 38048613 PMCID: PMC10907080 DOI: 10.1093/brain/awad402] [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: 06/27/2023] [Revised: 10/20/2023] [Accepted: 11/18/2023] [Indexed: 12/06/2023] Open
Abstract
Neurological and neurodevelopmental conditions are a major public health concern for which new therapies are urgently needed. The development of effective therapies relies on the precise mapping of the neural substrates causally involved in behaviour generation. Direct electrical stimulation (DES) performed during cognitive and neurological monitoring in awake surgery is currently considered the gold standard for the causal mapping of brain functions. However, DES is limited by the focal nature of the stimulation sites, hampering a real holistic exploration of human brain functions at the network level. We used 4137 DES points derived from 612 glioma patients in combination with human connectome data-resting-state functional MRI, n = 1000 and diffusion weighted imaging, n = 284-to provide a multimodal description of the causal macroscale functional networks subtending 12 distinct behavioural domains. To probe the validity of our procedure, we (i) compared the network topographies of healthy and clinical populations; (ii) tested the predictive capacity of DES-derived networks; (iii) quantified the coupling between structural and functional connectivity; and (iv) built a multivariate model able to quantify single subject deviations from a normative population. Lastly, we probed the translational potential of DES-derived functional networks by testing their specificity and sensitivity in identifying critical neuromodulation targets and neural substrates associated with postoperative language deficits. The combination of DES and human connectome data resulted in an average 29.4-fold increase in whole brain coverage compared to DES alone. DES-derived functional networks are predictive of future stimulation points (97.8% accuracy) and strongly supported by the anatomical connectivity of subcortical stimulations. We did not observe any significant topographical differences between the patients and the healthy population at both group and single subject level. Showcasing concrete clinical applications, we found that DES-derived functional networks overlap with effective neuromodulation targets across several functional domains, show a high degree of specificity when tested with the intracranial stimulation points of a different stimulation technique and can be used effectively to characterize postoperative behavioural deficits. The integration of DES with the human connectome fundamentally advances the quality of the functional mapping provided by DES or functional imaging alone. DES-derived functional networks can reliably predict future stimulation points, have a strong correspondence with the underlying white matter and can be used for patient specific functional mapping. Possible applications range from psychiatry and neurology to neuropsychology, neurosurgery and neurorehabilitation.
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Affiliation(s)
- Ludovico Coletta
- Neuroinformatics Laboratory (NiLab), Bruno Kessler Foundation (FBK), Trento 38123, Italy
- Center for Mind/Brain Sciences – CIMeC, University of Trento, Rovereto 38068, Italy
| | - Paolo Avesani
- Neuroinformatics Laboratory (NiLab), Bruno Kessler Foundation (FBK), Trento 38123, Italy
- Center for Mind/Brain Sciences – CIMeC, University of Trento, Rovereto 38068, Italy
| | - Luca Zigiotto
- Department of Neurosurgery, S. Chiara Hospital, Trento 38122, Italy
- Structural and Functional Connectivity Lab Project, S. Chiara Hospital, Trento 38122, Italy
- Department of Psychology, S. Chiara Hospital, Trento 38122, Italy
| | - Martina Venturini
- Department of Biotechnology and Life Sciences, Division of Neurosurgery, University of Insubria, Ospedale di Circolo e Fondazione Macchi, Varese 21100, Italy
| | - Luciano Annicchiarico
- Department of Neurosurgery, S. Chiara Hospital, Trento 38122, Italy
- Structural and Functional Connectivity Lab Project, S. Chiara Hospital, Trento 38122, Italy
| | - Laura Vavassori
- Center for Mind/Brain Sciences – CIMeC, University of Trento, Rovereto 38068, Italy
- Department of Neurosurgery, S. Chiara Hospital, Trento 38122, Italy
- Structural and Functional Connectivity Lab Project, S. Chiara Hospital, Trento 38122, Italy
| | - Sam Ng
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier 34094, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier 34295, France
| | - Hugues Duffau
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier 34094, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier 34295, France
| | - Silvio Sarubbo
- Department of Neurosurgery, S. Chiara Hospital, Trento 38122, Italy
- Structural and Functional Connectivity Lab Project, S. Chiara Hospital, Trento 38122, Italy
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15
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Kabakoff H, Yu L, Friedman D, Dugan P, Doyle WK, Devinsky O, Flinker A. Timing and location of speech errors induced by direct cortical stimulation. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.09.14.557732. [PMID: 37745363 PMCID: PMC10515921 DOI: 10.1101/2023.09.14.557732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 09/26/2023]
Abstract
Cortical regions supporting speech production are commonly established using neuroimaging techniques in both research and clinical settings. However, for neurosurgical purposes, structural function is routinely mapped peri-operatively using direct electrocortical stimulation. While this method is the gold standard for identification of eloquent cortical regions to preserve in neurosurgical patients, there is lack of specificity of the actual underlying cognitive processes being interrupted. To address this, we propose mapping the temporal dynamics of speech arrest across peri-sylvian cortices by quantifying the latency between stimulation and speech deficits. In doing so, we are able to substantiate hypotheses about distinct region-specific functional roles (e.g., planning versus motor execution). In this retrospective observational study, we analyzed 20 patients (12 female; age range 14-43) with refractory epilepsy who underwent continuous extra-operative intracranial EEG monitoring of an automatic speech task during clinical bedside language mapping. Latency to speech arrest was calculated as time from stimulation onset to speech arrest onset, controlling for individual speech rate. Most instances of motor-based arrest (87.5% of 96 instances) were in sensorimotor cortex with mid-range latencies to speech arrest with a distributional peak at 0.47 seconds. Speech arrest occurred in numerous regions, with relatively short latencies in supramarginal gyrus (0.46 seconds), superior temporal gyrus (0.51 seconds), and middle temporal gyrus (0.54 seconds), followed by relatively long latencies in sensorimotor cortex (0.72 seconds) and especially long latencies in inferior frontal gyrus (0.95 seconds). Nonparametric testing for speech arrest revealed that region predicted latency; latencies in supramarginal gyrus and in superior temporal gyrus were shorter than in sensorimotor cortex and in inferior frontal gyrus. Sensorimotor cortex is primarily responsible for motor-based arrest. Latencies to speech arrest in supramarginal gyrus and superior temporal gyrus (and to a lesser extent middle temporal gyrus) align with latencies to motor-based arrest in sensorimotor cortex. This pattern of relatively quick cessation of speech suggests that stimulating these regions interferes with the outgoing motor execution. In contrast, the latencies to speech arrest in inferior frontal gyrus and in ventral regions of sensorimotor cortex were significantly longer than those in temporoparietal regions. Longer latencies in the more frontal areas (including inferior frontal gyrus and ventral areas of precentral gyrus and postcentral gyrus) suggest that stimulating these areas interrupts a higher-level speech production process involved in planning. These results implicate the ventral specialization of sensorimotor cortex (including both precentral and postcentral gyri) for speech planning above and beyond motor execution.
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Affiliation(s)
- Heather Kabakoff
- Department of Neurology, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
| | - Leyao Yu
- Department of Biomedical Engineering, New York University School of Engineering, 6 MetroTech Center Ave., Brooklyn, NY, 11201, USA
| | - Daniel Friedman
- Department of Neurology, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
| | - Patricia Dugan
- Department of Neurology, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
| | - Werner K Doyle
- Department of Neurosurgery, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
| | - Orrin Devinsky
- Department of Neurology, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
| | - Adeen Flinker
- Department of Neurology, New York University School of Medicine, 550 1st Ave., New York, NY, 10016, USA
- Department of Biomedical Engineering, New York University School of Engineering, 6 MetroTech Center Ave., Brooklyn, NY, 11201, USA
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16
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Lu J, Li Y, Zhao Z, Liu Y, Zhu Y, Mao Y, Wu J, Chang EF. Neural control of lexical tone production in human laryngeal motor cortex. Nat Commun 2023; 14:6917. [PMID: 37903780 PMCID: PMC10616086 DOI: 10.1038/s41467-023-42175-9] [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: 04/26/2023] [Accepted: 09/28/2023] [Indexed: 11/01/2023] Open
Abstract
In tonal languages, which are spoken by nearly one-third of the world's population, speakers precisely control the tension of vocal folds in the larynx to modulate pitch in order to distinguish words with completely different meanings. The specific pitch trajectories for a given tonal language are called lexical tones. Here, we used high-density direct cortical recordings to determine the neural basis of lexical tone production in native Mandarin-speaking participants. We found that instead of a tone category-selective coding, local populations in the bilateral laryngeal motor cortex (LMC) encode articulatory kinematic information to generate the pitch dynamics of lexical tones. Using a computational model of tone production, we discovered two distinct patterns of population activity in LMC commanding pitch rising and lowering. Finally, we showed that direct electrocortical stimulation of different local populations in LMC evoked pitch rising and lowering during tone production, respectively. Together, these results reveal the neural basis of vocal pitch control of lexical tones in tonal languages.
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Affiliation(s)
- Junfeng Lu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Yuanning Li
- School of Biomedical Engineering, ShanghaiTech University, Shanghai, 201210, China
- Department of Neurological Surgery, University of California, San Francisco, CA, 94143, USA
- Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA
- State Key Laboratory of Advanced Medical Materials and Devices, ShanghaiTech University, Shanghai, 201210, China
| | - Zehao Zhao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Yan Liu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
| | - Yanming Zhu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China
- Speech and Hearing Bioscience & Technology Program, Division of Medical Sciences, Harvard University, Boston, MA, 02215, USA
| | - Ying Mao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China.
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, 200040, China.
- National Center for Neurological Disorders, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, 200040, China.
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, CA, 94143, USA.
- Weill Institute for Neurosciences, University of California, San Francisco, CA, 94158, USA.
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17
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Ren J, Ren W, Zhou Y, Dahmani L, Duan X, Fu X, Wang Y, Pan R, Zhao J, Zhang P, Wang B, Yu W, Chen Z, Zhang X, Sun J, Ding M, Huang J, Xu L, Li S, Wang W, Xie W, Zhang H, Liu H. Personalized functional imaging-guided rTMS on the superior frontal gyrus for post-stroke aphasia: A randomized sham-controlled trial. Brain Stimul 2023; 16:1313-1321. [PMID: 37652135 DOI: 10.1016/j.brs.2023.08.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Revised: 08/23/2023] [Accepted: 08/27/2023] [Indexed: 09/02/2023] Open
Abstract
BACKGROUND Aphasia affects approximately one-third of stroke patients and yet its rehabilitation outcomes are often unsatisfactory. More effective strategies are needed to promote recovery. OBJECTIVE We aimed to examine the efficacy and safety of the theta-burst stimulation (TBS) on the language area in the superior frontal gyrus (SFG) localized by personalized functional imaging, in facilitating post-stroke aphasia recovery. METHODS This randomized sham-controlled trial uses a parallel design (intermittent TBS [iTBS] in ipsilesional hemisphere vs. continuous TBS [cTBS] in contralesional hemisphere vs. sham group). Participants had aphasia symptoms resulting from their first stroke in the left hemisphere at least one month prior. Participants received three-week speech-language therapy coupled with either active or sham stimulation applied to the left or right SFG. The primary outcome was the change in Western Aphasia Battery-Revised (WAB-R) aphasia quotient after the three-week treatment. The secondary outcome was WAB-R aphasia quotient improvement after one week of treatment. RESULTS Ninety-seven patients were screened between January 2021 and January 2022, 45 of whom were randomized and 44 received intervention (15 in each active group, 14 in sham). Both iTBS (estimated difference = 14.75, p < 0.001) and cTBS (estimated difference = 13.43, p < 0.001) groups showed significantly greater improvement than sham stimulation after the 3-week intervention and immediately after one week of treatment (p's < 0.001). The adverse events observed were similar across groups. A seizure was recorded three days after the termination of the treatment in the iTBS group. CONCLUSION The stimulation showed high efficacy and SFG is a promising stimulation target for post-stroke language recovery.
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Affiliation(s)
- Jianxun Ren
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Weijing Ren
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China; University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China
| | - Ying Zhou
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Louisa Dahmani
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Xinyu Duan
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Xiaoxuan Fu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yezhe Wang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Ruiqi Pan
- Neural Galaxy Inc., Beijing, 102206, China
| | - Jingdu Zhao
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China
| | - Ping Zhang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | - Bo Wang
- Department of Hearing and Language Rehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Weiyong Yu
- Department of Radiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Zhenbo Chen
- Department of Radiology, Beijing Bo'ai Hospital, China Rehabilitation Research Center, Beijing, 100068, China
| | - Xin Zhang
- Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China
| | - Jian Sun
- Neural Galaxy Inc., Beijing, 102206, China
| | | | - Jianting Huang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China
| | - Liu Xu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; West China Medical School, Sichuan University, Chengdu, 610041, China
| | - Shiyi Li
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China
| | | | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University Health Science Center, Beijing, 100191, China
| | - Hao Zhang
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Department of Neurorehabilitation, Beijing Bo'ai Hospital, China Rehabilitation Research Center, School of Rehabilitation, Capital Medical University, Beijing, 100069, China; University of Health and Rehabilitation Sciences, Qingdao, Shandong, 266000, China; Cheeloo College of Medicine, Shandong University, Jinan, Shandong, 250100, China.
| | - Hesheng Liu
- Division of Brain Sciences, Changping Laboratory, Beijing, 102206, China; Biomedical Pioneering Innovation Center (BIOPIC), Peking University, Beijing, 100871, China.
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18
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Duque ACM, Cuesta TAC, Melo ADS, Maldonado IL. Right hemisphere and metaphor comprehension: A connectionist perspective. Neuropsychologia 2023; 187:108618. [PMID: 37321404 DOI: 10.1016/j.neuropsychologia.2023.108618] [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: 09/26/2022] [Revised: 04/11/2023] [Accepted: 06/10/2023] [Indexed: 06/17/2023]
Abstract
Metaphor comprehension is a cognitively complex task, with evidence pointing to the engagement of multiple cerebral areas. In addition, the involvement of the right hemisphere appears to vary with cognitive effort. Therefore, the interconnecting pathways of such distributed cortical centers should be taken into account when studying this topic. Despite this, the potential contribution of white matter fasciculi has received very little attention in the literature to date and is not mentioned in most metaphor comprehension studies. To highlight the probable implications of the right inferior fronto-occipital fasciculus, right superior longitudinal system, and callosal radiations, we bring together findings from different research fields. The aim is to describe important insights enabled by the cross-fertilization of functional neuroimaging, clinical findings, and structural connectivity.
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Affiliation(s)
- Anna Clara Mota Duque
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Taryn Ariadna Castro Cuesta
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Ailton de Souza Melo
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Faculdade de Medicina da Bahia, Universidade Federal da Bahia, Salvador, Brazil
| | - Igor Lima Maldonado
- Programa de Pós-Graduação em Medicina e Saúde, Universidade Federal da Bahia, Salvador, Brazil; Dep. Biomorfologia, Instituto de Ciências da Saúde, Universidade Federal da Bahia, Salvador, Brazil; UMR 1253, iBrain, Université de Tours, Inserm, Tours, France.
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19
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Boerger TF, Pahapill P, Butts AM, Arocho-Quinones E, Raghavan M, Krucoff MO. Large-scale brain networks and intra-axial tumor surgery: a narrative review of functional mapping techniques, critical needs, and scientific opportunities. Front Hum Neurosci 2023; 17:1170419. [PMID: 37520929 PMCID: PMC10372448 DOI: 10.3389/fnhum.2023.1170419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Accepted: 05/16/2023] [Indexed: 08/01/2023] Open
Abstract
In recent years, a paradigm shift in neuroscience has been occurring from "localizationism," or the idea that the brain is organized into separately functioning modules, toward "connectomics," or the idea that interconnected nodes form networks as the underlying substrates of behavior and thought. Accordingly, our understanding of mechanisms of neurological function, dysfunction, and recovery has evolved to include connections, disconnections, and reconnections. Brain tumors provide a unique opportunity to probe large-scale neural networks with focal and sometimes reversible lesions, allowing neuroscientists the unique opportunity to directly test newly formed hypotheses about underlying brain structural-functional relationships and network properties. Moreover, if a more complete model of neurological dysfunction is to be defined as a "disconnectome," potential avenues for recovery might be mapped through a "reconnectome." Such insight may open the door to novel therapeutic approaches where previous attempts have failed. In this review, we briefly delve into the most clinically relevant neural networks and brain mapping techniques, and we examine how they are being applied to modern neurosurgical brain tumor practices. We then explore how brain tumors might teach us more about mechanisms of global brain dysfunction and recovery through pre- and postoperative longitudinal connectomic and behavioral analyses.
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Affiliation(s)
- Timothy F. Boerger
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Peter Pahapill
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Alissa M. Butts
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
- Mayo Clinic, Rochester, MN, United States
| | - Elsa Arocho-Quinones
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Max O. Krucoff
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
- Department of Biomedical Engineering, Medical College of Wisconsin, Marquette University, Milwaukee, WI, United States
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20
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Ng S, Valdes PA, Moritz-Gasser S, Lemaitre AL, Duffau H, Herbet G. Intraoperative functional remapping unveils evolving patterns of cortical plasticity. Brain 2023; 146:3088-3100. [PMID: 37029961 DOI: 10.1093/brain/awad116] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 03/18/2023] [Accepted: 03/23/2023] [Indexed: 04/09/2023] Open
Abstract
The efficiency with which the brain reorganizes following injury not only depends on the extent and the severity of the lesion, but also on its temporal features. It is established that diffuse low-grade gliomas (DLGG), brain tumours with a slow-growth rate, induce a compensatory modulation of the anatomo-functional architecture, making this kind of tumours an ideal lesion model to study the dynamics of neuroplasticity. Direct electrostimulation (DES) mapping is a well-tried procedure used during awake resection surgeries to identify and spare cortical epicentres which are critical for a range of functions. Because DLGG is a chronic disease, it inevitably relapses years after the initial surgery, and thus requires a second surgery to reduce tumour volume again. In this context, contrasting the cortical mappings obtained during two sequential neurosurgeries offers a unique opportunity to both identify and characterize the dynamic (i.e. re-evolving) patterns of cortical re-arrangements. Here, we capitalized on an unprecedented series of 101 DLGG patients who benefited from two DES-guided neurosurgeries usually spaced several years apart, resulting in a large DES dataset of 2082 cortical sites. All sites (either non-functional or associated with language, speech, motor, somatosensory and semantic processing) were recorded in Montreal Neurological Institute (MNI) space. Next, we used a multi-step approach to generate probabilistic neuroplasticity maps that reflected the dynamic rearrangements of cortical mappings from one surgery to another, both at the population and individual level. Voxel-wise neuroplasticity maps revealed regions with a relatively high potential of evolving reorganizations at the population level, including the supplementary motor area (SMA, Pmax = 0.63), the dorsolateral prefrontal cortex (dlPFC, Pmax = 0.61), the anterior ventral premotor cortex (vPMC, Pmax = 0.43) and the middle superior temporal gyrus (STG Pmax = 0.36). Parcel-wise neuroplasticity maps confirmed this potential for the dlPFC (Fisher's exact test, PFDR-corrected = 6.6 × 10-5), the anterior (PFDR-corrected = 0.0039) and the ventral precentral gyrus (PFDR-corrected = 0.0058). A series of clustering analyses revealed a topological migration of clusters, especially within the left dlPFC and STG (language sites); the left vPMC (speech arrest/dysarthria sites) and the right SMA (negative motor response sites). At the individual level, these dynamic changes were confirmed for the dlPFC (bilateral), the left vPMC and the anterior left STG (threshold free cluster enhancement, 5000 permutations, family-wise error-corrected). Taken as a whole, our results provide a critical insight into the dynamic potential of DLGG-induced continuing rearrangements of the cerebral cortex, with considerable implications for re-operations.
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Affiliation(s)
- Sam Ng
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34095 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, F-34094 Montpellier, France
| | - Pablo A Valdes
- Department of Neurosurgery, University of Texas Medical Branch, Galveston, TX 78701-2982, USA
| | - Sylvie Moritz-Gasser
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34095 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, F-34094 Montpellier, France
| | - Anne-Laure Lemaitre
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34095 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, F-34094 Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34095 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, F-34094 Montpellier, France
| | - Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, F-34095 Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, F-34094 Montpellier, France
- Praxiling Laboratory, UMR 5267, CNRS, UPVM, F-34199 Montpellier, France
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21
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Zhao Z, Lu J, Wu J. Fiber Tractography-Based Cortical Language Mapping for Speech Output. World Neurosurg 2023; 175:151-152. [PMID: 37105893 DOI: 10.1016/j.wneu.2023.03.139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Affiliation(s)
- Zehao Zhao
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
| | - Junfeng Lu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
| | - Jinsong Wu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
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22
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Hickok G, Venezia J, Teghipco A. Beyond Broca: neural architecture and evolution of a dual motor speech coordination system. Brain 2023; 146:1775-1790. [PMID: 36746488 PMCID: PMC10411947 DOI: 10.1093/brain/awac454] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 11/04/2022] [Accepted: 11/19/2022] [Indexed: 02/08/2023] Open
Abstract
Classical neural architecture models of speech production propose a single system centred on Broca's area coordinating all the vocal articulators from lips to larynx. Modern evidence has challenged both the idea that Broca's area is involved in motor speech coordination and that there is only one coordination network. Drawing on a wide range of evidence, here we propose a dual speech coordination model in which laryngeal control of pitch-related aspects of prosody and song are coordinated by a hierarchically organized dorsolateral system while supralaryngeal articulation at the phonetic/syllabic level is coordinated by a more ventral system posterior to Broca's area. We argue further that these two speech production subsystems have distinguishable evolutionary histories and discuss the implications for models of language evolution.
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Affiliation(s)
- Gregory Hickok
- Department of Cognitive Sciences, University of California, Irvine, CA 92697, USA
- Department of Language Science, University of California, Irvine, CA 92697, USA
| | - Jonathan Venezia
- Auditory Research Laboratory, VA Loma Linda Healthcare System, Loma Linda, CA 92357, USA
- Department of Otolaryngology—Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, CA 92350, USA
| | - Alex Teghipco
- Department of Psychology, University of South Carolina, Columbia, SC 29208, USA
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23
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Yuan B, Xie H, Wang Z, Xu Y, Zhang H, Liu J, Chen L, Li C, Tan S, Lin Z, Hu X, Gu T, Lu J, Liu D, Wu J. The domain-separation language network dynamics in resting state support its flexible functional segregation and integration during language and speech processing. Neuroimage 2023; 274:120132. [PMID: 37105337 DOI: 10.1016/j.neuroimage.2023.120132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 04/21/2023] [Indexed: 04/29/2023] Open
Abstract
Modern linguistic theories and network science propose that language and speech processing are organized into hierarchical, segregated large-scale subnetworks, with a core of dorsal (phonological) stream and ventral (semantic) stream. The two streams are asymmetrically recruited in receptive and expressive language or speech tasks, which showed flexible functional segregation and integration. We hypothesized that the functional segregation of the two streams was supported by the underlying network segregation. A dynamic conditional correlation approach was employed to construct framewise time-varying language networks and k-means clustering was employed to investigate the temporal-reoccurring patterns. We found that the framewise language network dynamics in resting state were robustly clustered into four states, which dynamically reconfigured following a domain-separation manner. Spatially, the hub distributions of the first three states highly resembled the neurobiology of speech perception and lexical-phonological processing, speech production, and semantic processing, respectively. The fourth state was characterized by the weakest functional connectivity and was regarded as a baseline state. Temporally, the first three states appeared exclusively in limited time bins (∼15%), and most of the time (> 55%), state 4 was dominant. Machine learning-based dFC-linguistics prediction analyses showed that dFCs of the four states significantly predicted individual linguistic performance. These findings suggest a domain-separation manner of language network dynamics in resting state, which forms a dynamic "meta-network" framework to support flexible functional segregation and integration during language and speech processing.
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Affiliation(s)
- Binke Yuan
- Philosophy and Social Science Laboratory of Reading and Development in Children and Adolescents (South China Normal University), Ministry of Education, China; Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China.
| | - Hui Xie
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China; Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - Zhihao Wang
- CNRS - Centre d'Economie de la Sorbonne, Panthéon-Sorbonne University, France
| | - Yangwen Xu
- Center for Mind/Brain Sciences (CIMeC), University of Trento, Trento 38123, Italy
| | - Hanqing Zhang
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Jiaxuan Liu
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Lifeng Chen
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Chaoqun Li
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Shiyao Tan
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Zonghui Lin
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Xin Hu
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Tianyi Gu
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Junfeng Lu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
| | - Dongqiang Liu
- Research Center of Brain and Cognitive Neuroscience, Liaoning Normal University, Dalian, China; Key Laboratory of Brain and Cognitive Neuroscience, Liaoning Province, Dalian, PR China.
| | - Jinsong Wu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China; Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China; Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
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24
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Kitazawa Y, Sonoda M, Sakakura K, Mitsuhashi T, Firestone E, Ueda R, Kambara T, Iwaki H, Luat AF, Marupudi NI, Sood S, Asano E. Intra- and inter-hemispheric network dynamics supporting object recognition and speech production. Neuroimage 2023; 270:119954. [PMID: 36828156 PMCID: PMC10112006 DOI: 10.1016/j.neuroimage.2023.119954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 02/14/2023] [Accepted: 02/17/2023] [Indexed: 02/25/2023] Open
Abstract
We built normative brain atlases that animate millisecond-scale intra- and inter-hemispheric white matter-level connectivity dynamics supporting object recognition and speech production. We quantified electrocorticographic modulations during three naming tasks using event-related high-gamma activity from 1,114 nonepileptogenic intracranial electrodes (i.e., non-lesional areas unaffected by epileptiform discharges). Using this electrocorticography data, we visualized functional connectivity modulations defined as significant naming-related high-gamma modulations occurring simultaneously at two sites connected by direct white matter streamlines on diffusion-weighted imaging tractography. Immediately after stimulus onset, intra- and inter-hemispheric functional connectivity enhancements were confined mainly across modality-specific perceptual regions. During response preparation, left intra-hemispheric connectivity enhancements propagated in a posterior-to-anterior direction, involving the left precentral and prefrontal areas. After overt response onset, inter- and intra-hemispheric connectivity enhancements mainly encompassed precentral, postcentral, and superior-temporal (STG) gyri. We found task-specific connectivity enhancements during response preparation as follows. Picture naming enhanced activity along the left arcuate fasciculus between the inferior-temporal and precentral/posterior inferior-frontal (pIFG) gyri. Nonspeech environmental sound naming augmented functional connectivity via the left inferior longitudinal and fronto-occipital fasciculi between the medial-occipital and STG/pIFG. Auditory descriptive naming task enhanced usage of the left frontal U-fibers, involving the middle-frontal gyrus. Taken together, the commonly observed network enhancements include inter-hemispheric connectivity optimizing perceptual processing exerted in each hemisphere, left intra-hemispheric connectivity supporting semantic and lexical processing, and inter-hemispheric connectivity for symmetric oral movements during overt speech. Our atlases improve the currently available models of object recognition and speech production by adding neural dynamics via direct intra- and inter-hemispheric white matter tracts.
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Affiliation(s)
- Yu Kitazawa
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology and Stroke Medicine, Yokohama City University, Yokohama, 2360004, Japan
| | - Masaki Sonoda
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, Yokohama City University, Yokohama, 2360004, Japan
| | - Kazuki Sakakura
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, University of Tsukuba, Tsukuba, 3058575, Japan
| | - Takumi Mitsuhashi
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurosurgery, Juntendo University, Tokyo, 1138421, Japan
| | - Ethan Firestone
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Physiology, Wayne State University, Detroit, 48201, USA
| | - Riyo Ueda
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Toshimune Kambara
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Psychology, Hiroshima University, Hiroshima, 7398524, Japan
| | - Hirotaka Iwaki
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Psychiatry, Hachinohe City Hospital, Hachinohe, 0318555, Japan
| | - Aimee F Luat
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Pediatrics, Central Michigan University, Mount Pleasant, 48858, USA
| | - Neena I Marupudi
- Department of Neurosurgery, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Sandeep Sood
- Department of Neurosurgery, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA
| | - Eishi Asano
- Department of Pediatrics, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA; Department of Neurology, Children's Hospital of Michigan, Wayne State University, Detroit, 48201, USA.
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25
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Hu J, Small H, Kean H, Takahashi A, Zekelman L, Kleinman D, Ryan E, Nieto-Castañón A, Ferreira V, Fedorenko E. Precision fMRI reveals that the language-selective network supports both phrase-structure building and lexical access during language production. Cereb Cortex 2023; 33:4384-4404. [PMID: 36130104 PMCID: PMC10110436 DOI: 10.1093/cercor/bhac350] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 08/01/2022] [Accepted: 08/02/2022] [Indexed: 11/13/2022] Open
Abstract
A fronto-temporal brain network has long been implicated in language comprehension. However, this network's role in language production remains debated. In particular, it remains unclear whether all or only some language regions contribute to production, and which aspects of production these regions support. Across 3 functional magnetic resonance imaging experiments that rely on robust individual-subject analyses, we characterize the language network's response to high-level production demands. We report 3 novel results. First, sentence production, spoken or typed, elicits a strong response throughout the language network. Second, the language network responds to both phrase-structure building and lexical access demands, although the response to phrase-structure building is stronger and more spatially extensive, present in every language region. Finally, contra some proposals, we find no evidence of brain regions-within or outside the language network-that selectively support phrase-structure building in production relative to comprehension. Instead, all language regions respond more strongly during production than comprehension, suggesting that production incurs a greater cost for the language network. Together, these results align with the idea that language comprehension and production draw on the same knowledge representations, which are stored in a distributed manner within the language-selective network and are used to both interpret and generate linguistic utterances.
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Affiliation(s)
- Jennifer Hu
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
| | - Hannah Small
- Department of Cognitive Science, Johns Hopkins University, Baltimore, MD 21218, United States
| | - Hope Kean
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Atsushi Takahashi
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
| | - Leo Zekelman
- Program in Speech and Hearing Bioscience and Technology, Harvard University, Cambridge, MA 02138, United States
| | | | - Elizabeth Ryan
- St. George’s Medical School, St. George’s University, Grenada, West Indies
| | - Alfonso Nieto-Castañón
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- Department of Speech, Language, and Hearing Sciences, Boston University, Boston, MA 02215, United States
| | - Victor Ferreira
- Department of Psychology, UCSD, La Jolla, CA 92093, United States
| | - Evelina Fedorenko
- Department of Brain and Cognitive Sciences, MIT, Cambridge, MA 02139, United States
- McGovern Institute for Brain Research, MIT, Cambridge, MA 02139, United States
- Program in Speech and Hearing Bioscience and Technology, Harvard University, Cambridge, MA 02138, United States
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26
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Andrews JP, Cahn N, Speidel BA, Chung JE, Levy DF, Wilson SM, Berger MS, Chang EF. Dissociation of Broca's area from Broca's aphasia in patients undergoing neurosurgical resections. J Neurosurg 2023; 138:847-857. [PMID: 35932264 PMCID: PMC9899289 DOI: 10.3171/2022.6.jns2297] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 06/15/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Broca's aphasia is a syndrome of impaired fluency with retained comprehension. The authors used an unbiased algorithm to examine which neuroanatomical areas are most likely to result in Broca's aphasia following surgical lesions. METHODS Patients were prospectively evaluated with standardized language batteries before and after surgery. Broca's area was defined anatomically as the pars opercularis and triangularis of the inferior frontal gyrus. Broca's aphasia was defined by the Western Aphasia Battery language assessment. Resections were outlined from MRI scans to construct 3D volumes of interest. These were aligned using a nonlinear transformation to Montreal Neurological Institute brain space. A voxel-based lesion-symptom mapping (VLSM) algorithm was used to test for areas statistically associated with Broca's aphasia when incorporated into a resection, as well as areas associated with deficits in fluency independent of Western Aphasia Battery classification. Postoperative MRI scans were reviewed in blinded fashion to estimate the percentage resection of Broca's area compared to areas identified using the VLSM algorithm. RESULTS A total of 289 patients had early language evaluations, of whom 19 had postoperative Broca's aphasia. VLSM analysis revealed an area that was highly correlated (p < 0.001) with Broca's aphasia, spanning ventral sensorimotor cortex and supramarginal gyri, as well as extending into subcortical white matter tracts. Reduced fluency scores were significantly associated with an overlapping region of interest. The fluency score was negatively correlated with fraction of resected precentral, postcentral, and supramarginal components of the VLSM area. CONCLUSIONS Broca's aphasia does not typically arise from neurosurgical resections in Broca's area. When Broca's aphasia does occur after surgery, it is typically in the early postoperative period, improves by 1 month, and is associated with resections of ventral sensorimotor cortex and supramarginal gyri.
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Affiliation(s)
- John P. Andrews
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Nathan Cahn
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Benjamin A. Speidel
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Jason E. Chung
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Deborah F. Levy
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
| | - Edward F. Chang
- Department of Neurological Surgery, University of California, San Francisco, School of Medicine, San Francisco, California; and
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27
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Nourmohammadi A, Swift JR, de Pesters A, Guay CS, Adamo MA, Dalfino JC, Ritaccio AL, Schalk G, Brunner P. Passive functional mapping of receptive language cortex during general anesthesia using electrocorticography. Clin Neurophysiol 2023; 147:31-44. [PMID: 36634533 PMCID: PMC10267852 DOI: 10.1016/j.clinph.2022.11.021] [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: 04/18/2022] [Revised: 09/30/2022] [Accepted: 11/10/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE To investigate the feasibility of passive functional mapping in the receptive language cortex during general anesthesia using electrocorticographic (ECoG) signals. METHODS We used subdurally placed ECoG grids to record cortical responses to speech stimuli during awake and anesthesia conditions. We identified the cortical areas with significant responses to the stimuli using the spectro-temporal consistency of the brain signal in the broadband gamma (BBG) frequency band (70-170 Hz). RESULTS We found that ECoG BBG responses during general anesthesia effectively identify cortical regions associated with receptive language function. Our analyses demonstrated that the ability to identify receptive language cortex varies across different states and depths of anesthesia. We confirmed these results by comparing them to receptive language areas identified during the awake condition. Quantification of these results demonstrated an average sensitivity and specificity of passive language mapping during general anesthesia to be 49±7.7% and 100%, respectively. CONCLUSION Our results demonstrate that mapping receptive language cortex in patients during general anesthesia is feasible. SIGNIFICANCE Our proposed protocol could greatly expand the population of patients that can benefit from passive language mapping techniques, and could eliminate the risks associated with electrocortical stimulation during an awake craniotomy.
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Affiliation(s)
- Amin Nourmohammadi
- National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
| | - James R Swift
- National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
| | - Adriana de Pesters
- National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA.
| | - Christian S Guay
- Department of Anesthesiology, Washington University School of Medicine, St. Louis, MO, USA.
| | - Matthew A Adamo
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
| | - John C Dalfino
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA.
| | - Anthony L Ritaccio
- Department of Neurology, Albany Medical College, Albany, NY, USA; Department of Neurology, Mayo Clinic, Jacksonville, FL, USA.
| | - Gerwin Schalk
- National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; Chen Frontier Lab for Applied Neurotechnology, Tianqiao and Chrissy Chen Institute, Shanghai, P.R. China.
| | - Peter Brunner
- National Center for Adaptive Neurotechnologies, Washington University School of Medicine, St. Louis, MO, USA; Department of Neurosurgery, Washington University School of Medicine, St. Louis, MO, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; Department of Neurology, Albany Medical College, Albany, NY, USA.
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28
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Li S, Mu Y, Rao Y, Sun C, Li X, Liu H, Yu X, Yan X, Ding Y, Wang Y, Fei Z. Preoperative individual-target transcranial magnetic stimulation demonstrates an effect comparable to intraoperative direct electrical stimulation in language-eloquent glioma mapping and improves postsurgical outcome: A retrospective fiber-tracking and electromagnetic simulation study. Front Oncol 2023; 13:1089787. [PMID: 36816968 PMCID: PMC9936080 DOI: 10.3389/fonc.2023.1089787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/20/2023] [Indexed: 02/05/2023] Open
Abstract
Background Efforts to resection of glioma lesions located in brain-eloquent areas must balance the extent of resection (EOR) and functional preservation. Currently, intraoperative direct electrical stimulation (DES) is the gold standard for achieving the maximum EOR while preserving as much functionality as possible. However, intraoperative DES inevitably involves risks of infection and epilepsy. The aim of this study was to verify the reliability of individual-target transcranial magnetic stimulation (IT-TMS) in preoperative mapping relative to DES and evaluate its effectiveness based on postsurgical outcomes. Methods Sixteen language-eloquent glioma patients were enrolled. Nine of them underwent preoperative nTMS mapping (n=9, nTMS group), and the other seven were assigned to the non-nTMS group and did not undergo preoperative nTMS mapping (n=7). Before surgery, online IT-TMS was performed during a language task in the nTMS group. Sites in the cortex at which this task was disturbed in three consecutive trials were recorded and regarded as positive and designated nTMS hotspots (HSnTMS). Both groups then underwent awake surgery and intraoperative DES mapping. DES hotspots (HSDES) were also determined in a manner analogous to HSnTMS. The spatial distribution of HSnTMS and HSDES in the nTMS group was recorded, registered in a single brain template, and compared. The center of gravity (CoG) of HSnTMS (HSnTMS-CoG)-based and HSDES-CoG-based diffusion tensor imaging-fiber tracking (DTI-FT) was performed. The electromagnetic simulation was conducted, and the values were then compared between the nTMS and DES groups, as were the Western Aphasia Battery (WAB) scale and fiber-tracking values. Results HSnTMS and HSDES showed similar distributions (mean distance 6.32 ± 2.6 mm, distance range 2.2-9.3 mm, 95% CI 3.9-8.7 mm). A higher fractional anisotropy (FA) value in nTMS mapping (P=0.0373) and an analogous fiber tract length (P=0.2290) were observed. A similar distribution of the electric field within the brain tissues induced by nTMS and DES was noted. Compared with the non-nTMS group, the integration of nTMS led to a significant improvement in language performance (WAB scores averaging 78.4 in the nTMS group compared with 59.5 in the non-nTMS group, P=0.0321 < 0.05) as well as in brain-structure preservation (FA value, P=0.0156; tract length, P=0.0166). Conclusion Preoperative IT-TMS provides data equally crucial to DES and thus facilitates precise brain mapping and the preservation of linguistic function.
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Affiliation(s)
- Sanzhong Li
- Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, China,*Correspondence: Sanzhong Li, ; Zhou Fei,
| | - Yunfeng Mu
- Department of Gynecological Oncology, Shaanxi Provincial Cancer Hospital, Xi’an, China
| | - Yang Rao
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Chuanzhu Sun
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Xiang Li
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China,The Key Laboratory of Biomedical Information Engineering of Ministry of Education, Institute of Health and Rehabilitation Science, School of Life Science and Technology, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Huan Liu
- School of Mathematics and Statistics, Xi’an Jiaotong University, Xi’an, Shaanxi, China
| | - Xun Yu
- Product Department, Solide Brain Medical Technology, Ltd., Xi’an, Shaanxi, China
| | - Xiao Yan
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Yunxia Ding
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Yangtao Wang
- Shaanxi Brain Modulation and Scientific Research Center, Xi'an, Shaanxi, China
| | - Zhou Fei
- Department of Neurosurgery, Xijing Hospital, Air Force Medical University, Xi’an, Shaanxi, China,*Correspondence: Sanzhong Li, ; Zhou Fei,
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Li H, Liu J, Tian S, Fan S, Wang T, Qian H, Liu G, Zhu Y, Wu Y, Hu R. Language reorganization patterns in global aphasia-evidence from fNIRS. Front Neurol 2023; 13:1025384. [PMID: 36686505 PMCID: PMC9853054 DOI: 10.3389/fneur.2022.1025384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 12/09/2022] [Indexed: 01/09/2023] Open
Abstract
Background Exploring the brain reorganization patterns associated with language recovery would promote the treatment of global aphasia. While functional near-infrared spectroscopy (fNIRS) has been widely used in the study of speech and language impairment, its application in the field of global aphasia is still limited. Aims We aimed to identify cortical activation patterns of patients with global aphasia during naming and repetition tasks. Methods and procedures We recruited patients with post-stroke aphasia from the Department of Rehabilitation Medicine at Huashan Hospital. These individuals were diagnosed with global aphasia without cognitive impairments, as assessed by speech-language pathology evaluations. Age- and sex-matched healthy controls were recruited from the greater Shanghai area. During fNIRS measurement, patients and healthy controls completed the picture-naming and phrase repetition task. Cortical activation patterns on each of these language tasks were then compared between groups. Outcomes and results A total of nine patients with global aphasia and 14 healthy controls were included in this study. Compared with the healthy subjects, patients with global aphasia showed increased activation in the left Broca's area, middle temporal gyrus (MTG), superior temporal gyrus (STG), and pre-motor and supplementary motor cortex (SMA) (p < 0.05) in the picture-naming task. Furthermore, the latency of the oxyhemoglobin (HbO) concentration in the left supramarginal gyrus (SMG) region had a strong negative correlation with their score of the naming task (p < 0.01). In the phrase repetition task, decreased activation was detected in the left SMA and SMG (p < 0.05) of patients relative to controls. Conclusion The left SMG plays a critical role in the language function of patients with global aphasia, especially in their abilities to name and repeat. fNIRS is a promising approach to revealing the changes in brain activities in patients with aphasia, and we believe it will contribute to a deeper understanding of the neurological mechanisms and the establishment of a novel treatment approach for global aphasia.
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Affiliation(s)
- Haozheng Li
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianju Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Shan Tian
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Shunjuan Fan
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Tingwei Wang
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Hong Qian
- Department of Rehabilitation Medicine, Shanghai Fifth Rehabilitation Hospital, Shanghai, China
| | - Gang Liu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yulian Zhu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Yi Wu
- School of Rehabilitation Science, Shanghai University of Traditional Chinese Medicine, Shanghai, China,Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,*Correspondence: Yi Wu ✉
| | - Ruiping Hu
- Department of Rehabilitation Medicine, Huashan Hospital, Fudan University, Shanghai, China,Ruiping Hu ✉
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Yuan Y, Qiu T, Chong ST, Hsu SPC, Chu YH, Hsu YC, Xu G, Ko YT, Kuo KT, Yang Z, Zhu W, Lin CP, Song J. Automatic bundle-specific white matter fiber tracking tool using diffusion tensor imaging data: A pilot trial in the application of language-related glioma resection. Front Oncol 2023; 13:1089923. [PMID: 37035157 PMCID: PMC10080097 DOI: 10.3389/fonc.2023.1089923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 03/03/2023] [Indexed: 04/11/2023] Open
Abstract
Cerebral neoplasms like gliomas may cause intracranial pressure increasing, neural tract deviation, infiltration, or destruction in peritumoral areas, leading to neuro-functional deficits. Novel tracking technology, such as DTI, can objectively reveal and visualize three-dimensional white matter trajectories; in combination with intraoperative navigation, it can help achieve maximum resection whilst minimizing neurological deficit. Since the reconstruction of DTI raw data largely relies on the technical engineering and anatomical experience of the operator; it is time-consuming and prone to operator-induced bias. Here, we develop new user-friendly software to automatically segment and reconstruct functionally active areas to facilitate precise surgery. In this pilot trial, we used an in-house developed software (DiffusionGo) specially designed for neurosurgeons, which integrated a reliable diffusion-weighted image (DWI) preprocessing pipeline that embedded several functionalities from software packages of FSL, MRtrix3, and ANTs. The preprocessing pipeline is as follows: 1. DWI denoising, 2. Gibbs-ringing removing, 3. Susceptibility distortion correction (process if opposite polarity data were acquired), 4. Eddy current and motion correction, and 5. Bias correction. Then, this fully automatic multiple assigned criteria algorithms for fiber tracking were used to achieve easy modeling and assist precision surgery. We demonstrated the application with three language-related cases in three different centers, including a left frontal, a left temporal, and a left frontal-temporal glioma, to achieve a favorable surgical outcome with language function preservation or recovery. The DTI tracking result using DiffusionGo showed robust consistency with direct cortical stimulation (DCS) finding. We believe that this fully automatic processing pipeline provides the neurosurgeon with a solution that may reduce time costs and operating errors and improve care quality and surgical procedure quality across different neurosurgical centers.
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Affiliation(s)
- Yifan Yuan
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Tianming Qiu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Shin Tai Chong
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Sanford Pin-Chuan Hsu
- Department of Neurosurgery, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Ying-Hua Chu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Yi-Cheng Hsu
- Magnetic Resonance (MR) Collaboration, Siemens Healthineers Ltd., Shanghai, China
| | - Geng Xu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Yu-Ting Ko
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Kuan-Tsen Kuo
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
| | - Zixiao Yang
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Wei Zhu
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
| | - Ching-Po Lin
- Institute of Neuroscience, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- *Correspondence: Ching-Po Lin, ; Jianping Song,
| | - Jianping Song
- Department of Neurosurgery, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- National Center for Neurological Disorders, Shanghai, China
- Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Clinical Medical Center of Neurosurgery, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
- Research Units of New Technologies of Micro-Endoscopy Combination in Skull Base Surgery, Chinese Academy of Medical Sciences (CAMS), Shanghai, China
- Department of Neurosurgery, National Regional Medical Center, Fudan University Huashan Hospital, Fuzhou, Fujian, China
- *Correspondence: Ching-Po Lin, ; Jianping Song,
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Yao S, Yang R, Du C, Jiang C, Wang Y, Peng C, Bai H. Maximal safe resection of diffuse lower grade gliomas primarily within central lobe using cortical/subcortical direct electrical stimulation under awake craniotomy. Front Oncol 2023; 13:1089139. [PMID: 36895476 PMCID: PMC9990258 DOI: 10.3389/fonc.2023.1089139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/07/2023] [Indexed: 02/23/2023] Open
Abstract
Background Diffuse lower-grade glioma (DLGG) in the central lobe is a challenge for safe resection procedures. To improve the extent of resection and reduce the risk of postoperative neurological deficits, we performed an awake craniotomy with cortical-subcortical direct electrical stimulation (DES) mapping for patients with DLGG located primarily within the central lobe. We investigated the outcomes of cortical-subcortical brain mapping using DES in an awake craniotomy for central lobe DLGG resection. Methods We performed a retrospective analysis of clinical data of a cohort of consecutively treated patients from February 2017 to August 2021 with diffuse lower-grade gliomas located primarily within the central lobe. All patients underwent awake craniotomy with DES for cortical and subcortical mapping of eloquent brain areas, neuronavigation, and/or ultrasound to identify tumor location. Tumors were removed according to functional boundaries. Maximum safe tumor resection was the surgical objective for all patients. Results Thirteen patients underwent 15 awake craniotomies with intraoperative mapping of eloquent cortices and subcortical fibers using DES. Maximum safe tumor resection was achieved according to functional boundaries in all patients. The pre-operative tumor volumes ranged from 4.3 cm3 to 137.3 cm3 (median 19.2 cm3). The mean extent of tumor resection was 94.6%, with eight cases (53.3%) achieving total resection, four (26.7%) subtotal and three (20.0%) partial. The mean tumor residue was 1.2 cm3. All patients experienced early postoperative neurological deficits or worsening conditions. Three patients (20.0%) experienced late postoperative neurological deficits at the 3-month follow-up, including one moderate and two mild neurological deficits. None of the patients experienced late onset severe neurological impairments post-operatively. Ten patients with 12 tumor resections (80.0%) had resumed activities of daily living at the 3-month follow-up. Among 14 patients with pre-operative epilepsy, 12 (85.7%) were seizure-free after treatment with antiepileptic drugs 7 days after surgery up to the last follow-up. Conclusions DLGG located primarily in the central lobe deemed inoperable can be safely resected using awake craniotomy with intraoperative DES without severe permanent neurological sequelae. Patients experienced an improved quality of life in terms of seizure control.
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Affiliation(s)
- Shujing Yao
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Ruixin Yang
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Chenggang Du
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Che Jiang
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Yang Wang
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Chongqi Peng
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
| | - Hongmin Bai
- Department of Neurosurgery, General Hospital of Southern Theater Command of PLA, Guangzhou, China
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Silva AB, Liu JR, Zhao L, Levy DF, Scott TL, Chang EF. A Neurosurgical Functional Dissection of the Middle Precentral Gyrus during Speech Production. J Neurosci 2022; 42:8416-8426. [PMID: 36351829 PMCID: PMC9665919 DOI: 10.1523/jneurosci.1614-22.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 08/30/2022] [Indexed: 11/17/2022] Open
Abstract
Classical models have traditionally focused on the left posterior inferior frontal gyrus (Broca's area) as a key region for motor planning of speech production. However, converging evidence suggests that it is not critical for either speech motor planning or execution. Alternative cortical areas supporting high-level speech motor planning have yet to be defined. In this review, we focus on the precentral gyrus, whose role in speech production is often thought to be limited to lower-level articulatory muscle control. In particular, we highlight neurosurgical investigations that have shed light on a cortical region anatomically located near the midpoint of the precentral gyrus, hence called the middle precentral gyrus (midPrCG). The midPrCG is functionally located between dorsal hand and ventral orofacial cortical representations and exhibits unique sensorimotor and multisensory functions relevant for speech processing. This includes motor control of the larynx, auditory processing, as well as a role in reading and writing. Furthermore, direct electrical stimulation of midPrCG can evoke complex movements, such as vocalization, and selective injury can cause deficits in verbal fluency, such as pure apraxia of speech. Based on these findings, we propose that midPrCG is essential to phonological-motoric aspects of speech production, especially syllabic-level speech sequencing, a role traditionally ascribed to Broca's area. The midPrCG is a cortical brain area that should be included in contemporary models of speech production with a unique role in speech motor planning and execution.
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Affiliation(s)
- Alexander B Silva
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Medical Scientist Training Program, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Jessie R Liu
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
| | - Lingyun Zhao
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Deborah F Levy
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Terri L Scott
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
| | - Edward F Chang
- Department of Neurological Surgery, University of California, San Francisco, California, 94158
- Weill Institute for Neurosciences, University of California, San Francisco, California, 94158
- Graduate Program in Bioengineering, University of California, Berkeley, California 94720, & University of California, San Francisco, California, 94158
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McGrath H, Zaveri HP, Collins E, Jafar T, Chishti O, Obaid S, Ksendzovsky A, Wu K, Papademetris X, Spencer DD. High-resolution cortical parcellation based on conserved brain landmarks for localization of multimodal data to the nearest centimeter. Sci Rep 2022; 12:18778. [PMID: 36335146 PMCID: PMC9637135 DOI: 10.1038/s41598-022-21543-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Accepted: 09/28/2022] [Indexed: 11/06/2022] Open
Abstract
Precise cortical brain localization presents an important challenge in the literature. Brain atlases provide data-guided parcellation based on functional and structural brain metrics, and each atlas has its own unique benefits for localization. We offer a parcellation guided by intracranial electroencephalography, a technique which has historically provided pioneering advances in our understanding of brain structure-function relationships. We used a consensus boundary mapping approach combining anatomical designations in Duvernoy's Atlas of the Human Brain, a widely recognized textbook of human brain anatomy, with the anatomy of the MNI152 template and the magnetic resonance imaging scans of an epilepsy surgery cohort. The Yale Brain Atlas consists of 690 one-square centimeter parcels based around conserved anatomical features and each with a unique identifier to communicate anatomically unambiguous localization. We report on the methodology we used to create the Atlas along with the findings of a neuroimaging study assessing the accuracy and clinical usefulness of cortical localization using the Atlas. We also share our vision for the Atlas as a tool in the clinical and research neurosciences, where it may facilitate precise localization of data on the cortex, accurate description of anatomical locations, and modern data science approaches using standardized brain regions.
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Affiliation(s)
- Hari McGrath
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA.
- GKT School of Medical Education, King's College London, London, UK.
| | - Hitten P Zaveri
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Evan Collins
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
- Yale School of Engineering and Applied Science, New Haven, CT, USA
- Department of Biological Engineering, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Tamara Jafar
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Omar Chishti
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
- Yale School of Engineering and Applied Science, New Haven, CT, USA
| | - Sami Obaid
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Alexander Ksendzovsky
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
- Department of Neurosurgery, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kun Wu
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
| | - Xenophon Papademetris
- Department of Radiology and Biomedical Engineering, Yale School of Medicine, New Haven, CT, USA
- Department of Biomedical Engineering, Yale School of Medicine, New Haven, CT, USA
| | - Dennis D Spencer
- Department of Neurosurgery, Yale School of Medicine, New Haven, CT, USA
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Zhou Y, Zhao Z, Zhang J, Hameed NUF, Zhu F, Feng R, Zhang X, Lu J, Wu J. Electrical stimulation-induced speech-related negative motor responses in the lateral frontal cortex. J Neurosurg 2022; 137:496-504. [PMID: 34952509 DOI: 10.3171/2021.9.jns211069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Accepted: 09/30/2021] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Speech arrest is a common but crucial negative motor response (NMR) recorded during intraoperative brain mapping. However, recent studies have reported nonspeech-specific NMR sites in the ventral precentral gyrus (vPrCG), where stimulation halts both speech and ongoing hand movement. The aim of this study was to investigate the spatial relationship between speech-specific NMR sites and nonspeech-specific NMR sites in the lateral frontal cortex. METHODS In this prospective cohort study, an intraoperative mapping strategy was designed to identify positive motor response (PMR) sites and NMR sites in 33 consecutive patients undergoing awake craniotomy for the treatment of left-sided gliomas. Patients were asked to count, flex their hands, and simultaneously perform these two tasks to map NMRs. Each site was plotted onto a standard atlas and further analyzed. The speech and hand motor arrest sites in the supplementary motor area of 2 patients were resected. The 1- and 3-month postoperative language and motor functions of all patients were assessed. RESULTS A total of 91 PMR sites and 72 NMR sites were identified. NMR and PMR sites were anteroinferiorly and posterosuperiorly distributed in the precentral gyrus, respectively. Three distinct NMR sites were identified: 24 pure speech arrest (speech-specific NMR) sites (33.33%), 7 pure hand motor arrest sites (9.72%), and 41 speech and hand motor arrest (nonspeech-specific NMR) sites (56.94%). Nonspeech-specific NMR sites and speech-specific NMR sites were dorsoventrally distributed in the vPrCG. For language function, 1 of 2 patients in the NMA resection group had language dysfunction at the 1-month follow-up but had recovered by the 3-month follow-up. All patients in the NMA resection group had fine motor dysfunction at the 1- and 3-month follow-ups. CONCLUSIONS The study results demonstrated a functional segmentation of speech-related NMRs in the lateral frontal cortex and that most of the stimulation-induced speech arrest sites are not specific to speech. A better understanding of the spatial distribution of speech-related NMR sites will be helpful in surgical planning and intraoperative mapping and provide in-depth insight into the motor control of speech production.
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Affiliation(s)
- Yuyao Zhou
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
| | - Zehao Zhao
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
| | - Jie Zhang
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
| | - N U Farrukh Hameed
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
| | - Fengping Zhu
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
| | - Rui Feng
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
| | - Xiaoluo Zhang
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
| | - Junfeng Lu
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
- 3Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
| | - Jinsong Wu
- 1Neurologic Surgery Department, Huashan Hospital, Fudan University
- 2Brain Function Laboratory, Neurosurgical Institute of Fudan University
- 3Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
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Optical Fiber-Based Recording of Climbing Fiber Ca2+ Signals in Freely Behaving Mice. BIOLOGY 2022; 11:biology11060907. [PMID: 35741428 PMCID: PMC9220032 DOI: 10.3390/biology11060907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 06/09/2022] [Accepted: 06/11/2022] [Indexed: 11/16/2022]
Abstract
Simple Summary In this study, we established a robust and accessible method to chronically record calcium signals from climbing fiber (CF) projections to the cerebellar cortex in freely behaving mice. This technique was demonstrated with optical fiber photometry in lobule IV/V of the cerebellar vermis during open field exploration, where various movement-evoked CF Ca2+ signals were observed, and the onset of exploratory-like behaviors was highly synchronous with the recorded CF activity. Abstract The olivocerebellar circuitry is important to convey both motor and non-motor information from the inferior olive (IO) to the cerebellar cortex. Several methods are currently established to observe the dynamics of the olivocerebellar circuitry, largely by recording the complex spike activity of cerebellar Purkinje cells; however, these techniques can be technically challenging to apply in vivo and are not always possible in freely behaving animals. Here, we developed a method for the direct, accessible, and robust recording of climbing fiber (CF) Ca2+ signals based on optical fiber photometry. We first verified the IO stereotactic coordinates and the organization of contralateral CF projections using tracing techniques and then injected Ca2+ indicators optimized for axonal labeling, followed by optical fiber-based recordings. We demonstrated this method by recording CF Ca2+ signals in lobule IV/V of the cerebellar vermis, comparing the resulting signals in freely moving mice. We found various movement-evoked CF Ca2+ signals, but the onset of exploratory-like behaviors, including rearing and tiptoe standing, was highly synchronous with recorded CF activity. Thus, we have successfully established a robust and accessible method to record the CF Ca2+ signals in freely behaving mice, which will extend the toolbox for studying cerebellar function and related disorders.
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Yuan B, Zhang N, Gong F, Wang X, Yan J, Lu J, Wu J. Longitudinal assessment of network reorganizations and language recovery in postoperative patients with glioma. Brain Commun 2022; 4:fcac046. [PMID: 35415604 PMCID: PMC8994117 DOI: 10.1093/braincomms/fcac046] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 12/13/2021] [Accepted: 04/02/2022] [Indexed: 12/22/2022] Open
Abstract
For patients with glioma located in or adjacent to the linguistic eloquent cortex, awake surgery with an emphasis on the preservation of language function is preferred. However, the brain network basis of postoperative linguistic functional outcomes remains largely unknown. In this work, 34 patients with left cerebral gliomas who underwent awake surgery were assessed for language function and resting-state network properties before and after surgery. We found that there were 28 patients whose language function returned to at least 80% of the baseline scores within 3 months after surgery or to 85% within 6 months after surgery. For these patients, the spontaneous recovery of language function synchronized with changes within the language and cognitive control networks, but not with other networks. Specifically, compared with baseline values, language functions and global network properties were the worst within 1 month after surgery and gradually recovered within 6 months after surgery. The recovery of connections was tumour location dependent and was attributed to both ipsihemispheric and interhemispheric connections. In contrast, for six patients whose language function did not recover well, severe network disruptions were observed before surgery and persisted into the chronic phase. This study suggests the synchronization of functional network normalization and spontaneous language recovery in postoperative patients with glioma.
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Affiliation(s)
- Binke Yuan
- Key Laboratory of Brain, Cognition and Education Sciences, Ministry of Education, Guangzhou, China
- Institute for Brain Research and Rehabilitation, South China Normal University, Guangzhou, China
| | - Nan Zhang
- Department of Neurosurgery, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Fangyuan Gong
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xindi Wang
- National Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Key Laboratory of Brain Imaging and Connectomics, Beijing Normal University, Beijing, China
- IDG/McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
| | - Jing Yan
- Department of MRI, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Junfeng Lu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
| | - Jinsong Wu
- Glioma Surgery Division, Neurologic Surgery Department, Huashan Hospital, Shanghai Medical College, Fudan University, Shanghai, China
- Brain Function Laboratory, Neurosurgical Institute of Fudan University, Shanghai, China
- Shanghai Key Laboratory of Brain Function Restoration and Neural Regeneration, Shanghai, China
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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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Sarubbo S, Duffau H. Connectomic evidences driving a functional approach in neuro-oncological surgery. J Neurosurg Sci 2022; 65:545-547. [PMID: 35128917 DOI: 10.23736/s0390-5616.21.05517-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
- Silvio Sarubbo
- Department of Neurosurgery, "Santa Chiara" Hospital, Azienda Provinciale per i Servizi Sanitari (APSS), Trento, Italy -
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France.,Institut of Functional Genomics, University of Montpellier, Montpellier, France
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Cui W, Wang Y, Ren J, Hubbard CS, Fu X, Fang S, Wang D, Zhang H, Li Y, Li L, Jiang T, Liu H. Personalized
fMRI
delineates functional regions preserved within brain tumors. Ann Neurol 2022; 91:353-366. [PMID: 35023218 PMCID: PMC9107064 DOI: 10.1002/ana.26303] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Revised: 01/09/2022] [Accepted: 01/10/2022] [Indexed: 11/09/2022]
Abstract
Objective Methods Results Interpretation
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Affiliation(s)
- Weigang Cui
- Department of Automation Science and Electrical Engineering Beihang University Beijing China
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
- Department of Neuroscience Medical University of South Carolina Charleston SC USA
- School of Engineering Medicine, Beihang University Beijing China
| | - Yinyan Wang
- Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University Beijing China
- Beijing Neurosurgical Institute, Capital Medical University Beijing China
| | - Jianxun Ren
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
- National Engineering Laboratory for Neuromodulation School of Aerospace Engineering, Tsinghua University Beijing China
| | - Catherine S. Hubbard
- Department of Neuroscience Medical University of South Carolina Charleston SC USA
| | - Xiaoxuan Fu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
- Department of Neuroscience Medical University of South Carolina Charleston SC USA
- State Key Laboratory of Reliability and Intelligence of Electrical Equipment Hebei University of Technology Tianjin China
| | - Shengyu Fang
- Beijing Neurosurgical Institute, Capital Medical University Beijing China
| | - Danhong Wang
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
| | - Hao Zhang
- Department of Neurological Rehabilitation Beijing Bo'ai Hospital, China Rehabilitation Research Center Beijing China
| | - Yang Li
- Department of Automation Science and Electrical Engineering Beihang University Beijing China
| | - Luming Li
- National Engineering Laboratory for Neuromodulation School of Aerospace Engineering, Tsinghua University Beijing China
- Precision Medicine & Healthcare Research Center, Tsinghua‐Berkeley Shenzhen Institute, Tsinghua University Shenzhen Guangdong China
- IDG/McGovern Institute for Brain Research at Tsinghua University Beijing China
| | - Tao Jiang
- Department of Neurosurgery Beijing Tiantan Hospital, Capital Medical University Beijing China
- Beijing Neurosurgical Institute, Capital Medical University Beijing China
| | - Hesheng Liu
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology Massachusetts General Hospital, Harvard Medical School Charlestown MA USA
- Department of Neuroscience Medical University of South Carolina Charleston SC USA
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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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Sonoda M, Silverstein BH, Jeong JW, Sugiura A, Nakai Y, Mitsuhashi T, Rothermel R, Luat AF, Sood S, Asano E. Six-dimensional dynamic tractography atlas of language connectivity in the developing brain. Brain 2021; 144:3340-3354. [PMID: 34849596 PMCID: PMC8677551 DOI: 10.1093/brain/awab225] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Revised: 05/23/2021] [Accepted: 06/05/2021] [Indexed: 11/12/2022] Open
Abstract
During a verbal conversation, our brain moves through a series of complex linguistic processing stages: sound decoding, semantic comprehension, retrieval of semantically coherent words, and overt production of speech outputs. Each process is thought to be supported by a network consisting of local and long-range connections bridging between major cortical areas. Both temporal and extratemporal lobe regions have functional compartments responsible for distinct language domains, including the perception and production of phonological and semantic components. This study provides quantitative evidence of how directly connected inter-lobar neocortical networks support distinct stages of linguistic processing across brain development. Novel six-dimensional tractography was used to intuitively visualize the strength and temporal dynamics of direct inter-lobar effective connectivity between cortical areas activated during each linguistic processing stage. We analysed 3401 non-epileptic intracranial electrode sites from 37 children with focal epilepsy (aged 5-20 years) who underwent extra-operative electrocorticography recording. Principal component analysis of auditory naming-related high-gamma modulations determined the relative involvement of each cortical area during each linguistic processing stage. To quantify direct effective connectivity, we delivered single-pulse electrical stimulation to 488 temporal and 1581 extratemporal lobe sites and measured the early cortico-cortical spectral responses at distant electrodes. Mixed model analyses determined the effects of naming-related high-gamma co-augmentation between connecting regions, age, and cerebral hemisphere on the strength of effective connectivity independent of epilepsy-related factors. Direct effective connectivity was strongest between extratemporal and temporal lobe site pairs, which were simultaneously activated between sentence offset and verbal response onset (i.e. response preparation period); this connectivity was approximately twice more robust than that with temporal lobe sites activated during stimulus listening or overt response. Conversely, extratemporal lobe sites activated during overt response were equally connected with temporal lobe language sites. Older age was associated with increased strength of inter-lobar effective connectivity especially between those activated during response preparation. The arcuate fasciculus supported approximately two-thirds of the direct effective connectivity pathways from temporal to extratemporal auditory language-related areas but only up to half of those in the opposite direction. The uncinate fasciculus consisted of <2% of those in the temporal-to-extratemporal direction and up to 6% of those in the opposite direction. We, for the first time, provided an atlas which quantifies and animates the strength, dynamics, and direction specificity of inter-lobar neural communications between language areas via the white matter pathways. Language-related effective connectivity may be strengthened in an age-dependent manner even after the age of 5.
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Affiliation(s)
- Masaki Sonoda
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Department of Neurosurgery, Yokohama City University, Yokohama, Kanagawa 2360004, Japan
| | - Brian H Silverstein
- Translational Neuroscience Program, Wayne State University, Detroit, MI 48201, USA
| | - Jeong-Won Jeong
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University, Detroit, MI 48201, USA
- Department of Neurology, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
| | - Ayaka Sugiura
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
| | - Yasuo Nakai
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Department of Neurological Surgery, Wakayama Medical University, Wakayama, Wakayama 6418509, Japan
| | - Takumi Mitsuhashi
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Department of Neurosurgery, Juntendo University, School of Medicine, Tokyo, 1138421, Japan
| | - Robert Rothermel
- Department of Psychiatry, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
| | - Aimee F Luat
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Department of Neurology, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Department of Pediatrics, Central Michigan University, Mount Pleasant, MI 48858, USA
| | - Sandeep Sood
- Department of Neurosurgery, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
| | - Eishi Asano
- Department of Pediatrics, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
- Translational Neuroscience Program, Wayne State University, Detroit, MI 48201, USA
- Department of Neurology, Children’s Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI 48201, USA
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Duffau H. The death of localizationism: The concepts of functional connectome and neuroplasticity deciphered by awake mapping, and their implications for best care of brain-damaged patients. Rev Neurol (Paris) 2021; 177:1093-1103. [PMID: 34563375 DOI: 10.1016/j.neurol.2021.07.016] [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: 04/04/2021] [Revised: 06/20/2021] [Accepted: 07/23/2021] [Indexed: 11/28/2022]
Abstract
Although clinical neurology was mainly erected on the dogma of localizationism, numerous reports have described functional recovery after lesions involving presumed non-compensable areas in an inflexible view of brain processing. Here, the purpose is to review new insights into the functional connectome and the mechanisms underpinning neural plasticity, gained from intraoperative direct electrostimulation mapping and real-time behavioral monitoring in awake patients, combined with perioperative neuropsychological and neuroimaging data. Such longitudinal anatomo-functional correlations resulted in the reappraisal of classical models of cognition, especially by highlighting the dynamic interplay within and between neural circuits, leading to the concept of meta-network (network of networks), as well as by emphasizing that subcortical connectivity is the main limitation of neuroplastic potential. Beyond their contribution to basic neurosciences, these findings might also be helpful for an optimization of care for brain-damaged patients, such as in resective oncological or epilepsy neurosurgery in structures traditionally deemed inoperable (e.g., in Broca's area) as well as for elaborating new programs of functional rehabilitation, eventually combined with transcranial brain stimulation, aiming to change the connectivity patterns in order to enhance cognitive competences following cerebral injury.
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Affiliation(s)
- H Duffau
- Department of Neurosurgery, Gui-de-Chauliac Hospital, Montpellier University Medical Center, 80, avenue Augustin-Fliche, 34295 Montpellier, France; National Institute for Health and Medical Research (INSERM), U1191 Laboratory, Team "Brain Plasticity, Stem Cells and Low-Grade Gliomas", Institute of Functional Genomics, University of Montpellier, 34091 Montpellier, France.
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