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Matoba K, Matsumoto R, Shimotake A, Nakae T, Imamura H, Togo M, Yamao Y, Usami K, Kikuchi T, Yoshida K, Matsuhashi M, Kunieda T, Miyamoto S, Takahashi R, Ikeda A. Basal temporal language area revisited in Japanese language with a language function density map. Cereb Cortex 2024; 34:bhae218. [PMID: 38858838 DOI: 10.1093/cercor/bhae218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 05/04/2024] [Accepted: 05/08/2024] [Indexed: 06/12/2024] Open
Abstract
We revisited the anatomo-functional characteristics of the basal temporal language area (BTLA), first described by Lüders et al. (1986), using electrical cortical stimulation (ECS) in the context of Japanese language and semantic networks. We recruited 11 patients with focal epilepsy who underwent chronic subdural electrode implantation and ECS mapping with multiple language tasks for presurgical evaluation. A semiquantitative language function density map delineated the anatomo-functional characteristics of the BTLA (66 electrodes, mean 3.8 cm from the temporal tip). The ECS-induced impairment probability was higher in the following tasks, listed in a descending order: spoken-word picture matching, picture naming, Kanji word reading, paragraph reading, spoken-verbal command, and Kana word reading. The anterior fusiform gyrus (FG), adjacent anterior inferior temporal gyrus (ITG), and the anterior end where FG and ITG fuse, were characterized by stimulation-induced impairment during visual and auditory tasks requiring verbal output or not, whereas the middle FG was characterized mainly by visual input. The parahippocampal gyrus was the least impaired of the three gyri in the basal temporal area. We propose that the BTLA has a functional gradient, with the anterior part involved in amodal semantic processing and the posterior part, especially the middle FG in unimodal semantic processing.
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Affiliation(s)
- Kento Matoba
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Riki Matsumoto
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akihiro Shimotake
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takuro Nakae
- Department of Neurosurgery, Shiga General Hospital, 5-4-30 Moriyama, Moriyama, Shiga 524-0022, Japan
| | - Hisaji Imamura
- Department of Neurology, Fukui Red Cross Hospital, 2-4-1, Tsukimi, Fukui, 918-8011, Japan
| | - Masaya Togo
- Division of Neurology, Kobe University Graduate School of Medicine, 7-5-2, Kusunoki-cho, Chuo-ku, Kobe, Hyogo 650-0017, Japan
| | - Yukihiro Yamao
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kiyohide Usami
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takayuki Kikuchi
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Masao Matsuhashi
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
- Human Brain Research Center, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Takeharu Kunieda
- Department of Neurosurgery, Ehime University Graduate School of Medicine, 454 Shitsukawa, Toon, Ehime, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
| | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Kyoto University Graduate School of Medicine, 54 Kawaharacho, Shogoin, Sakyo-ku, Kyoto 606-8507, Japan
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Burkhardt E, Zemmoura I, Hirsch F, Lemaitre AL, Deverdun J, Moritz-Gasser S, Duffau H, Herbet G. The central role of the left inferior longitudinal fasciculus in the face-name retrieval network. Hum Brain Mapp 2023; 44:3254-3270. [PMID: 37051699 PMCID: PMC10171495 DOI: 10.1002/hbm.26279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 02/18/2023] [Accepted: 03/06/2023] [Indexed: 04/14/2023] Open
Abstract
Unsuccessful retrieval of proper names (PNs) is commonly observed in patients suffering from neurological conditions such as stroke or epilepsy. While a large body of works has suggested that PN retrieval relies on a cortical network centered on the left anterior temporal lobe (ATL), much less is known about the white matter connections underpinning this process. Sparse studies provided evidence for a possible role of the uncinate fasciculus, but the inferior longitudinal fasciculus (ILF) might also contribute, since it mainly projects into the ATL, interconnects it with the posterior lexical interface and is engaged in common name (CN) retrieval. To ascertain this hypothesis, we assessed 58 patients having undergone a neurosurgery for a left low-grade glioma by means of a famous face naming (FFN) task. The behavioural data were processed following a multilevel lesion approach, including location-based analyses, voxel-based lesion-symptom mapping (VLSM) and disconnection-symptom mapping. Different statistical models were generated to control for sociodemographic data, familiarity, biographical knowledge and control cognitive performances (i.e., semantic and episodic memory and CN retrieval). Overall, VLSM analyses indicated that damage to the mid-to-anterior part of the ventro-basal temporal cortex was especially associated with PN retrieval deficits. As expected, tract-oriented analyses showed that the left ILF was the most strongly associated pathway. Our results provide evidence for the pivotal role of the ILF in the PN retrieval network. This novel finding paves the way for a better understanding of the pathophysiological bases underlying PN retrieval difficulties in the various neurological conditions marked by white matter abnormalities.
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Affiliation(s)
- Eléonor Burkhardt
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
| | - Ilyess Zemmoura
- UMR1253, iBrain, University of Tours, INSERM, Tours, France
- Department of Neurosurgery, Bretonneau Hospital, CHRU de Tours, Tours, France
| | - Fabrice Hirsch
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
| | - Anne-Laure Lemaitre
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Jeremy Deverdun
- Department of Neuroradiology, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
- I2FH, Institut d'Imagerie Fonctionnelle Humaine, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Sylvie Moritz-Gasser
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Hugues Duffau
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
| | - Guillaume Herbet
- Praxiling Laboratory, UMR5267, CNRS & Paul Valéry University, Montpellier, France
- Institute of Functional Genomics, University of Montpellier, CNRS, INSERM, Montpellier, France
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France
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Intermediate stimulation frequencies for language mapping using Stereo-EEG. Clin Neurophysiol 2022; 144:91-97. [PMID: 36327599 DOI: 10.1016/j.clinph.2022.10.003] [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: 05/25/2022] [Revised: 09/27/2022] [Accepted: 10/03/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Identification of eloquent cortices is a prerequisite for the surgical plan but may be challenging, in particular for language areas (LAs), considering the complexity of language function and organization. Electrical intracerebral stimulations (ES) during Stereo-electroencephalography are an essential tool in the localization of LAs and high frequency ES (HFS, 50 Hz) are current gold standard. Low frequencies (1 Hz) are not effective. We aim to investigate different ES frequencies for establishing their utility in localizing LAs. METHODS We implemented an observational and prospective study evaluating frequencies lower than 50 and higher than 1 Hz; indicated as "intermediate" frequencies (IFS) performed at 6, 9 and 12 Hz and lasting 15 seconds. We included ten patients and carried out a standardized protocol comparing IFS to HFS. RESULTS Eighty-six ES were carried out in LAs, positive for a language interference in 61.6% without noteworthy difference between IFS and HFS. Among these, 53.3% IFS vs 21.7% HFS yielded no after-discharge. CONCLUSIONS IFS were similarly effective as HFS, with lower incidence of ADs. Their longer duration facilitated more accurate clinical testing. SIGNIFICANCE Our results are promising, suggesting that IFS can be useful in the study of LAs.
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Riva M, Wilson SM, Cai R, Castellano A, Jordan KM, Henry RG, Gorno Tempini ML, Berger MS, Chang EF. Evaluating syntactic comprehension during awake intraoperative cortical stimulation mapping. J Neurosurg 2022; 138:1403-1410. [PMID: 36208435 PMCID: PMC10159588 DOI: 10.3171/2022.8.jns221335] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2022] [Accepted: 08/04/2022] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Electrocortical stimulation mapping (ECS) is widely used to identify essential language areas, but sentence-level processing has rarely been investigated.
METHODS
While undergoing awake surgery in the dominant left hemisphere, 6 subjects were asked to comprehend sentences varying in their demands on syntactic processing.
RESULTS
In all 6 subjects, stimulation of the inferior frontal gyrus disrupted comprehension of passive sentences, which critically depend on syntactic processing to correctly assign grammatical roles, without disrupting comprehension of simpler tasks. In 4 of the 6 subjects, these sites were localized to the pars opercularis. Sentence comprehension was also disrupted by stimulation of other perisylvian sites, but in a more variable manner.
CONCLUSIONS
These findings suggest that there may be language regions that differentially contribute to sentence processing and which therefore are best identified using sentence-level tasks. The functional consequences of resecting these sites remain to be investigated.
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Affiliation(s)
- Marco Riva
- Department of Biomedical Sciences, Humanitas University, Pieve Emanuele, Milan
- IRCCS Humanitas Research Hospital, Rozzano, Milan, Italy
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Stephen M. Wilson
- Department of Hearing and Speech Sciences, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ruofan Cai
- Department of Speech and Hearing Sciences, University of Washington, Seattle
- Institute for Learning & Brain Sciences, University of Washington, Seattle, Washington
| | - Antonella Castellano
- Department of Neuroradiology & CERMAC, Università Vita-Salute and Ospedale San Raffaele, Milan, Italy
| | - Kesshi M. Jordan
- Bioengineering Graduate Group, University of California, San Francisco, and University of California, Berkeley
| | - Roland G. Henry
- Department of Neurology,
- Department of Radiology and Biomedical Imaging,
| | | | - Mitchel S. Berger
- Department of Neurological Surgery, University of California, San Francisco, California
| | - Edward F. Chang
- Department of Neurological Surgery, University of California, San Francisco, California
- Center for Integrative Neuroscience, University of California, San Francisco, California
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Aron O, Krieg J, Brissart H, Abdallah C, Colnat-Coulbois S, Jonas J, Maillard L. Naming impairments evoked by focal cortical electrical stimulation in the ventral temporal cortex correlate with increased functional connectivity. Neurophysiol Clin 2022; 52:312-322. [PMID: 35777988 DOI: 10.1016/j.neucli.2022.06.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 06/13/2022] [Accepted: 06/14/2022] [Indexed: 10/17/2022] Open
Abstract
BACKGROUND High-frequency cortical electrical stimulations (HF-CES) are the gold standard for presurgical functional mapping. In the dominant ventral temporal cortex (VTC) HF-CES can elicit transient naming impairment (eloquent sites), defining a basal temporal language area (BTLA). OBJECTIVE Whether naming impairments induced by HF-CES within the VTC are related to a specific pattern of connectivity of the BTLA within the temporal lobe remains unknown. We addressed this issue by comparing the connectivity of eloquent and non-eloquent sites from the VTC using cortico-cortical evoked potentials (CCEP). METHODS Low frequency cortical electrical stimulations (LF-CES) were used to evoke CCEP in nine individual brains explored with Stereo-Electroencephalography. We compared the connectivity of eloquent versus non eloquent sites within the VTC using Pearson's correlation matrix. RESULTS Overall, within the VTC, eloquent sites were associated with increased functional connectivity compared to non-eloquent sites. Among the VTC structures, this pattern holds true for the inferior temporal gyrus and the parahippocampal gyrus while the fusiform gyrus specifically showed a high connectivity in both non eloquent and eloquent sites. CONCLUSIONS Our findings suggest that the cognitive effects of focal HF-CES are related to the functional connectivity properties of the stimulated sites, and therefore to the disturbance of a wide cortical network. They further suggest that functional specialization of a cortical region emerges from its specific pattern of functional connectivity. Cortical electrical stimulation functional mapping protocols including LF coupled to HF-CES could provide valuable data characterizing both local and distant functional architecture.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France.
| | - Julien Krieg
- Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Helene Brissart
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France
| | - Chifaou Abdallah
- Neurology and Neurosurgery Department, Montreal Neurological Institute (C.A.) McGill University, Montreal, Quebec, Canada
| | - Sophie Colnat-Coulbois
- Department of Neurosurgery, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Jacques Jonas
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
| | - Louis Maillard
- Department of Neurology, University Hospital of Nancy, Lorraine University, F-54000 Nancy, France; Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR, 7039 Vandoeuvre, France
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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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Abdallah C, Brissart H, Colnat-Coulbois S, Pierson L, Aron O, Forthoffer N, Vignal JP, Tyvaert L, Jonas J, Maillard L. Stereoelectroencephalographic language mapping of the basal temporal cortex predicts postoperative naming outcome. J Neurosurg 2021; 135:1466-1476. [PMID: 33636700 DOI: 10.3171/2020.8.jns202431] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Accepted: 08/31/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE In drug-resistant temporal lobe epilepsy (TLE) patients, the authors evaluated early and late outcomes for decline in visual object naming after dominant temporal lobe resection (TLR) according to the resection status of the basal temporal language area (BTLA) identified by cortical stimulation during stereoelectroencephalography (SEEG). METHODS Twenty patients who underwent SEEG for drug-resistant TLE met the inclusion criteria. During language mapping, a site was considered positive when stimulation of two contiguous contacts elicited at least one naming impairment during two remote sessions. After TLR ipsilateral to their BTLA, patients were classified as BTLA+ when at least one positive language site was resected and as BTLA- when all positive language sites were preserved. Outcomes in naming and verbal fluency tests were assessed using pre- and postoperative (means of 7 and 25 months after surgery) scores at the group level and reliable change indices (RCIs) for clinically meaningful changes at the individual level. RESULTS BTLA+ patients (n = 7) had significantly worse naming scores than BTLA- patients (n = 13) within 1 year after surgery but not at the long-term evaluation. No difference in verbal fluency tests was observed. When RCIs were used, 5 of 18 patients (28%) had naming decline within 1 year postoperatively (corresponding to 57% of BTLA+ and 9% of BTLA- patients). A significant correlation was found between BTLA resection and naming decline. CONCLUSIONS BTLA resection is associated with a specific and early naming decline. Even if this decline is transient, naming scores in BTLA+ patients tend to remain lower compared to their baseline. SEEG mapping helps to predict postoperative language outcome after dominant TLR.
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Affiliation(s)
- Chifaou Abdallah
- Departments of1Neurology and
- 4Neurology and Neurosurgery Department, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada
| | | | | | | | | | | | | | - Louise Tyvaert
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
| | - Jacques Jonas
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
| | - Louis Maillard
- Departments of1Neurology and
- 3Neurosciences of Systems and Cognition Project, BioSiS Department (Department Biologie, Signaux et Systèmes en Cancérologie et Neurosciences), Research Center for Automatic Control of Nancy (CRAN), Lorraine University, CNRS, UMR 7039, Vandoeuvre, France; and
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A distributed network supports spatiotemporal cerebral dynamics of visual naming. Clin Neurophysiol 2021; 132:2948-2958. [PMID: 34715419 DOI: 10.1016/j.clinph.2021.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/31/2021] [Accepted: 09/18/2021] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Cerebral spatiotemporal dynamics of visual naming were investigated in epilepsy patients undergoing stereo-electroencephalography (SEEG) monitoring. METHODS Brain networks were defined by Parcel-Activation-Resection-Symptom matching (PARS) approach by matching high-gamma (50-150 Hz) modulations (HGM) in neuroanatomic parcels during visual naming, with neuropsychological outcomes after resection/ablation of those parcels. Brain parcels with >50% electrode contacts simultaneously showing significant HGM were aligned, to delineate spatiotemporal course of naming-related HGM. RESULTS In 41 epilepsy patients, neuroanatomic parcels showed sequential yet temporally overlapping HGM course during visual naming. From bilateral occipital lobes, HGM became increasingly left lateralized, coursing through limbic system. Bilateral superior temporal HGM was noted around response time, and right frontal HGM thereafter. Correlations between resected/ablated parcels, and post-surgical neuropsychological outcomes showed specific regional groupings. CONCLUSIONS Convergence of data from spatiotemporal course of HGM during visual naming, and functional role of specific parcels inferred from neuropsychological deficits after resection/ablation of those parcels, support a model with six cognitive subcomponents of visual naming having overlapping temporal profiles. SIGNIFICANCE Cerebral substrates supporting visual naming are bilaterally distributed with relative hemispheric contribution dependent on cognitive demands at a specific time. PARS approach can be extended to study other cognitive and functional brain networks.
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Aron O, Jonas J, Colnat-Coulbois S, Maillard L. Language Mapping Using Stereo Electroencephalography: A Review and Expert Opinion. Front Hum Neurosci 2021; 15:619521. [PMID: 33776668 PMCID: PMC7987679 DOI: 10.3389/fnhum.2021.619521] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Accepted: 02/11/2021] [Indexed: 11/25/2022] Open
Abstract
Stereo-electroencephalography (sEEG) is a method that uses stereotactically implanted depth electrodes for extra-operative mapping of epileptogenic and functional networks. sEEG derived functional mapping is achieved using electrical cortical stimulations (ECS) that are currently the gold standard for delineating eloquent cortex. As this stands true especially for primary cortices (e.g., visual, sensitive, motor, etc.), ECS applied to higher order brain areas determine more subtle behavioral responses. While anterior and posterior language areas in the dorsal language stream seem to share characteristics with primary cortices, basal temporal language area (BTLA) in the ventral temporal cortex (VTC) behaves as a highly associative cortex. After a short introduction and considerations about methodological aspects of ECS using sEEG, we review the sEEG language mapping literature in this perspective. We first establish the validity of this technique to map indispensable language cortices in the dorsal language stream. Second, we highlight the contrast between the growing empirical ECS experience and the lack of understanding regarding the fundamental mechanisms underlying ECS behavioral effects, especially concerning the dispensable language cortex in the VTC. Evidences for considering network architecture as determinant for ECS behavioral response complexities are discussed. Further, we address the importance of designing new research in network organization of language as this could enhance ECS ability to map interindividual variability, pathology driven reorganization, and ultimately identify network resilience markers in order to better predict post-operative language deficit. Finally, based on a whole body of available studies, we believe there is strong evidence to consider sEEG as a valid, safe and reliable method for defining eloquent language cortices although there have been no proper comparisons between surgical resections with or without extra-operative or intra-operative language mapping.
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Affiliation(s)
- Olivier Aron
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | - Jacques Jonas
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
| | | | - Louis Maillard
- Department of Neurology, Nancy University Hospital Center, Nancy, France
- CRAN, Université́ de Lorraine, CNRS, Nancy, France
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Grande KM, Ihnen SKZ, Arya R. Electrical Stimulation Mapping of Brain Function: A Comparison of Subdural Electrodes and Stereo-EEG. Front Hum Neurosci 2020; 14:611291. [PMID: 33364930 PMCID: PMC7750438 DOI: 10.3389/fnhum.2020.611291] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Accepted: 11/16/2020] [Indexed: 11/13/2022] Open
Abstract
Despite technological and interpretative advances, the non-invasive modalities used for pre-surgical evaluation of patients with drug-resistant epilepsy (DRE), fail to generate a concordant anatomo-electroclinical hypothesis for the location of the seizure onset zone in many patients. This requires chronic monitoring with intracranial electroencephalography (EEG), which facilitates better localization of the seizure onset zone, and allows evaluation of the functional significance of cortical regions-of-interest by electrical stimulation mapping (ESM). There are two principal modalities for intracranial EEG, namely subdural electrodes and stereotactic depth electrodes (stereo-EEG). Although ESM is considered the gold standard for functional mapping with subdural electrodes, there have been concerns about its utility with stereo-EEG. This is mainly because subdural electrodes allow contiguous sampling of the dorsolateral convexity of cerebral hemispheres, and permit delineation of the extent of eloquent functional areas on the cortical surface. Stereo-EEG, while having relatively sparse sampling on the cortical surface, offers the ability to access the depth of sulci, mesial and basal surfaces of cerebral hemispheres, and deep structures such as the insula, which are largely inaccessible to subdural electrodes. As stereo-EEG is increasingly the preferred modality for intracranial monitoring, we find it opportune to summarize the literature for ESM with stereo-EEG in this narrative review. Emerging evidence shows that ESM for defining functional neuroanatomy is feasible with stereo-EEG, but probably requires a different approach for interpretation and clinical decision making compared to ESM with subdural electrodes. We have also compared ESM with stereo-EEG and subdural electrodes, for current thresholds required to evoke desired functional responses vs. unwanted after-discharges. In this regard, there is preliminary evidence that ESM with stereo-EEG may be safer than ESM with subdural grids. Finally, we have highlighted important unanswered clinical and scientific questions for ESM with stereo-EEG in the hope to encourage future research and collaborative efforts.
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Affiliation(s)
- Krista M. Grande
- Division of Neurology, Comprehensive Epilepsy Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Sarah K. Z. Ihnen
- Division of Neurology, Comprehensive Epilepsy Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
| | - Ravindra Arya
- Division of Neurology, Comprehensive Epilepsy Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH, United States
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH, United States
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11
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Binder JR, Tong JQ, Pillay SB, Conant LL, Humphries CJ, Raghavan M, Mueller WM, Busch RM, Allen L, Gross WL, Anderson CT, Carlson CE, Lowe MJ, Langfitt JT, Tivarus ME, Drane DL, Loring DW, Jacobs M, Morgan VL, Allendorfer JB, Szaflarski JP, Bonilha L, Bookheimer S, Grabowski T, Vannest J, Swanson SJ. Temporal lobe regions essential for preserved picture naming after left temporal epilepsy surgery. Epilepsia 2020; 61:1939-1948. [PMID: 32780878 DOI: 10.1111/epi.16643] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/10/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To define left temporal lobe regions where surgical resection produces a persistent postoperative decline in naming visual objects. METHODS Pre- and postoperative brain magnetic resonance imaging data and picture naming (Boston Naming Test) scores were obtained prospectively from 59 people with drug-resistant left temporal lobe epilepsy. All patients had left hemisphere language dominance at baseline and underwent surgical resection or ablation in the left temporal lobe. Postoperative naming assessment occurred approximately 7 months after surgery. Surgical lesions were mapped to a standard template, and the relationship between presence or absence of a lesion and the degree of naming decline was tested at each template voxel while controlling for effects of overall lesion size. RESULTS Patients declined by an average of 15% in their naming score, with wide variation across individuals. Decline was significantly related to damage in a cluster of voxels in the ventral temporal lobe, located mainly in the fusiform gyrus approximately 4-6 cm posterior to the temporal tip. Extent of damage to this region explained roughly 50% of the variance in outcome. Picture naming decline was not related to hippocampal or temporal pole damage. SIGNIFICANCE The results provide the first statistical map relating lesion location in left temporal lobe epilepsy surgery to picture naming decline, and they support previous observations of transient naming deficits from electrical stimulation in the basal temporal cortex. The critical lesion is relatively posterior and could be avoided in many patients undergoing left temporal lobe surgery for intractable epilepsy.
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Affiliation(s)
- Jeffrey R Binder
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Jia-Qing Tong
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Sara B Pillay
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Lisa L Conant
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Colin J Humphries
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Manoj Raghavan
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Wade M Mueller
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Robyn M Busch
- Department of Neurology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - Linda Allen
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - William L Gross
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | | | - Chad E Carlson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
| | - Mark J Lowe
- Department of Radiology, Cleveland Clinic Foundation, Cleveland, Ohio, USA
| | - John T Langfitt
- Department of Neurology, University of Rochester, Rochester, New York, USA
| | - Madalina E Tivarus
- Department of Imaging Sciences, University of Rochester, Rochester, New York, USA
| | - Daniel L Drane
- Department of Neurology and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - David W Loring
- Department of Neurology and Pediatrics, Emory University, Atlanta, Georgia, USA
| | - Monica Jacobs
- Department of Psychology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Victoria L Morgan
- Department of Radiology, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Jane B Allendorfer
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Jerzy P Szaflarski
- Department of Neurology, University of Alabama at Birmingham, Birmingham, Alabama, USA
| | - Leonardo Bonilha
- Department of Neurology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Susan Bookheimer
- Department of Neurology, University of California, Los Angeles, California, USA
| | - Thomas Grabowski
- Department of Neurology, University of Washington, Seattle, Washington, USA
| | - Jennifer Vannest
- Department of Neurology, University of Cincinnati, Cincinnati, Ohio, USA
| | - Sara J Swanson
- Department of Neurology, Medical College of Wisconsin, Milwaukee, Wisconsin, USA
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12
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Caruana F, Avanzini P, Pelliccia V, Mariani V, Zauli F, Sartori I, Del Vecchio M, Lo Russo G, Rizzolatti G. Mirroring other's laughter. Cingulate, opercular and temporal contributions to laughter expression and observation. Cortex 2020; 128:35-48. [DOI: 10.1016/j.cortex.2020.02.023] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2019] [Revised: 01/29/2020] [Accepted: 02/25/2020] [Indexed: 01/19/2023]
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13
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Herbet G, Duffau H. Revisiting the Functional Anatomy of the Human Brain: Toward a Meta-Networking Theory of Cerebral Functions. Physiol Rev 2020; 100:1181-1228. [PMID: 32078778 DOI: 10.1152/physrev.00033.2019] [Citation(s) in RCA: 119] [Impact Index Per Article: 29.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
For more than one century, brain processing was mainly thought in a localizationist framework, in which one given function was underpinned by a discrete, isolated cortical area, and with a similar cerebral organization across individuals. However, advances in brain mapping techniques in humans have provided new insights into the organizational principles of anatomo-functional architecture. Here, we review recent findings gained from neuroimaging, electrophysiological, as well as lesion studies. Based on these recent data on brain connectome, we challenge the traditional, outdated localizationist view and propose an alternative meta-networking theory. This model holds that complex cognitions and behaviors arise from the spatiotemporal integration of distributed but relatively specialized networks underlying conation and cognition (e.g., language, spatial cognition). Dynamic interactions between such circuits result in a perpetual succession of new equilibrium states, opening the door to considerable interindividual behavioral variability and to neuroplastic phenomena. Indeed, a meta-networking organization underlies the uniquely human propensity to learn complex abilities, and also explains how postlesional reshaping can lead to some degrees of functional compensation in brain-damaged patients. We discuss the major implications of this approach in fundamental neurosciences as well as for clinical developments, especially in neurology, psychiatry, neurorehabilitation, and restorative neurosurgery.
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Affiliation(s)
- Guillaume Herbet
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," INSERM U1191, Institute of Functional Genomics, Montpellier, France; and University of Montpellier, Montpellier, France
| | - Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; Team "Plasticity of Central Nervous System, Stem Cells and Glial Tumors," INSERM U1191, Institute of Functional Genomics, Montpellier, France; and University of Montpellier, Montpellier, France
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14
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Hamberger MJ, Schevon CA, Seidel WT, McKhann GM, Morrison C. Cortical naming sites and increasing age in adults with refractory epilepsy: More might be less. Epilepsia 2019; 60:1619-1626. [PMID: 31251399 PMCID: PMC6687550 DOI: 10.1111/epi.16097] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Revised: 05/22/2019] [Accepted: 06/05/2019] [Indexed: 11/27/2022]
Abstract
OBJECTIVE Critical decisions regarding resection boundaries for epilepsy surgery are often based on results of electrical stimulation mapping (ESM). Despite the potentially serious implications for postoperative functioning, age-referenced data that might facilitate the procedure are lacking. Age might be particularly relevant, as pediatric ESM studies have shown a paucity of language sites in young children followed by a rapid increase at approximately 8-10 years. Beyond adolescence, it has generally been assumed that the language system remains stable, and therefore, potential age-related changes across the adult age span have not been examined. However, increasing age during adulthood is associated with both positive and negative language-related changes, such as a broadening vocabulary and increased word finding difficulty. Because most patients who undergo ESM are adults, we aimed to determine the potential impact of age on the incidence of ESM-identified naming sites across the adult age span in patients with refractory epilepsy. METHODS We analyzed clinical language ESM results from 47 patients, ages 17-64 years, with refractory dominant-hemisphere epilepsy. Patients had comparable location and number of cortical sites tested. The incidence of naming sites was examined as a function of age, and compared between younger and older adults. RESULTS Significantly more naming sites were found in older than younger adults, and age was found to be a significant predictor of number of naming sites identified. SIGNIFICANCE Unlike the developmental changes that coincide with increased naming sites in children, increased naming sites in older adults might signify greater vulnerability of the language system to disruption. Because preservation of language sites can limit the extent of the resection, and thereby reduce the likelihood of seizure freedom, further work should aim to determine the clinical relevance of increased naming sites in older adults.
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Affiliation(s)
- Marla J. Hamberger
- Department of Neurology, Columbia University Medical Center, New York, New York
| | | | | | - Guy M. McKhann
- Department of Neurological Surgery, Columbia University Medical Center, New York, New York
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15
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Wang L, Kuperberg G, Jensen O. Specific lexico-semantic predictions are associated with unique spatial and temporal patterns of neural activity. eLife 2018; 7:e39061. [PMID: 30575521 PMCID: PMC6322859 DOI: 10.7554/elife.39061] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Accepted: 12/20/2018] [Indexed: 11/13/2022] Open
Abstract
We used Magnetoencephalography (MEG) in combination with Representational Similarity Analysis to probe neural activity associated with distinct, item-specific lexico-semantic predictions during language comprehension. MEG activity was measured as participants read highly constraining sentences in which the final words could be predicted. Before the onset of the predicted words, both the spatial and temporal patterns of brain activity were more similar when the same words were predicted than when different words were predicted. The temporal patterns localized to the left inferior and medial temporal lobe. These findings provide evidence that unique spatial and temporal patterns of neural activity are associated with item-specific lexico-semantic predictions. We suggest that the unique spatial patterns reflected the prediction of spatially distributed semantic features associated with the predicted word, and that the left inferior/medial temporal lobe played a role in temporally 'binding' these features, giving rise to unique lexico-semantic predictions.
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Affiliation(s)
- Lin Wang
- Department of PsychiatryHarvard Medical SchoolBostonUnited States
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownUnited States
- Department of PsychologyTufts UniversityMedfordUnited States
| | - Gina Kuperberg
- Department of PsychiatryHarvard Medical SchoolBostonUnited States
- Athinoula A. Martinos Center for Biomedical ImagingMassachusetts General HospitalCharlestownUnited States
- Department of PsychologyTufts UniversityMedfordUnited States
| | - Ole Jensen
- School of PsychologyCentre for Human Brain Health, University of BirminghamBirminghamUnited Kingdom
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16
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Enatsu R, Kanno A, Ookawa S, Ochi S, Ishiai S, Nagamine T, Mikuni N. Distribution and Network of Basal Temporal Language Areas: A Study of the Combination of Electric Cortical Stimulation and Diffusion Tensor Imaging. World Neurosurg 2017. [DOI: 10.1016/j.wneu.2017.06.116] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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17
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Hassan H, Ehsanula H, Pattanshetti M. Stroke of the inferiomedial temporal lobe causing word agnosia. BMJ Case Rep 2017; 2017:bcr-2015-214184. [DOI: 10.1136/bcr-2015-214184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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18
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Połczyńska M, Japardi K, Curtiss S, Moody T, Benjamin C, Cho A, Vigil C, Kuhn T, Jones M, Bookheimer S. Improving language mapping in clinical fMRI through assessment of grammar. NEUROIMAGE-CLINICAL 2017; 15:415-427. [PMID: 28616382 PMCID: PMC5458087 DOI: 10.1016/j.nicl.2017.05.021] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/08/2016] [Revised: 05/03/2017] [Accepted: 05/25/2017] [Indexed: 11/27/2022]
Abstract
Introduction Brain surgery in the language dominant hemisphere remains challenging due to unintended post-surgical language deficits, despite using pre-surgical functional magnetic resonance (fMRI) and intraoperative cortical stimulation. Moreover, patients are often recommended not to undergo surgery if the accompanying risk to language appears to be too high. While standard fMRI language mapping protocols may have relatively good predictive value at the group level, they remain sub-optimal on an individual level. The standard tests used typically assess lexico-semantic aspects of language, and they do not accurately reflect the complexity of language either in comprehension or production at the sentence level. Among patients who had left hemisphere language dominance we assessed which tests are best at activating language areas in the brain. Method We compared grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking) with standard tests (object naming, auditory and visual responsive naming), using pre-operative fMRI. Twenty-five surgical candidates (13 females) participated in this study. Sixteen patients presented with a brain tumor, and nine with epilepsy. All participants underwent two pre-operative fMRI protocols: one including CYCLE-N grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking); and a second one with standard fMRI tests (object naming, auditory and visual responsive naming). fMRI activations during performance in both protocols were compared at the group level, as well as in individual candidates. Results The grammar tests generated more volume of activation in the left hemisphere (left/right angular gyrus, right anterior/posterior superior temporal gyrus) and identified additional language regions not shown by the standard tests (e.g., left anterior/posterior supramarginal gyrus). The standard tests produced more activation in left BA 47. Ten participants had more robust activations in the left hemisphere in the grammar tests and two in the standard tests. The grammar tests also elicited substantial activations in the right hemisphere and thus turned out to be superior at identifying both right and left hemisphere contribution to language processing. Conclusion The grammar tests may be an important addition to the standard pre-operative fMRI testing. We added comprehensive grammar tests to standard presurgical fMRI of language. The grammar tests generated more volume of activation bilaterally. The tests identified additional language regions not shown by the standard tests. The grammar tests may be an important addition to standard pre-operative fMRI.
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Affiliation(s)
- Monika Połczyńska
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA; Faculty of English, Adam Mickiewicz University, Poznań, Poland.
| | - Kevin Japardi
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | | | - Teena Moody
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA.
| | | | - Andrew Cho
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | - Celia Vigil
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | - Taylor Kuhn
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA.
| | - Michael Jones
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA
| | - Susan Bookheimer
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, CA 90095, USA.
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19
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Benjamin CF, Walshaw PD, Hale K, Gaillard WD, Baxter LC, Berl MM, Polczynska M, Noble S, Alkawadri R, Hirsch LJ, Constable RT, Bookheimer SY. Presurgical language fMRI: Mapping of six critical regions. Hum Brain Mapp 2017; 38:4239-4255. [PMID: 28544168 PMCID: PMC5518223 DOI: 10.1002/hbm.23661] [Citation(s) in RCA: 73] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 05/12/2017] [Accepted: 05/15/2017] [Indexed: 02/01/2023] Open
Abstract
Language mapping is a key goal in neurosurgical planning. fMRI mapping typically proceeds with a focus on Broca's and Wernicke's areas, although multiple other language‐critical areas are now well‐known. We evaluated whether clinicians could use a novel approach, including clinician‐driven individualized thresholding, to reliably identify six language regions, including Broca's Area, Wernicke's Area (inferior, superior), Exner's Area, Supplementary Speech Area, Angular Gyrus, and Basal Temporal Language Area. We studied 22 epilepsy and tumor patients who received Wada and fMRI (age 36.4[12.5]; Wada language left/right/mixed in 18/3/1). fMRI tasks (two × three tasks) were analyzed by two clinical neuropsychologists who flexibly thresholded and combined these to identify the six regions. The resulting maps were compared to fixed threshold maps. Clinicians generated maps that overlapped significantly, and were highly consistent, when at least one task came from the same set. Cases diverged when clinicians prioritized different language regions or addressed noise differently. Language laterality closely mirrored Wada data (85% accuracy). Activation consistent with all six language regions was consistently identified. In blind review, three external, independent clinicians rated the individualized fMRI language maps as superior to fixed threshold maps; identified the majority of regions significantly more frequently; and judged language laterality to mirror Wada lateralization more often. These data provide initial validation of a novel, clinician‐based approach to localizing language cortex. They also demonstrate clinical fMRI is superior when analyzed by an experienced clinician and that when fMRI data is of low quality judgments of laterality are unreliable and should be withheld. Hum Brain Mapp 38:4239–4255, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Christopher F Benjamin
- Department of Neurology, Comprehensive Epilepsy Center, Yale School of Medicine, New Haven, Connecticut.,Department of Neurosurgery, Yale School of Medicine, New Haven, Connecticut
| | - Patricia D Walshaw
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California
| | - Kayleigh Hale
- U.S. Department of Veterans Affairs, War Related Illness and Injury Study Center, Washington, DC
| | - William D Gaillard
- Center for Neuroscience Research, Children's National Health System, Washington, DC
| | - Leslie C Baxter
- Department of Neuroimaging Research, Barrow Neurological Institute, Phoenix, Arizona
| | - Madison M Berl
- Center for Neuroscience Research, Children's National Health System, Washington, DC
| | - Monika Polczynska
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California.,Faculty of English, Adam Mickiewicz University, Poznań, Poland
| | - Stephanie Noble
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Rafeed Alkawadri
- Department of Neurology, Comprehensive Epilepsy Center, Yale School of Medicine, New Haven, Connecticut
| | - Lawrence J Hirsch
- Department of Neurology, Comprehensive Epilepsy Center, Yale School of Medicine, New Haven, Connecticut
| | - R Todd Constable
- Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, Connecticut
| | - Susan Y Bookheimer
- UCLA Department of Psychiatry and Biobehavioral Sciences, Los Angeles, California
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20
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Li J, Du D, Gao W, Sun X, Xie H, Zhang G, Li J, Li H, Li K. The regional neuronal activity in left posterior middle temporal gyrus is correlated with the severity of chronic aphasia. Neuropsychiatr Dis Treat 2017; 13:1937-1945. [PMID: 28790829 PMCID: PMC5530067 DOI: 10.2147/ndt.s140091] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND Aphasia is one of the most disabling cognitive deficits affecting >2 million people in the USA. The neuroimaging characteristics of chronic aphasic patients (>6 months post onset) remain largely unknown. OBJECTIVE The objective of this study was to investigate the regional signal changes of spontaneous neuronal activity of brain and the inter-regional connectivity in chronic aphasia. MATERIALS AND METHODS Resting-state blood oxygenation level-dependent functional magnetic resonance imaging (fMRI) was used to obtain fMRI data from 17 chronic aphasic patients and 20 healthy control subjects in a Siemens Verio 3.0T MR Scanner. The amplitude of low-frequency fluctuation (ALFF) was determined, which directly reflects the regional neuronal activity. The functional connectivity (FC) of fMRI was assessed using a seed voxel linear correlation approach. The severity of aphasia was evaluated by aphasia quotient (AQ) scores obtained from Western Aphasia Battery test. RESULTS Compared with normal subjects, aphasic patients showed decreased ALFF values in the regions of left posterior middle temporal gyrus (PMTG), left medial prefrontal gyrus, and right cerebellum. The ALFF values in left PMTG showed strong positive correlation with the AQ score (coefficient r=0.79, P<0.05). There was a positive FC in chronic aphasia between left PMTG and left inferior temporal gyrus (BA20), fusiform gyrus (BA37), and inferior frontal gyrus (BA47\45\44). CONCLUSION Left PMTG might play an important role in language dysfunction of chronic aphasia, and ALFF value might be a promising indicator to evaluate the severity of aphasia.
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Affiliation(s)
- Jianlin Li
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Dunren Du
- Department of Radiology, Yantai Laishan Branch Hospital of Yuhuangding Hospital, Medical College of Qingdao University
| | - Wei Gao
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Xichun Sun
- Department of Radiology, Yantai Hospital of Traditional Chinese Medicine, Yantai, China
| | - Haizhu Xie
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Gang Zhang
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Jian Li
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Honglun Li
- Department of Radiology, Yantai Yuhuangding Hospital
| | - Kefeng Li
- School of Medicine, University of California, San Diego, CA, USA
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21
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Roux FE, Durand JB, Djidjeli I, Moyse E, Giussani C. Variability of intraoperative electrostimulation parameters in conscious individuals: language cortex. J Neurosurg 2016; 126:1641-1652. [PMID: 27419823 DOI: 10.3171/2016.4.jns152434] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Electrostimulation in awake brain mapping is widely used to guide tumor removal, but methodologies can differ substantially across institutions. The authors studied electrostimulation brain mapping data to characterize the variability of the current intensity threshold across patients and the effect of its variations on the number, type, and surface area of the essential language areas detected. METHODS Over 7 years, the authors prospectively studied 100 adult patients who were undergoing intraoperative brain mapping during resection of left hemisphere tumors. In all 100 cases, the same protocol of electrostimulation brain mapping (a controlled naming task-bipolar stimulation with biphasic square wave pulses of 1-msec duration and 60-Hz trains, maximum train duration 6 sec) and electrocorticography was used to detect essential language areas. RESULTS The minimum positive thresholds of stimulation varied from patient to patient; the mean minimum intensity required to detect interference was 4.46 mA (range 1.5-9 mA), and in a substantial proportion of sites (13.5%) interference was detected only at intensities above 6 mA. The threshold varied within a given patient for different naming areas in 22% of cases. Stimulation of the same naming area with greater intensities led to slight changes in the type of response in 19% of cases and different types of responses in 4.5%. Naming sites detected were located in subcentimeter cortical areas (50% were less than 20 mm2), but their extent varied with the intensity of stimulation. During a brain mapping session, the same intensity of stimulation reproduced the same type of interference in 94% of the cases. There was no statistically significant difference between the mean stimulation intensities required to produce interfereince in the left inferior frontal lobe (Broca's area), the supramarginal gyri, and the posterior temporal region. CONCLUSIONS Intrasubject and intersubject variations of the minimum thresholds of positive naming areas and changes in the type of response and in the size of these areas according to the intensity used may limit the interpretation of data from electrostimulation in awake brain mapping. To optimize the identification of language areas during electrostimulation brain mapping, it is important to use different intensities of stimulation at the maximum possible currents, avoiding afterdischarges. This could refine the clinical results and scientific data derived from these mapping sessions.
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Affiliation(s)
- Franck-Emmanuel Roux
- Pôle Neuroscience (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse.,Centre de Recherche Cerveau et Cognition (CNRS; CerCo), Toulouse, France; and
| | | | - Imène Djidjeli
- Pôle Neuroscience (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse.,Centre de Recherche Cerveau et Cognition (CNRS; CerCo), Toulouse, France; and
| | - Emmanuel Moyse
- Pôle Neuroscience (Neurochirurgie), Centre Hospitalo-Universitaire de Toulouse.,Université de Toulouse, UPS
| | - Carlo Giussani
- Neurosurgery, Dipartimento di Medicina e Chirurgia, Università degli Studi di Milano-Bicocca, Ospedale San, Gerardo, Monza, Italy
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23
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The Semantic Network at Work and Rest: Differential Connectivity of Anterior Temporal Lobe Subregions. J Neurosci 2016; 36:1490-501. [PMID: 26843633 DOI: 10.1523/jneurosci.2999-15.2016] [Citation(s) in RCA: 133] [Impact Index Per Article: 16.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
UNLABELLED The anterior temporal lobe (ATL) makes a critical contribution to semantic cognition. However, the functional connectivity of the ATL and the functional network underlying semantic cognition has not been elucidated. In addition, subregions of the ATL have distinct functional properties and thus the potential differential connectivity between these subregions requires investigation. We explored these aims using both resting-state and active semantic task data in humans in combination with a dual-echo gradient echo planar imaging (EPI) paradigm designed to ensure signal throughout the ATL. In the resting-state analysis, the ventral ATL (vATL) and anterior middle temporal gyrus (MTG) were shown to connect to areas responsible for multimodal semantic cognition, including bilateral ATL, inferior frontal gyrus, medial prefrontal cortex, angular gyrus, posterior MTG, and medial temporal lobes. In contrast, the anterior superior temporal gyrus (STG)/superior temporal sulcus was connected to a distinct set of auditory and language-related areas, including bilateral STG, precentral and postcentral gyri, supplementary motor area, supramarginal gyrus, posterior temporal cortex, and inferior and middle frontal gyri. Complementary analyses of functional connectivity during an active semantic task were performed using a psychophysiological interaction (PPI) analysis. The PPI analysis highlighted the same semantic regions suggesting a core semantic network active during rest and task states. This supports the necessity for semantic cognition in internal processes occurring during rest. The PPI analysis showed additional connectivity of the vATL to regions of occipital and frontal cortex. These areas strongly overlap with regions found to be sensitive to executively demanding, controlled semantic processing. SIGNIFICANCE STATEMENT Previous studies have shown that semantic cognition depends on subregions of the anterior temporal lobe (ATL). However, the network of regions functionally connected to these subregions has not been demarcated. Here, we show that these ventrolateral anterior temporal subregions form part of a network responsible for semantic processing during both rest and an explicit semantic task. This demonstrates the existence of a core functional network responsible for multimodal semantic cognition regardless of state. Distinct connectivity is identified in the superior ATL, which is connected to auditory and language areas. Understanding the functional connectivity of semantic cognition allows greater understanding of how this complex process may be performed and the role of distinct subregions of the anterior temporal cortex.
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Toledano R, Jiménez-Huete A, Campo P, Poch C, García-Morales I, Gómez Angulo JC, Coras R, Blümcke I, Álvarez-Linera J, Gil-Nagel A. Small temporal pole encephalocele: A hidden cause of “normal” MRI temporal lobe epilepsy. Epilepsia 2016; 57:841-51. [DOI: 10.1111/epi.13371] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2016] [Indexed: 12/27/2022]
Affiliation(s)
- Rafael Toledano
- Epilepsy Unit; Department of Neurology; Hospital Ruber Internacional; Madrid Spain
- Epilepsy Unit; Department of Neurology; Hospital Ramon y Cajal; Madrid Spain
| | | | - Pablo Campo
- Department of Basic Psychology; Autonoma University of Madrid; Madrid Spain
| | - Claudia Poch
- Department of Biological and Health Psychology; Autonoma University of Madrid; Madrid Spain
| | - Irene García-Morales
- Epilepsy Unit; Department of Neurology; Hospital Ruber Internacional; Madrid Spain
- Epilepsy Unit; Department of Neurology; Hospital Clinico San Carlos; Madrid Spain
| | | | - Roland Coras
- Department of Neuropathology; University Hospital Erlangen; Erlangen Germany
| | - Ingmar Blümcke
- Department of Neuropathology; University Hospital Erlangen; Erlangen Germany
| | | | - Antonio Gil-Nagel
- Epilepsy Unit; Department of Neurology; Hospital Ruber Internacional; Madrid Spain
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25
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Chen Y, Shimotake A, Matsumoto R, Kunieda T, Kikuchi T, Miyamoto S, Fukuyama H, Takahashi R, Ikeda A, Lambon Ralph MA. The 'when' and 'where' of semantic coding in the anterior temporal lobe: Temporal representational similarity analysis of electrocorticogram data. Cortex 2016; 79:1-13. [PMID: 27085891 PMCID: PMC4884671 DOI: 10.1016/j.cortex.2016.02.015] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/18/2015] [Accepted: 03/01/2016] [Indexed: 10/28/2022]
Abstract
Electrocorticograms (ECoG) provide a unique opportunity to monitor neural activity directly at the cortical surface. Ten patients with subdural electrodes covering ventral and lateral anterior temporal regions (ATL) performed a picture naming task. Temporal representational similarity analysis (RSA) was used, for the first time, to compare spatio-temporal neural patterns from the ATL surface with pre-defined theoretical models. The results indicate that the neural activity in the ventral subregion of the ATL codes semantic representations from 250 msec after picture onset. The observed activation similarity was not related to the visual similarity of the pictures or the phonological similarity of their names. In keeping with convergent evidence for the importance of the ATL in semantic processing, these results provide the first direct evidence of semantic coding from the surface of the ventral ATL and its time-course.
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Affiliation(s)
- Y Chen
- Neuroscience and Aphasia Research Unit, School of Psychological Sciences, University of Manchester, Manchester, UK
| | - A Shimotake
- Department of Neurology, Graduate School of Medicine, Kyoto University, Japan
| | - R Matsumoto
- Department of Epilepsy, Movement Disorders and Physiology, Graduate School of Medicine, Kyoto University, Japan.
| | - T Kunieda
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Japan
| | - T Kikuchi
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Japan
| | - S Miyamoto
- Department of Neurosurgery, Graduate School of Medicine, Kyoto University, Japan
| | - H Fukuyama
- Human Brain Research Center, Graduate School of Medicine, Kyoto University, Japan
| | - R Takahashi
- Department of Neurology, Graduate School of Medicine, Kyoto University, Japan
| | - A Ikeda
- Department of Epilepsy, Movement Disorders and Physiology, Graduate School of Medicine, Kyoto University, Japan
| | - M A Lambon Ralph
- Neuroscience and Aphasia Research Unit, School of Psychological Sciences, University of Manchester, Manchester, UK.
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Duffau H. A two-level model of interindividual anatomo-functional variability of the brain and its implications for neurosurgery. Cortex 2016; 86:303-313. [PMID: 26920729 DOI: 10.1016/j.cortex.2015.12.009] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2015] [Revised: 10/06/2015] [Accepted: 12/11/2015] [Indexed: 10/22/2022]
Abstract
The classical dogma of localizationism implicitly resulted in the principle of a similar brain functional anatomy between individuals, as for example the pars opercularis of the left "dominant" hemisphere corresponding to the speech area. This fixed "single brain" model led neurosurgeons to define a set of "eloquent" areas, for which injury would induce severe and persistent neurological worsening, making their surgical resections impossible. Therefore, numerous patients with a cerebral lesion justifying surgery were a priori not selected for resection and lost a chance to be treated. In fact, advances in brain mapping showed a considerable inter-individual variability explained by a networking organization of the brain, in which one function is not underpinned by one specific region, but by interactions between dynamic large-scale delocalized sub-circuits. Indeed, using non-invasive neuroimaging, a variability of both structural and functional anatomy was demonstrated in healthy volunteers. Moreover, intraoperative electrical stimulation mapping of cortex and white matter tracts in awake patients who underwent surgery for tumor or epilepsy also showed an important anatomo-functional variability. However, a remarkable observation is that this variability is huge at the cortical level, while it is very low at the subcortical level. Based upon these intrasurgical findings, the goal of this review is to propose a two-level model of inter-individual variability (high cortical variation, low subcortical variation), breaking with the traditional rigid workframe, and making neurosurgery in traditionally presumed "eloquent" areas feasible without permanent deficits, on condition nonetheless to preserve the "invariant common core" of the brain.
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Affiliation(s)
- Hugues Duffau
- Department of Neurosurgery, Gui de Chauliac Hospital, Montpellier University Medical Center, Montpellier, France; National Institute for Health and Medical Research (INSERM), U1051 Laboratory, Team "Brain Plasticity, Stem Cells and Glial Tumors", Institute for Neurosciences of Montpellier, Montpellier University Medical Center, Montpellier, France.
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27
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Shimotake A, Matsumoto R, Ueno T, Kunieda T, Saito S, Hoffman P, Kikuchi T, Fukuyama H, Miyamoto S, Takahashi R, Ikeda A, Lambon Ralph MA. Direct Exploration of the Role of the Ventral Anterior Temporal Lobe in Semantic Memory: Cortical Stimulation and Local Field Potential Evidence From Subdural Grid Electrodes. Cereb Cortex 2015; 25:3802-17. [PMID: 25491206 PMCID: PMC4585516 DOI: 10.1093/cercor/bhu262] [Citation(s) in RCA: 87] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Semantic memory is a crucial higher cortical function that codes the meaning of objects and words, and when impaired after neurological damage, patients are left with significant disability. Investigations of semantic dementia have implicated the anterior temporal lobe (ATL) region, in general, as crucial for multimodal semantic memory. The potentially crucial role of the ventral ATL subregion has been emphasized by recent functional neuroimaging studies, but the necessity of this precise area has not been selectively tested. The implantation of subdural electrode grids over this subregion, for the presurgical assessment of patients with partial epilepsy or brain tumor, offers the dual yet rare opportunities to record cortical local field potentials while participants complete semantic tasks and to stimulate the functionally identified regions in the same participants to evaluate the necessity of these areas in semantic processing. Across 6 patients, and utilizing a variety of semantic assessments, we evaluated and confirmed that the anterior fusiform/inferior temporal gyrus is crucial in multimodal, receptive, and expressive, semantic processing.
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Affiliation(s)
| | - Riki Matsumoto
- Department of Epilepsy, Movement Disorders and Physiology
| | - Taiji Ueno
- Neuroscience and Aphasia Research Unit (NARU), School of Psychological Sciences, University of Manchester, Manchester, UK
| | | | - Satoru Saito
- Neuroscience and Aphasia Research Unit (NARU), School of Psychological Sciences, University of Manchester, Manchester, UK
- Department of Cognitive Psychology in Education, Graduate School of Education, Kyoto University, Kyoto, Japan
| | - Paul Hoffman
- Neuroscience and Aphasia Research Unit (NARU), School of Psychological Sciences, University of Manchester, Manchester, UK
| | | | - Hidenao Fukuyama
- Human Brain Research Center, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | | | | | - Akio Ikeda
- Department of Epilepsy, Movement Disorders and Physiology
| | - Matthew A. Lambon Ralph
- Neuroscience and Aphasia Research Unit (NARU), School of Psychological Sciences, University of Manchester, Manchester, UK
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28
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Lopes R, Nunes RG, Simões MR, Secca MF, Leal A. The Visual Word Form Area remains in the dominant hemisphere for language in late-onset left occipital lobe epilepsies: A postsurgery analysis of two cases. Epilepsy Behav 2015; 46:91-8. [PMID: 25940105 DOI: 10.1016/j.yebeh.2015.04.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2015] [Revised: 03/30/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
Abstract
Automatic recognition of words from letter strings is a critical processing step in reading that is lateralized to the left-hemisphere middle fusiform gyrus in the so-called Visual Word Form Area (VWFA). Surgical lesions in this location can lead to irreversible alexia. Very early left hemispheric lesions can lead to transfer of the VWFA to the nondominant hemisphere, but it is currently unknown if this capability is preserved in epilepsies developing after reading acquisition. In this study, we aimed to determine the lateralization of the VWFA in late-onset left inferior occipital lobe epilepsies and also the effect of surgical disconnection from the adjacent secondary visual areas. Two patients with focal epilepsies with onset near the VWFA underwent to surgery for epilepsy, with sparing of this area. Neuropsychology evaluations were performed before and after surgery, as well as quantitative evaluation of the speed of word reading. Comparison of the surgical localization of the lesion, with the BOLD activation associated with the contrast of words-strings, was performed, as well as a study of the associated main white fiber pathways using diffusion-weighted imaging. Neither of the patients developed alexia after surgery (similar word reading speed before and after surgery) despite the fact that the inferior occipital surgical lesions reached the neighborhood (less than 1cm) of the VWFA. Surgeries partly disconnected the VWFA from left secondary visual areas, suggesting that pathways connecting to the posterior visual ventral stream were severely affected but did not induce alexia. The anterior and superior limits of the resection suggest that the critical connection between the VWFA and the Wernicke's Angular Gyrus cortex was not affected, which is supported by the detection of this tract with probabilistic tractography. Left occipital lobe epilepsies developing after reading acquisition did not produce atypical localizations of the VWFA, even with foci in the close neighborhood. Surgery for occipital lobe epilepsy should take this into consideration, as well as the fact that disconnection from the left secondary visual areas may not produce alexia.
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Affiliation(s)
- Ricardo Lopes
- Faculty of Psychology and Education Sciences - University of Coimbra, Coimbra, Portugal.
| | - Rita Gouveia Nunes
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Portugal
| | | | - Mário Forjaz Secca
- Department of Physics - Faculty of Sciences and Technologies, New University of Lisbon, Caparica, Portugal; Ressonância Magnética - Caselas, Lisboa, Portugal
| | - Alberto Leal
- Department of Neurophysiology, Centro Hospitalar Psiquiátrico de Lisboa, Lisbon, Portugal
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29
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Geranmayeh F, Leech R, Wise RJS. Semantic retrieval during overt picture description: Left anterior temporal or the parietal lobe? Neuropsychologia 2014; 76:125-35. [PMID: 25497693 PMCID: PMC4582804 DOI: 10.1016/j.neuropsychologia.2014.12.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Revised: 12/07/2014] [Accepted: 12/08/2014] [Indexed: 11/15/2022]
Abstract
Retrieval of semantic representations is a central process during overt speech production. There is an increasing consensus that an amodal semantic 'hub' must exist that draws together modality-specific representations of concepts. Based on the distribution of atrophy and the behavioral deficit of patients with the semantic variant of fronto-temporal lobar degeneration, it has been proposed that this hub is localized within both anterior temporal lobes (ATL), and is functionally connected with verbal 'output' systems via the left ATL. An alternative view, dating from Geschwind's proposal in 1965, is that the angular gyrus (AG) is central to object-based semantic representations. In this fMRI study we examined the connectivity of the left ATL and parietal lobe (PL) with whole brain networks known to be activated during overt picture description. We decomposed each of these two brain volumes into 15 regions of interest (ROIs), using independent component analysis. A dual regression analysis was used to establish the connectivity of each ROI with whole brain-networks. An ROI within the left anterior superior temporal sulcus (antSTS) was functionally connected to other parts of the left ATL, including anterior ventromedial left temporal cortex (partially attenuated by signal loss due to susceptibility artifact), a large left dorsolateral prefrontal region (including 'classic' Broca's area), extensive bilateral sensory-motor cortices, and the length of both superior temporal gyri. The time-course of this functionally connected network was associated with picture description but not with non-semantic baseline tasks. This system has the distribution expected for the production of overt speech with appropriate semantic content, and the auditory monitoring of the overt speech output. In contrast, the only left PL ROI that showed connectivity with brain systems most strongly activated by the picture-description task, was in the superior parietal lobe (supPL). This region showed connectivity with predominantly posterior cortical regions required for the visual processing of the pictorial stimuli, with additional connectivity to the dorsal left AG and a small component of the left inferior frontal gyrus. None of the other PL ROIs that included part of the left AG were activated by Speech alone. The best interpretation of these results is that the left antSTS connects the proposed semantic hub (specifically localized to ventral anterior temporal cortex based on clinical neuropsychological studies) to posterior frontal regions and sensory-motor cortices responsible for the overt production of speech.
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Affiliation(s)
- Fatemeh Geranmayeh
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital, London W12 0NN, UK.
| | - Robert Leech
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital, London W12 0NN, UK
| | - Richard J S Wise
- Computational Cognitive and Clinical Neuroimaging Laboratory, Imperial College, Hammersmith Hospital, London W12 0NN, UK
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30
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Boido D, Kapetis D, Gnatkovsky V, Pastori C, Galbardi B, Sartori I, Tassi L, Cardinale F, Francione S, de Curtis M. Stimulus-evoked potentials contribute to map the epileptogenic zone during stereo-EEG presurgical monitoring. Hum Brain Mapp 2014; 35:4267-81. [PMID: 24706574 PMCID: PMC6869715 DOI: 10.1002/hbm.22516] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2013] [Revised: 02/03/2014] [Accepted: 03/18/2014] [Indexed: 11/07/2022] Open
Abstract
Presurgical monitoring with intracerebral electrodes in patients with drug-resistant focal epilepsy represents a standard invasive procedure to localize the sites of seizures origin, defined as the epileptogenic zone (EZ). During presurgical evaluation, intracerebral single-pulse electrical stimulation (SPES) is performed to define the boundaries of eloquent areas and to evoke seizure-associated symptoms. Extensive intracranial exploration and stimulation generate a large dataset on brain connectivity that can be used to improve EZ detection and to understand the organization of the human epileptic brain. We developed a protocol to analyse field responses evoked by intracranial stimulation. Intracerebral recordings were performed with 105-162 recording sites positioned in fronto-temporal regions in 12 patients with pharmacoresistant focal epilepsy. Recording sites were used for bipolar SPES at 1 Hz. Reproducible early and late phases (<60 ms and 60-500 ms from stimulus artefact, respectively) were identified on averaged evoked responses. Phase 1 and 2 responses recorded at all and each recording sites were plotted on a 3D brain reconstructions. Based on connectivity properties, electrode contacts were primarily identified as receivers, mainly activators or bidirectional. We used connectivity patterns to construct networks and applied cluster partitioning to study the proprieties between potentials evoked/stimulated in different regions. We demonstrate that bidirectional connectivity during phase 1 is a prevalent feature that characterize contacts included in the EZ. This study shows that the application of an analytical protocol on intracerebral stimulus-evoked recordings provides useful information that may contribute to EZ detection and to the management of surgical-remediable epilepsies.
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Affiliation(s)
- Davide Boido
- Experimental Neurophysiology and Epileptology UnitFondazione Istituto Neurologico Carlo BestaMilanoItaly
| | - Dimos Kapetis
- Bioinformatics Unit of Scientific DirectionFondazione Istituto Neurologico Carlo BestaMilanoItaly
| | - Vadym Gnatkovsky
- Experimental Neurophysiology and Epileptology UnitFondazione Istituto Neurologico Carlo BestaMilanoItaly
| | - Chiara Pastori
- Experimental Neurophysiology and Epileptology UnitFondazione Istituto Neurologico Carlo BestaMilanoItaly
| | - Barbara Galbardi
- Bioinformatics Unit of Scientific DirectionFondazione Istituto Neurologico Carlo BestaMilanoItaly
| | - Ivana Sartori
- Claudio Munari Epilepsy Surgery CenterOspedale Niguarda Cà GrandaMilanoItaly
| | - Laura Tassi
- Claudio Munari Epilepsy Surgery CenterOspedale Niguarda Cà GrandaMilanoItaly
| | - Francesco Cardinale
- Claudio Munari Epilepsy Surgery CenterOspedale Niguarda Cà GrandaMilanoItaly
| | - Stefano Francione
- Claudio Munari Epilepsy Surgery CenterOspedale Niguarda Cà GrandaMilanoItaly
| | - Marco de Curtis
- Experimental Neurophysiology and Epileptology UnitFondazione Istituto Neurologico Carlo BestaMilanoItaly
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Araki K, Terada K, Usui K, Usui N, Araki Y, Baba K, Matsuda K, Tottori T, Inoue Y. Bidirectional neural connectivity between basal temporal and posterior language areas in humans. Clin Neurophysiol 2014; 126:682-8. [PMID: 25190148 DOI: 10.1016/j.clinph.2014.07.020] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2014] [Revised: 06/12/2014] [Accepted: 07/10/2014] [Indexed: 11/17/2022]
Abstract
OBJECTIVE The basal temporal language area (BTL) is known to be involved in the semantic processing of language. To investigate the neural connectivity between BTL and the posterior language area (PL), we used cortico-cortical evoked potential (CCEP) technique. METHODS Four patients with intractable epilepsy who underwent presurgical evaluation with subdural electrodes were examined. All patients were right-handed and left language dominance by Wada test. We directly stimulated 20 pairs of electrodes placed on BTL in patient 1-3, putative BTL in patient 4, and PL in patient 1-4. In patient 4, all electrodes on the left temporal basal area were stimulated. RESULTS We could record 132 CCEP responses including 40 responses by the left basal temporal stimulation in patient 4. The waveforms from PL to BTL were triphasic, while those from BTL to PL were biphasic. The mean latency of the first negative peak (N1) was shorter at BTL (31.8-41.0ms; mean 35.1ms) than at PL (39.6-73.2ms; mean 52.3ms). CONCLUSIONS We revealed the uneven bidirectional connection between BTL and PL. SIGNIFICANCE We speculated that the two language areas are connected mainly through subcortical fibers from PL to BTL and through cortico-cortical fibers from BTL to PL, mediated by multisynaptic transmissions.
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Affiliation(s)
- Kunihiko Araki
- Department of Neurology, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Kiyohito Terada
- Department of Neurology, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan.
| | - Keiko Usui
- Department of Neurology, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Naotaka Usui
- Department of Neurosurgery, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Yasukiyo Araki
- Department of Neurology, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Koichi Baba
- Department of Neurosurgery, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Kazumi Matsuda
- Department of Neurosurgery, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Takayasu Tottori
- Department of Neurosurgery, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
| | - Yushi Inoue
- Department of Psychiatry, National Epilepsy Center, Shizuoka Institute of Epilepsy and Neurological Disorders, Japan
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Abstract
Intraoperative neurophysiologic monitoring endeavors to preserve the integrity of the nervous system at a time of potential risk. The examination of language function in the operative setting is a unique task that requires a detailed and systematic approach to be carried out efficiently and reliably in this dynamic environment. In this review, we detail the technique used to identify eloquent language cortex during awake craniotomy. This technique requires a coordinated effort to testing, which is reliant on preoperative assessment and structured approach to functional cortical mapping by the surgical, anesthetic, and neurophysiology teams. Despite the intricate nature of this modality of testing, the accurate identification of language areas facilitates neurosurgeries for tumor and focal epilepsy syndromes in the dominant cerebral hemisphere, which depend on maximal margins of resection for best outcomes.
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Trujillo-Pozo I, Martín-Monzón I, Rodríguez-Romero R. Brain lateralization and neural plasticity for musical and cognitive abilities in an epileptic musician. Front Hum Neurosci 2013; 7:829. [PMID: 24367312 PMCID: PMC3853870 DOI: 10.3389/fnhum.2013.00829] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2013] [Accepted: 11/17/2013] [Indexed: 11/13/2022] Open
Abstract
The use of intracarotid propofol procedure (IPP) when assessing musical lateralization has not been reported in literature up to now. This procedure (similar to Wada Test) has provided the opportunity to investigate not only lateralization of language and memory functions on epileptic patients but also offers a functional mapping approach with superior spatial and temporal resolution to analyze the lateralization of musical abilities. Findings in literature suggest that musical training modifies functional and structural brain organization. We studied hemispheric lateralization in a professional musician, a 33 years old woman with refractory left medial temporal lobe (MTL) epilepsy (TLE). A longitudinal neuropsychological study was performed over a period of 21 months. Before epilepsy surgery, musical abilities, language and memory were tested during IPP by means of a novel and exhaustive neuropsychological battery focusing on the processing of music. We used a selection of stimuli to analyze listening, score reading, and tempo discrimination. Our results suggested that IPP is an excellent method to determine not only language, semantic, and episodic memory, but also musical dominance in a professional musician who may be candidate for epilepsy surgery. Neuropsychological testing revealed that right hemisphere's patient is involved in semantic and episodic musical memory processes, whereas her score reading and tempo processing require contribution from both hemispheres. At one-year follow-up, outcome was excellent with respect to seizures and professional skills, meanwhile cognitive abilities improved. These findings indicate that IPP helps to predict who might be at risk for postoperative musical, language, and memory deficits after epilepsy surgery. Our research suggests that musical expertise and epilepsy critically modifies long-term memory processes and induces brain structural and functional plasticity.
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Affiliation(s)
- Isabel Trujillo-Pozo
- Laboratory of Psychobiology, Faculty of Psychology, Campus Santiago Ramón y Cajal, University of SevillaSevilla, Spain
| | - Isabel Martín-Monzón
- Laboratory of Psychobiology, Faculty of Psychology, Campus Santiago Ramón y Cajal, University of SevillaSevilla, Spain
| | - Rafael Rodríguez-Romero
- Neuroradiology Unit, Radiodiagnostic Department, Virgen del Rocío University HospitalSevilla, Spain
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Kuang Y, Yang T, Gu J, Kong B, Cheng L. Comparison of therapeutic effects between selective amygdalohippocampectomy and anterior temporal lobectomy for the treatment of temporal lobe epilepsy: A meta-analysis. Br J Neurosurg 2013; 28:374-7. [DOI: 10.3109/02688697.2013.841854] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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35
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Fernández Coello A, Moritz-Gasser S, Martino J, Martinoni M, Matsuda R, Duffau H. Selection of intraoperative tasks for awake mapping based on relationships between tumor location and functional networks. J Neurosurg 2013; 119:1380-94. [PMID: 24053503 DOI: 10.3171/2013.6.jns122470] [Citation(s) in RCA: 119] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Intraoperative electrical brain mapping is currently the most reliable method to identify eloquent cortical and subcortical structures at the individual level and to optimize the extent of resection of intrinsic brain tumors. The technique allows the preservation of quality of life, not only allowing avoidance of severe neurological deficits but also facilitating preservation of high neurocognitive functions. To accomplish this goal, however, it is crucial to optimize the selection of appropriate intraoperative tasks, given the limited intrasurgical awake time frame. In this review, the authors' aim was to propose specific parameters that could be used to build a personalized protocol for each patient. They have focused on lesion location and relationships with functional networks to guide selection of intrasurgical tasks in an effort to increase reproducibility among neurooncological centers.
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Affiliation(s)
- Alejandro Fernández Coello
- Department of Neurosurgery, Hospital Universitario de Bellvitge, L'Hospitalet de Llobregat, Barcelona, Spain
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Dien J, Brian ES, Molfese DL, Gold BT. Combined ERP/fMRI evidence for early word recognition effects in the posterior inferior temporal gyrus. Cortex 2013; 49:2307-21. [PMID: 23701693 DOI: 10.1016/j.cortex.2013.03.008] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2012] [Revised: 01/08/2013] [Accepted: 03/24/2013] [Indexed: 11/26/2022]
Abstract
Two brain regions with established roles in reading are the posterior middle temporal gyrus and the posterior fusiform gyrus (FG). Lesion studies have also suggested that the region located between them, the posterior inferior temporal gyrus (pITG), plays a central role in word recognition. However, these lesion results could reflect disconnection effects since neuroimaging studies have not reported consistent lexicality effects in pITG. Here we tested whether these reported pITG lesion effects are due to disconnection effects or not using parallel Event-related Potentials (ERP)/functional magnetic resonance imaging (fMRI) studies. We predicted that the Recognition Potential (RP), a left-lateralized ERP negativity that peaks at about 200-250 msec, might be the electrophysiological correlate of pITG activity and that conditions that evoke the RP (perceptual degradation) might therefore also evoke pITG activity. In Experiment 1, twenty-three participants performed a lexical decision task (temporally flanked by supraliminal masks) while having high-density 129-channel ERP data collected. In Experiment 2, a separate group of fifteen participants underwent the same task while having fMRI data collected in a 3T scanner. Examination of the ERP data suggested that a canonical RP effect was produced. The strongest corresponding effect in the fMRI data was in the vicinity of the pITG. In addition, results indicated stimulus-dependent functional connectivity between pITG and a region of the posterior FG near the Visual Word Form Area (VWFA) during word compared to nonword processing. These results provide convergent spatiotemporal evidence that the pITG contributes to early lexical access through interaction with the VWFA.
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Affiliation(s)
- Joseph Dien
- Center for Advanced Study of Language, University of Maryland, College Park, MD, USA; Department of Psychological & Brain Sciences, University of Louisville, Louisville, KY, USA.
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Longitudinal changes of cortical thickness in early- versus late-onset Alzheimer's disease. Neurobiol Aging 2013; 34:1921.e9-1921.e15. [PMID: 23391426 DOI: 10.1016/j.neurobiolaging.2013.01.004] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Revised: 12/31/2012] [Accepted: 01/05/2013] [Indexed: 11/22/2022]
Abstract
Early-onset Alzheimer's disease (EOAD) has been shown to progress more rapidly than late-onset Alzheimer's disease (LOAD). However, no studies have compared the topography of brain volume reduction over time. The purpose of this 3-year longitudinal study was to compare EOAD and LOAD in terms of their rates of decline in cognitive testing and topography of cortical thinning. We prospectively recruited 36 patients with AD (14 EOAD and 22 LOAD) and 14 normal controls. All subjects were assessed with neuropsychological tests and with magnetic resonance imaging at baseline, Year 1, and Year 3. The EOAD group showed more rapid decline than the LOAD group in attention, language, and frontal-executive tests. The EOAD group also showed more rapid cortical thinning in widespread association cortices. In contrast, the LOAD group presented more rapid cortical thinning than the EOAD group only in the left parahippocampal gyrus. Our study suggests that patients with EOAD show more rapid cortical atrophy than patients with LOAD, which accounts for faster cognitive decline on neuropsychological tests.
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Visual processing in the inferior temporal cortex: an intracranial event related potential study. Clin Neurophysiol 2012; 124:164-70. [PMID: 22999318 DOI: 10.1016/j.clinph.2012.07.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2011] [Revised: 06/11/2012] [Accepted: 07/02/2012] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To investigate visual processing over the inferior temporal cortex (ITC) by recording intracranial event-related potentials (IERPs), and correlating the results with those of electrocortical stimulation mapping (ESM). METHODS IERPs to word, non-word, and non-letter visual stimuli were recorded over the ITC in 6 patients with intractable epilepsy. Two patients underwent ESM of the same contacts. RESULTS IERPs were observed at 18 electrodes in 4 out of 6 patients. Nine electrodes showed early IERPs (peak latency ≤ 200 ms) over the posterior and middle ITC and 7 of them showed a following late ERP component, "early+late IERPs". Nine electrodes showed late IERPs (peak latency>200 ms) over the middle and anterior ITC. Among four electrodes showing language or visual phenomena by ESM, one electrode showed a short latency IERP, another electrode showed a late IERP, and the remaining two electrodes showed no IERPs. CONCLUSIONS Our findings further support that the visual recognition occurred sequentially from posterior to anterior ITC. Dissociation of IERPs and ESM may be explained by the methodological difference. SIGNIFICANCE IERP study disclosed that visual recognition occurred sequentially from posterior to anterior ITC.
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Speech comprehension aided by multiple modalities: behavioural and neural interactions. Neuropsychologia 2012; 50:762-76. [PMID: 22266262 DOI: 10.1016/j.neuropsychologia.2012.01.010] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2011] [Revised: 12/30/2011] [Accepted: 01/08/2012] [Indexed: 11/24/2022]
Abstract
Speech comprehension is a complex human skill, the performance of which requires the perceiver to combine information from several sources - e.g. voice, face, gesture, linguistic context - to achieve an intelligible and interpretable percept. We describe a functional imaging investigation of how auditory, visual and linguistic information interact to facilitate comprehension. Our specific aims were to investigate the neural responses to these different information sources, alone and in interaction, and further to use behavioural speech comprehension scores to address sites of intelligibility-related activation in multifactorial speech comprehension. In fMRI, participants passively watched videos of spoken sentences, in which we varied Auditory Clarity (with noise-vocoding), Visual Clarity (with Gaussian blurring) and Linguistic Predictability. Main effects of enhanced signal with increased auditory and visual clarity were observed in overlapping regions of posterior STS. Two-way interactions of the factors (auditory × visual, auditory × predictability) in the neural data were observed outside temporal cortex, where positive signal change in response to clearer facial information and greater semantic predictability was greatest at intermediate levels of auditory clarity. Overall changes in stimulus intelligibility by condition (as determined using an independent behavioural experiment) were reflected in the neural data by increased activation predominantly in bilateral dorsolateral temporal cortex, as well as inferior frontal cortex and left fusiform gyrus. Specific investigation of intelligibility changes at intermediate auditory clarity revealed a set of regions, including posterior STS and fusiform gyrus, showing enhanced responses to both visual and linguistic information. Finally, an individual differences analysis showed that greater comprehension performance in the scanning participants (measured in a post-scan behavioural test) were associated with increased activation in left inferior frontal gyrus and left posterior STS. The current multimodal speech comprehension paradigm demonstrates recruitment of a wide comprehension network in the brain, in which posterior STS and fusiform gyrus form sites for convergence of auditory, visual and linguistic information, while left-dominant sites in temporal and frontal cortex support successful comprehension.
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Hamberger MJ, Cole J. Language organization and reorganization in epilepsy. Neuropsychol Rev 2011; 21:240-51. [PMID: 21842185 PMCID: PMC3193181 DOI: 10.1007/s11065-011-9180-z] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2011] [Accepted: 07/31/2011] [Indexed: 10/17/2022]
Abstract
The vast majority of healthy individuals are left hemisphere dominant for language; however, individuals with left hemisphere epilepsy have a higher likelihood of atypical language organization. The cerebral organization of language in epilepsy has been studied with invasive procedures such as Wada testing and electrical cortical stimulation mapping (ESM), and more recently, with noninvasive neuroimaging techniques such as functional magnetic resonance imaging (fMRI). Investigators have used these techniques to explore the influence of unique clinical features inherent in epilepsy that might contribute to the reorganization of language, such as location of seizure onset, age of seizure onset, and extent of interictal epileptiform activity. In this paper, we review the contribution of these and other clinical variables to the lateralization and localization of language in epilepsy, and how these patient-related variables affect the results from these three different, yet complementary methodologies. Unlike the abrupt language changes that occur following acute brain injury with disruption of established language circuits, converging evidence suggests that the chronic nature of epileptic activity can result in a developmental shift of language from the left to the right hemisphere or re-routing of language pathways from traditional to non-traditional areas within the dominant left hemisphere. Clinical variables have been shown to contribute to cerebral language reorganization in the setting of chronic seizure disorders, yet such factors have not been reliable predictors of altered language networks in individual patients, underscoring the need for language lateralization and localization procedures when definitive identification of language cortex is necessary for clinical care.
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Affiliation(s)
- Marla J Hamberger
- The Neurological Institute, Columbia University Medical Center, 710 West 168th Street, 7th floor, New York, NY 10032, USA.
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Skipper LM, Ross LA, Olson IR. Sensory and semantic category subdivisions within the anterior temporal lobes. Neuropsychologia 2011; 49:3419-29. [PMID: 21889520 DOI: 10.1016/j.neuropsychologia.2011.07.033] [Citation(s) in RCA: 83] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2011] [Revised: 07/12/2011] [Accepted: 07/31/2011] [Indexed: 11/29/2022]
Abstract
In the semantic memory literature the anterior temporal lobe (ATL) is frequently discussed as one homogeneous region when in fact, anatomical studies indicate that it is likely that there are discrete subregions within this area. Indeed, the influential Hub Account of semantic memory has proposed that this region is a sensory-amodal, general-purpose semantic processing region. However review of the literature suggested two potential demarcations: sensory subdivisions and a social/nonsocial subdivision. To test this, participants were trained to associate social or non-social words with novel auditory, visual, or audiovisual stimuli. Later, study participants underwent an fMRI scan where they were presented with the sensory stimuli and the task was to recall the semantic associate. The results showed that there were sensory specific subdivisions within the ATL - that the perceptual encoding of auditory stimuli preferentially activated the superior ATL, visual stimuli the inferior ATL, and multisensory stimuli the polar ATL. Moreover, our data showed that there is stimulus-specific sensitivity within the ATL - the superior and polar ATLs were more sensitive to the retrieval of social knowledge as compared to non-social knowledge. No ATL regions were more sensitive to the retrieval of non-social knowledge. These findings indicate that the retrieval of newly learned semantic associations activates the ATL. In addition, superior and polar aspects of the ATL are sensitive to social stimuli but relatively insensitive to non-social stimuli, a finding that is predicted by anatomical connectivity and single-unit studies in non-human primates. And lastly, the ATL contains sensory processing subdivisions that fall along superior (auditory), inferior (visual), polar (audiovisual) subdivisions.
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Affiliation(s)
- Laura M Skipper
- Department of Psychology, Temple University, Philadelphia, PA 19122, United States.
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Kim H, Lee C, Knowlton R, Rozzelle C, Blount JP. Safety and utility of supplemental depth electrodes for localizing the ictal onset zone in pediatric neocortical epilepsy. J Neurosurg Pediatr 2011; 8:49-56. [PMID: 21721889 DOI: 10.3171/2011.4.peds10519] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECT Depth electrodes provide a better sampling of sulci and regions of cortex that lie tangential to the plane of subdural electrodes. The aim of this study was to evaluate the utility of supplemental depth electrodes in the surgical treatment of pediatric patients with neocortical epilepsy. METHODS Cases involving 12 consecutive pediatric patients (mean age [SD] 10.9 ± 4.4 years) were reviewed. Focal resective surgery (in 9 cases) or functional hemispherectomy (in 3 cases) was performed after intracranial monitoring. The mean total number of electrodes was 118 ± 29; the mean numbers of grid, strip, and depth electrodes were 95 ± 27, 10 ± 6, and 13 ± 5, respectively The most common pathological condition was focal cortical dysplasia. RESULTS In 4 cases, depth electrodes demonstrated the ictal onset zone in an area not easily accessible by grids or strips (in the basal temporal region in 3 cases and the upper opercular region in 1 case). In 3 of these 4 cases, the ictal onset zone was defined exclusively by the depth electrodes. In each of these 3 cases, the surface electrodes (on grids or strips) demonstrated early propagation but not ictal onset. In 9 cases, the depth electrodes also demonstrated the early propagation zone. The information about the ictal onset zone and the early propagation zone helped to provide additional information that affected the extent (in 7 cases) or depth (in 3 cases) of the resection. The proportion of the electrodes involved in resection relative to the total number of implanted electrodes was low (mean ± SD, 0.26 ± 0.09). Nine patients (75.0%) became seizure free (Engel class IA outcome) after surgery (mean duration of follow-up 25.7 ± 4.29 months). There were no surgical complications related to intracranial electroencephalography monitoring. CONCLUSIONS Most patients (75.0%) became seizure free after extensive monitoring and more limited resection of seizure-onset regions. Supplemental depth electrodes contribute to improved outcome by providing information about the ictal onset zone that is not accessible by grid or strip electrodes in some cases. The supplemental depth electrodes conferred an extra dimension of depth to the analysis, which allowed for successful outcome with more limited resection.
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Affiliation(s)
- Hyunmi Kim
- Department of Pediatrics, Division of Pediatric Neurology, University of Alabama at Birmingham, Alabama 35233, USA
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Koubeissi MZ, Lesser RP, Sinai A, Gaillard WD, Franaszczuk PJ, Crone NE. Connectivity between perisylvian and bilateral basal temporal cortices. Cereb Cortex 2011; 22:918-25. [PMID: 21715651 DOI: 10.1093/cercor/bhr163] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Language processing requires the orchestrated action of different neuronal populations, and some studies suggest that the role of the basal temporal (BT) cortex in language processing is bilaterally distributed. Our aim was to demonstrate connectivity between perisylvian cortex and both BT areas. We recorded corticocortical evoked potentials (CCEPs) in 8 patients with subdural electrodes implanted for surgical evaluation of intractable epilepsy. Four patients had subdural grids over dominant perisylvian and BT areas, and 4 had electrode strips over both BT areas and left posterior superior temporal gyrus (LPSTG). After electrocortical mapping, patients with grids had 1-Hz stimulation of language areas. Patients with strips did not undergo mapping but had 1-Hz stimulation of the LPSTG. Posterior language area stimulation elicited CCEPs in ipsilateral BT cortex in 3/4 patients with left hemispheric grids. CCEPs were recorded in bilateral BT cortices in 3/4 patients with strips upon stimulation of the LPSTG, and in the LPSTG in the fourth patient upon stimulation of either BT area. This is the first in vivo demonstration of connectivity between LPSTG and both BT cortices. The role of BT cortex in language processing may be bilaterally distributed and related to linking visual information with phonological representations stored in the LPSTG.
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Affiliation(s)
- Mohamad Z Koubeissi
- Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
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Korzeniewska A, Franaszczuk PJ, Crainiceanu CM, Kuś R, Crone NE. Dynamics of large-scale cortical interactions at high gamma frequencies during word production: event related causality (ERC) analysis of human electrocorticography (ECoG). Neuroimage 2011; 56:2218-37. [PMID: 21419227 PMCID: PMC3105123 DOI: 10.1016/j.neuroimage.2011.03.030] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2010] [Revised: 03/08/2011] [Accepted: 03/09/2011] [Indexed: 11/16/2022] Open
Abstract
Intracranial EEG studies in humans have shown that functional brain activation in a variety of functional-anatomic domains of human cortex is associated with an increase in power at a broad range of high gamma (>60Hz) frequencies. Although these electrophysiological responses are highly specific for the location and timing of cortical processing and in animal recordings are highly correlated with increased population firing rates, there has been little direct empirical evidence for causal interactions between different recording sites at high gamma frequencies. Such causal interactions are hypothesized to occur during cognitive tasks that activate multiple brain regions. To determine whether such causal interactions occur at high gamma frequencies and to investigate their functional significance, we used event-related causality (ERC) analysis to estimate the dynamics, directionality, and magnitude of event-related causal interactions using subdural electrocorticography (ECoG) recorded during two word production tasks: picture naming and auditory word repetition. A clinical subject who had normal hearing but was skilled in American Signed Language (ASL) provided a unique opportunity to test our hypothesis with reference to a predictable pattern of causal interactions, i.e. that language cortex interacts with different areas of sensorimotor cortex during spoken vs. signed responses. Our ERC analyses confirmed this prediction. During word production with spoken responses, perisylvian language sites had prominent causal interactions with mouth/tongue areas of motor cortex, and when responses were gestured in sign language, the most prominent interactions involved hand and arm areas of motor cortex. Furthermore, we found that the sites from which the most numerous and prominent causal interactions originated, i.e. sites with a pattern of ERC "divergence", were also sites where high gamma power increases were most prominent and where electrocortical stimulation mapping interfered with word production. These findings suggest that the number, strength and directionality of event-related causal interactions may help identify network nodes that are not only activated by a task but are critical to its performance.
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Affiliation(s)
- Anna Korzeniewska
- Department of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe St., Meyer 2-147, Baltimore, MD 21287, USA.
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Masuda T, Kimura N, Nakamura KI, Okazaki T, Arakawa R, Kumamoto T. [A case of limbic encephalitis repeated aphasic status epilepticus with periodic lateralized epileptiform discharges]. Rinsho Shinkeigaku 2011; 51:135-40. [PMID: 21404615 DOI: 10.5692/clinicalneurol.51.135] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
We report a case of limbic encephalitis repeated aphasic status epilepticus with periodic lateralized epileptiform discharges (PLEDs). A 51-year-old man developed convulsions, psychiatric symptoms such as anxiety, phobia and ease of anger, and Wernicke's aphasia. Analysis of the cerebrospinal fluid (CSF) showed increase of leukocyte count (148/microl, mononuclear cells). Brain magnetic resonance imaging (MRI) showed hyperintensity lesions in the left medial temporal area and basal frontal area on T2-weighted and fluid-attenuated inversion recovery (FLAIR) images. The electroencephalography (EEG) showed PLEDs over the left hemisphere, occurring at intervals of 0.5-1 Hz. Although his limbic symptoms improved, Wernicke's aphasia occurred periodically with PLEDs appearance. After the administration of antiepileptic drugs, his language performance improved, and PLEDs were completely disappeared. We diagnosed him limbic encephalitis with non-convulsive repeated aphasic status epilepticus with periodic lateralized epileptiform discharges. Aphasic status epilepticus should be considered in the patients with limbic encephalitis, and careful evaluation of aphasia and EEG should be necessary to diagnose of aphasic status epilepticus.
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Affiliation(s)
- Teruaki Masuda
- Department of General Internal Medicine III, Faculty of Medicine, Oita University
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Giussani C, Riva M, Gallucci M, Boukhatem L, Sganzerla EP, Demonet JF, Roux FE. Anatomical correlates for category-specific naming of living and non-living things. Neuroimage 2011; 56:323-9. [PMID: 21296167 DOI: 10.1016/j.neuroimage.2011.01.080] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2010] [Revised: 01/22/2011] [Accepted: 01/28/2011] [Indexed: 10/18/2022] Open
Abstract
INTRODUCTION Selective naming categories impairments for living and non-living things are widely reported in brain damaged patients. Electrostimulation mapping was used to study the possible anatomical segregation of living/non-living categories in a prospective series of patients operated on for tumor removal. MATERIALS AND METHODS Fifty brain mappings (patients with no language impairment; range: 14-80 years; mean: 48 years; 26 males; 5 left handed) were performed in 46 left and 4 right hemispheres using two linguistically controlled tasks (naming for living and non-living things) during an awake surgery procedure. Fifteen regions and four macro cortical areas were designed to analyze the distribution of the interference sites. RESULTS Over 761 sites stimulated in the lateral hemispheres, 130 naming interferences sites were detected in small cortical areas (<1cm(2)). High individual variability was observed for living/non-living word retrieval localization and organization with a majority (62%) of shared living/non-living interferences. Specific living (12%) or non-living (26%) interferences were found too. In group analysis, no statistical significant anatomical localization was observed for living items in left lateral hemispheric cortex. A statistical significant representation of interference sites for non-living objects was found (Generalized Estimating Equation methodology, z-test=2.28, p=0.027) in the left posterolateral temporoparietal cortex. No influence of histopathology, gender and age on anatomical localization of naming categories was detected. CONCLUSION The existence of dedicated neural structures for naming non-living things in the left posterolateral temporoparietal cortex is supported by this study although high individual differences exist in the organization of word categories retrieval.
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Affiliation(s)
- Carlo Giussani
- Centres Hospitalo-Universitaires, F-31059 Toulouse, France.
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Cervenka MC, Boatman-Reich DF, Ward J, Franaszczuk PJ, Crone NE. Language mapping in multilingual patients: electrocorticography and cortical stimulation during naming. Front Hum Neurosci 2011; 5:13. [PMID: 21373361 PMCID: PMC3044479 DOI: 10.3389/fnhum.2011.00013] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 01/23/2011] [Indexed: 11/29/2022] Open
Abstract
Multilingual patients pose a unique challenge when planning epilepsy surgery near language cortex because the cortical representations of each language may be distinct. These distinctions may not be evident with routine electrocortical stimulation mapping (ESM). Electrocorticography (ECoG) has recently been used to detect task-related spectral perturbations associated with functional brain activation. We hypothesized that using broadband high gamma augmentation (HGA, 60–150 Hz) as an index of cortical activation, ECoG would complement ESM in discriminating the cortical representations of first (L1) and second (L2) languages. We studied four adult patients for whom English was a second language, in whom subdural electrodes (a total of 358) were implanted to guide epilepsy surgery. Patients underwent ECoG recordings and ESM while performing the same visual object naming task in L1 and L2. In three of four patients, ECoG found sites activated during naming in one language but not the other. These language-specific sites were not identified using ESM. In addition, ECoG HGA was observed at more sites during L2 versus L1 naming in two patients, suggesting that L2 processing required additional cortical resources compared to L1 processing in these individuals. Post-operative language deficits were identified in three patients (one in L2 only). These deficits were predicted by ECoG spectral mapping but not by ESM. These results suggest that pre-surgical mapping should include evaluation of all utilized languages to avoid post-operative functional deficits. Finally, this study suggests that ECoG spectral mapping may potentially complement the results of ESM of language.
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Affiliation(s)
- Mackenzie C Cervenka
- Department of Neurology, Johns Hopkins University School of Medicine Baltimore, MD, USA
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Using subdural electrodes to assess the safety of resections. Epilepsy Behav 2011; 20:223-9. [PMID: 20880755 DOI: 10.1016/j.yebeh.2010.08.022] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2010] [Accepted: 08/20/2010] [Indexed: 11/20/2022]
Abstract
Subdural electrodes are frequently used to aid in the neurophysiological assessment of patients with intractable seizures. We review their use for localizing cortical regions supporting movement, sensation, and language.
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David O, Bastin J, Chabardès S, Minotti L, Kahane P. Studying network mechanisms using intracranial stimulation in epileptic patients. Front Syst Neurosci 2010; 4:148. [PMID: 21060722 PMCID: PMC2972750 DOI: 10.3389/fnsys.2010.00148] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2010] [Accepted: 09/20/2010] [Indexed: 11/13/2022] Open
Abstract
Patients suffering from focal drug-resistant epilepsy who are explored using intracranial electrodes allow to obtain data of exceptional value for studying brain dynamics in correlation with pathophysiological and cognitive processes. Direct electrical stimulation (DES) of cortical regions and axonal tracts in those patients elicits a number of very specific perceptual or behavioral responses, but also abnormal responses due to specific configurations of epileptic networks. Here, we review how anatomo-functional brain connectivity and epilepsy network mechanisms can be assessed from DES responses measured in patients. After a brief summary of mechanisms of action of brain electrical stimulation, we recall the conceptual framework for interpreting DES results in the context of brain connectivity and review how DES can be used for the characterization of functional networks, the identification of the seizure onset zone, the study of brain plasticity mechanisms, and the anticipation of epileptic seizures. This pool of exceptional data may be underexploited by fundamental research on brain connectivity and leaves much to be learned.
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Affiliation(s)
- Olivier David
- INSERM U836, Grenoble Institut des Neurosciences Grenoble, France
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50
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Lesser RP, Crone NE, Webber WRS. Subdural electrodes. Clin Neurophysiol 2010; 121:1376-1392. [PMID: 20573543 PMCID: PMC2962988 DOI: 10.1016/j.clinph.2010.04.037] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2010] [Revised: 04/21/2010] [Accepted: 04/27/2010] [Indexed: 10/19/2022]
Abstract
Subdural electrodes are frequently used to aid in the neurophysiological assessment of patients with intractable seizures. We review the indications for these, their uses for localizing epileptogenic regions and for localizing cortical regions supporting movement, sensation, and language.
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Affiliation(s)
- Ronald P Lesser
- Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA; Department of Neurosurgery, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA.
| | - Nathan E Crone
- Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
| | - W R S Webber
- Department of Neurology, Johns Hopkins Medical Institutions, Baltimore, MD 21287, USA
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