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Kaufmann A, Parmigiani S, Kawagoe T, Zabaroff E, Wells B. Two models of mind blanking. Eur J Neurosci 2024; 59:786-795. [PMID: 37778749 DOI: 10.1111/ejn.16164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 08/23/2023] [Accepted: 09/15/2023] [Indexed: 10/03/2023]
Abstract
Mind blanking is a mental state in which attention does not bring any perceptual input into conscious awareness. As this state is still largely unexplored, we suggest that a comprehensive understanding of mind blanking can be achieved through a multifaceted approach combining self-assessment methods, neuroimaging and neuromodulation. In this article, we explain how electroencephalography and transcranial magnetic stimulation could be combined to help determine whether mind blanking is associated with a lack of mental content or a lack of linguistically or conceptually determinable mental content. We also question whether mind blanking occurs spontaneously or intentionally and whether these two forms are instantiated by the same or different neural correlates.
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Affiliation(s)
- Angelica Kaufmann
- Institut für Philosophie II, Ruhr-Universität Bochum, Bochum, Germany
- Mind and Cognition Lab, PhiLab, University of Milan, Milan, Italy
| | - Sara Parmigiani
- Department of Psychiatry and Behavioral Sciences, Stanford University Medical Center, Stanford, CA, USA
- Mind and Cognition Lab, PhiLab, University of Milan, Milan, Italy
| | - Toshikazu Kawagoe
- School of Humanities and Science, Kyushu Campus, Tokai University, Kumamoto, Japan
| | - Elliot Zabaroff
- Mind and Cognition Lab, PhiLab, University of Milan, Milan, Italy
| | - Barnaby Wells
- Mind and Cognition Lab, PhiLab, University of Milan, Milan, Italy
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2
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Silcox JW, Mickey B, Payne BR. Disruption to left inferior frontal cortex modulates semantic prediction effects in reading and subsequent memory: Evidence from simultaneous TMS-EEG. Psychophysiology 2023; 60:e14312. [PMID: 37203307 DOI: 10.1111/psyp.14312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 01/25/2023] [Accepted: 03/21/2023] [Indexed: 05/20/2023]
Abstract
Readers use prior context to predict features of upcoming words. When predictions are accurate, this increases the efficiency of comprehension. However, little is known about the fate of predictable and unpredictable words in memory or the neural systems governing these processes. Several theories suggest that the speech production system, including the left inferior frontal cortex (LIFC), is recruited for prediction but evidence that LIFC plays a causal role is lacking. We first examined the effects of predictability on memory and then tested the role of posterior LIFC using transcranial magnetic stimulation (TMS). In Experiment 1, participants read category cues, followed by a predictable, unpredictable, or incongruent target word for later recall. We observed a predictability benefit to memory, with predictable words remembered better than unpredictable words. In Experiment 2, participants performed the same task with electroencephalography (EEG) while undergoing event-related TMS over posterior LIFC using a protocol known to disrupt speech production, or over the right hemisphere homologue as an active control site. Under control stimulation, predictable words were better recalled than unpredictable words, replicating Experiment 1. This predictability benefit to memory was eliminated under LIFC stimulation. Moreover, while an a priori ROI-based analysis did not yield evidence for a reduction in the N400 predictability effect, mass-univariate analyses did suggest that the N400 predictability effect was reduced in spatial and temporal extent under LIFC stimulation. Collectively, these results provide causal evidence that the LIFC is recruited for prediction during silent reading, consistent with prediction-through-production accounts.
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Affiliation(s)
- Jack W Silcox
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
| | - Brian Mickey
- Department of Psychiatry, Huntsman Mental Health Institute, University of Utah, Salt Lake City, Utah, USA
- Neuroscience Program, University of Utah, Salt Lake City, Utah, USA
| | - Brennan R Payne
- Department of Psychology, University of Utah, Salt Lake City, Utah, USA
- Neuroscience Program, University of Utah, Salt Lake City, Utah, USA
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3
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Fujiki M, Hata N, Anan M, Matsushita W, Kawasaki Y, Fudaba H. Monophasic-quadri-burst stimulation robustly activates bilateral swallowing motor cortices. Front Neurosci 2023; 17:1163779. [PMID: 37304027 PMCID: PMC10248141 DOI: 10.3389/fnins.2023.1163779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 04/28/2023] [Indexed: 06/13/2023] Open
Abstract
A stable, reliable, non-invasive, quantitative assessment of swallowing function remains to be established. Transcranial magnetic stimulation (TMS) is commonly used to aid in the diagnosis of dysphagia. Most diagnostic applications involve single-pulse TMS and motor evoked potential (MEP) recordings, the use of which is not clinically suitable in patients with severe dysphagia given the large variability in MEPs measured from the muscles involved in swallowing. Previously, we developed a TMS device that can deliver quadripulse theta-burst stimulation in 16 monophasic magnetic pulses through a single coil, enabling the measurement of MEPs related to hand function. We applied a system for MEP conditioning that relies on a 5 ms interval-monophasic quadripulse magnetic stimulation (QPS5) paradigm to produce 5 ms interval-four sets of four burst trains; quadri-burst stimulation (QBS5), which is expected to induce long-term potentiation (LTP) in the stroke patient motor cortex. Our analysis indicated that QBS5 conditioned left motor cortex induced robust facilitation in the bilateral mylohyoid MEPs. Swallowing dysfunction scores after intracerebral hemorrhage were significantly correlated with QBS5 conditioned-MEP parameters, including resting motor threshold and amplitude. The degree of bilateral mylohyoid MEP facilitation after left side motor cortical QBS5 conditioning and the grade of severity of swallowing dysfunction exhibited a significant linear correlation (r = -0.48/-0.46 and 0.83/0.83; R2 = 0.23/0.21 and 0.68/0.68, P < 0.001; Rt./Lt. side MEP-RMT and amplitudes, respectively). The present results indicate that RMT and amplitude of bilateral mylohyoid-MEPs after left motor cortical QBS5 conditioning as surrogate quantitative biomarkers for swallowing dysfunction after ICH. Thus, the safety and limitations of QBS5 conditioned-MEPs in this population should be further explored.
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Relationship among Connectivity of the Frontal Aslant Tract, Executive Functions, and Speech and Language Impairment in Children with Childhood Apraxia of Speech. Brain Sci 2022; 13:brainsci13010078. [PMID: 36672059 PMCID: PMC9856897 DOI: 10.3390/brainsci13010078] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Revised: 12/16/2022] [Accepted: 12/26/2022] [Indexed: 01/03/2023] Open
Abstract
Childhood apraxia of speech (CAS) is a subtype of motor speech disorder usually co-occurring with language impairment. A supramodal processing difficulty, involving executive functions (EFs), might contribute to the cognitive endophenotypes and behavioral manifestations. The present study aimed to profile the EFs in CAS, investigating the relationship between EFs, speech and language severity, and the connectivity of the frontal aslant tract (FAT), a white matter tract involved in both speech and EFs. A total of 30 preschool children with CAS underwent speech, language, and EF assessments and brain MRIs. Their FAT connectivity metrics were compared to those of 30 children without other neurodevelopmental disorders (NoNDs), who also underwent brain MRIs. Alterations in some basic EF components were found. Inhibition and working memory correlated with speech and language severity. Compared to NoND children, a weak, significant reduction in fractional anisotropy (FA) in the left presupplementary motor area (preSMA) FAT component was found. Only speech severity correlated and predicted FA values along with the FAT in both of its components, and visual-spatial working memory moderated the relationship between speech severity and FA in the left SMA. Our study supports the conceptualization of a composite and complex picture of CAS, not limited to the speech core deficit, but also involving high-order cognitive skills.
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Giustiniani A, Vallesi A, Oliveri M, Tarantino V, Ambrosini E, Bortoletto M, Masina F, Busan P, Siebner H, Fadiga L, Koch G, Leocani L, Lefaucheur J, Rotenberg A, Zangen A, Violante I, Moliadze V, Gamboa O, Ugawa Y, Pascual-Leone A, Ziemann U, Miniussi C, Burgio F. A questionnaire to collect unintended effects of Transcranial Magnetic Stimulation: A consensus based approach. Clin Neurophysiol 2022; 141:101-108. [DOI: 10.1016/j.clinph.2022.06.008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Revised: 05/18/2022] [Accepted: 06/10/2022] [Indexed: 11/03/2022]
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Fujiki M, Matsushita W, Kawasaki Y, Fudaba H. Monophasic-Quadripulse Theta Burst Magnetic Stimulation for Motor Palsy Functional Evaluation After Intracerebral Hemorrhage. Front Integr Neurosci 2022; 16:827518. [PMID: 35359705 PMCID: PMC8963344 DOI: 10.3389/fnint.2022.827518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is commonly employed for diagnostic and therapeutic purposes to enhance recovery following brain injury, such as stroke or intracerebral hemorrhage (ICH). Single-pulse TMS, most commonly used for diagnostic purposes and with motor evoked potential (MEP) recordings, is not suitable for clinical use in patients with severe motor paresis. To overcome this problem, we developed a quadripulse theta burst transcranial magnetic stimulation (QTS) device that combines the output from 16 stimulators to deliver a train of 16 monophasic magnetic pulses through a single coil. High-frequency theta rhythm magnetic bursts (bursts of four monophasic pulses, at 500 Hz, i.e., with a 2-ms interpulse interval, repeated at 5 Hz) were generated via a set of 16 separate magnetic stimulators connected to a specially designed combination module. No adverse effects or electroencephalogram (EEGs) abnormalities were identified during or after the recordings. MEP amplification in the QTS during four-burst theta rhythm stimulations produced four independent MEPs 20 ms after each burst onset maximizing the final third or fourth burst, which exhibited significantly greater amplitude than those resulting from a single burst or pulse. Motor functional palsy grades after ICH and QTS-MEP parameters and resting motor threshold (RMT) and amplitudes were significantly correlated (r = −0.83/−0.81 and 0.89/0.87; R2 = 0.69/0.66 and 0.79/0.76, p < 0.001; anterior/posterior-stimulus polarity, respectively). In conclusion, QTS-MEPs enabled a linear functional evaluation in patients with various degrees of motor paresis. However, the benefits, safety, and limitations of this device should be further explored in future studies.
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MacDonald DB, Simon MV, Nuwer MR. Neurophysiology during epilepsy surgery. HANDBOOK OF CLINICAL NEUROLOGY 2022; 186:103-121. [PMID: 35772880 DOI: 10.1016/b978-0-12-819826-1.00017-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Intraoperative neuromonitoring (IONM) complements modern presurgical investigations by providing information about the epileptic focus as well as real-time identification of critical functional tissue and assessment of ongoing neural integrity during resective epilepsy surgery. This chapter summarizes current IONM methods for mapping the epileptic focus and for mapping and monitoring functionally important structures with direct brain stimulation and evoked potentials. These techniques include electrocorticography, computerized high-frequency oscillation mapping, single-pulse electric stimulation, cortical and subcortical motor evoked potentials, somatosensory evoked potentials, visual evoked potentials, and cortico-cortical evoked potentials. They may help to maximize epileptic tissue resection while avoiding permanent postoperative neurologic deficits.
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Affiliation(s)
| | - Mirela V Simon
- Department of Neurology, Massachusetts General Hospital, Boston, MA, United States
| | - Marc R Nuwer
- Departments of Neurology and Clinical Neurophysiology, David Geffen School of Medicine, University of California Los Angeles, and Ronald Reagan UCLA Medical Center, Los Angeles, CA, United States
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Nettekoven C, Pieczewski J, Neuschmelting V, Jonas K, Goldbrunner R, Grefkes C, Weiss Lucas C. Improving the efficacy and reliability of rTMS language mapping by increasing the stimulation frequency. Hum Brain Mapp 2021; 42:5309-5321. [PMID: 34387388 PMCID: PMC8519874 DOI: 10.1002/hbm.25619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 11/08/2022] Open
Abstract
Repetitive TMS (rTMS) with a frequency of 5–10 Hz is widely used for language mapping. However, it may be accompanied by discomfort and is limited in the number and reliability of evoked language errors. We, here, systematically tested the influence of different stimulation frequencies (i.e., 10, 30, and 50 Hz) on tolerability, number, reliability, and cortical distribution of language errors aiming at improved language mapping. 15 right‐handed, healthy subjects (m = 8, median age: 29 yrs) were investigated in two sessions, separated by 2–5 days. In each session, 10, 30, and 50 Hz rTMS were applied over the left hemisphere in a randomized order during a picture naming task. Overall, 30 Hz rTMS evoked significantly more errors (20 ± 12%) compared to 50 Hz (12 ± 8%; p <.01), whereas error rates were comparable between 30/50 and 10 Hz (18 ± 11%). Across all conditions, a significantly higher error rate was found in Session 1 (19 ± 13%) compared to Session 2 (13 ± 7%, p <.05). The error rate was poorly reliable between sessions for 10 (intraclass correlation coefficient, ICC = .315) and 30 Hz (ICC = .427), whereas 50 Hz showed a moderate reliability (ICC = .597). Spatial reliability of language errors was low to moderate with a tendency toward increased reliability for higher frequencies, for example, within frontal regions. Compared to 10 Hz, both, 30 and 50 Hz were rated as less painful. Taken together, our data favor the use of rTMS‐protocols employing higher frequencies for evoking language errors reliably and with reduced discomfort, depending on the region of interest.
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Affiliation(s)
- Charlotte Nettekoven
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Julia Pieczewski
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Volker Neuschmelting
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Kristina Jonas
- Faculty of Human Sciences, Department of Rehabilitation and Special Education, University of Cologne, Cologne, Germany
| | - Roland Goldbrunner
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Christian Grefkes
- Faculty of Medicine and University Hospital, Department of Neurology, University of Cologne, Cologne, Germany.,Juelich Research Centre, Institute of Neuroscience and Medicine (INM-3), Juelich, Germany
| | - Carolin Weiss Lucas
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
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9
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Busan P, Moret B, Masina F, Del Ben G, Campana G. Speech Fluency Improvement in Developmental Stuttering Using Non-invasive Brain Stimulation: Insights From Available Evidence. Front Hum Neurosci 2021; 15:662016. [PMID: 34456692 PMCID: PMC8386014 DOI: 10.3389/fnhum.2021.662016] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 07/12/2021] [Indexed: 11/21/2022] Open
Abstract
Developmental stuttering (DS) is a disturbance of the normal rhythm of speech that may be interpreted as very debilitating in the most affected cases. Interventions for DS are historically based on the behavioral modifications of speech patterns (e.g., through speech therapy), which are useful to regain a better speech fluency. However, a great variability in intervention outcomes is normally observed, and no definitive evidence is currently available to resolve stuttering, especially in the case of its persistence in adulthood. In the last few decades, DS has been increasingly considered as a functional disturbance, affecting the correct programming of complex motor sequences such as speech. Compatibly, understanding of the neurophysiological bases of DS has dramatically improved, thanks to neuroimaging, and techniques able to interact with neural tissue functioning [e.g., non-invasive brain stimulation (NIBS)]. In this context, the dysfunctional activity of the cortico-basal-thalamo-cortical networks, as well as the defective patterns of connectivity, seems to play a key role, especially in sensorimotor networks. As a consequence, a direct action on the functionality of "defective" or "impaired" brain circuits may help people who stutter to manage dysfluencies in a better way. This may also "potentiate" available interventions, thus favoring more stable outcomes of speech fluency. Attempts aiming at modulating (and improving) brain functioning of people who stutter, realized by using NIBS, are quickly increasing. Here, we will review these recent advancements being applied to the treatment of DS. Insights will be useful not only to assess whether the speech fluency of people who stutter may be ameliorated by acting directly on brain functioning but also will provide further suggestions about the complex and dynamic pathophysiology of DS, where causal effects and "adaptive''/''maladaptive" compensation mechanisms may be strongly overlapped. In conclusion, this review focuses future research toward more specific, targeted, and effective interventions for DS, based on neuromodulation of brain functioning.
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Affiliation(s)
| | | | | | - Giovanni Del Ben
- Department of Life Sciences, University of Trieste, Trieste, Italy
| | - Gianluca Campana
- Department of General Psychology, University of Padua, Padua, Italy
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10
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Narayana S, Gibbs SK, Fulton SP, McGregor AL, Mudigoudar B, Weatherspoon SE, Boop FA, Wheless JW. Clinical Utility of Transcranial Magnetic Stimulation (TMS) in the Presurgical Evaluation of Motor, Speech, and Language Functions in Young Children With Refractory Epilepsy or Brain Tumor: Preliminary Evidence. Front Neurol 2021; 12:650830. [PMID: 34093397 PMCID: PMC8170483 DOI: 10.3389/fneur.2021.650830] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Accepted: 03/25/2021] [Indexed: 11/25/2022] Open
Abstract
Accurate presurgical mapping of motor, speech, and language cortices, while crucial for neurosurgical planning and minimizing post-operative functional deficits, is challenging in young children with neurological disease. In such children, both invasive (cortical stimulation mapping) and non-invasive functional mapping imaging methods (MEG, fMRI) have limited success, often leading to delayed surgery or adverse post-surgical outcomes. We therefore examined the clinical utility of transcranial magnetic stimulation (TMS) in young children who require functional mapping. In a retrospective chart review of TMS studies performed on children with refractory epilepsy or a brain tumor, at our institution, we identified 47 mapping sessions in 36 children 3 years of age or younger, in whom upper and lower extremity motor mapping was attempted; and 13 children 5–6 years old in whom language mapping, using a naming paradigm, was attempted. The primary hand motor cortex was identified in at least one hemisphere in 33 of 36 patients, and in both hemispheres in 27 children. In 17 children, primary leg motor cortex was also successfully identified. The language cortices in temporal regions were successfully mapped in 11 of 13 patients, and in six of them language cortices in frontal regions were also mapped, with most children (n = 5) showing right hemisphere dominance for expressive language. Ten children had a seizure that was consistent with their clinical semiology during or immediately following TMS, none of which required intervention or impeded completion of mapping. Using TMS, both normal motor, speech, and language developmental patterns and apparent disease induced reorganization were demonstrated in this young cohort. The successful localization of motor, speech, and language cortices in young children improved the understanding of the risk-benefit ratio prior to surgery and facilitated surgical planning aimed at preserving motor, speech, and language functions. Post-operatively, motor function was preserved or improved in nine out of 11 children who underwent surgery, as was language function in all seven children who had surgery for lesions near eloquent cortices. We provide feasibility data that TMS is a safe, reliable, and effective tool to map eloquent cortices in young children.
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Affiliation(s)
- Shalini Narayana
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN, United States
| | - Savannah K Gibbs
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Stephen P Fulton
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Amy Lee McGregor
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Basanagoud Mudigoudar
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Sarah E Weatherspoon
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
| | - Frederick A Boop
- Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States.,Semmes Murphey Neurologic and Spine Institute, Memphis, TN, United States.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, United States
| | - James W Wheless
- Division of Pediatric Neurology, Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN, United States.,Le Bonheur Children's Hospital, The Neuroscience Institute, Memphis, TN, United States
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Han Y, Tong X, Wang X, Teng F, Deng Q, Zhou J, Guan Y, Yan Z, Chen L, Luan G, Wang M. A concordance study determining language dominance between navigated transcranial magnetic stimulation and the Wada test in patients with drug-resistant epilepsy. Epilepsy Behav 2021; 117:107711. [PMID: 33636527 DOI: 10.1016/j.yebeh.2020.107711] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2020] [Revised: 11/18/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE It remains unclear whether transcranial magnetic stimulation (TMS) can replace the Wada test to determine language hemisphere dominance (HD). Using the Wada test as the gold standard, this study aimed to investigate the accuracy of navigated TMS (nTMS) in determining language HD. METHODS This study enrolled nine right-handed patients with drug-resistant epilepsy. We hypothesized that application of nTMS to language-related areas of the language-dominant hemisphere would induce positive manifestation of language dysfunction (LD). To test our hypothesis, the patients were instructed to perform a visual object-naming task while nTMS was applied to the anterior (e.g., Broca's area) and posterior (e.g., Wernicke's area) regions, which are closely related to language processing. The Wada test result was used as the gold standard, and the diagnostic value of nTMS was assessed using the Kappa consistency test. RESULTS The nTMS-induced LD positive rate for the bilateral anterior language areas (85.7%) was higher than that for the posterior language areas (57.1%). There was high consistency between nTMS stimulation of the left anterior and posterior language areas and the Wada test results for determining language HD. In contrast, the consistency of stimulation of the right anterior and posterior transfer sites was moderate (Kappa value = 0.545, P = 0.171) and low, respectively. For the latter, no statistical calculation was performed because stimulation of the right posterior speech area was negative in all patients compared with the Wada test results. CONCLUSIONS Our findings revealed that using nTMS to stimulate language-related left anterior and posterior areas could predict language HD with high accuracy. When the stimulation performance of these areas is positive, nTMS and the Wada test are equally accurate. Observing only negative performance may indicate that language HD has been transferred to the right side.
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Affiliation(s)
- Yixian Han
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xuezhi Tong
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Xiongfei Wang
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Fei Teng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Qinqin Deng
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Jian Zhou
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Yuguang Guan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Zhaofen Yan
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Lingling Chen
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China
| | - Guoming Luan
- Department of Neurosurgery, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China; Beijing Key Laboratory of Epilepsy, Beijing 100093, China; Center of Epilepsy, Beijing Institute for Brain Disorders, Beijing 100093, China.
| | - Mengyang Wang
- Department of Neurology, SanBo Brain Hospital, Capital Medical University, Beijing 100093, China.
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12
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Sakreida K, Blume-Schnitzler J, Heim S, Willmes K, Clusmann H, Neuloh G. Phonological picture–word interference in language mapping with transcranial magnetic stimulation: an objective approach for functional parcellation of Broca’s region. Brain Struct Funct 2019; 224:2027-2044. [DOI: 10.1007/s00429-019-01891-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2018] [Accepted: 05/11/2019] [Indexed: 10/26/2022]
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13
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Klaus J, Hartwigsen G. Dissociating semantic and phonological contributions of the left inferior frontal gyrus to language production. Hum Brain Mapp 2019; 40:3279-3287. [PMID: 30969004 DOI: 10.1002/hbm.24597] [Citation(s) in RCA: 43] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 04/01/2019] [Accepted: 04/02/2019] [Indexed: 11/09/2022] Open
Abstract
While the involvement of the left inferior frontal gyrus (IFG) in language production is undisputed, the role of specific subregions at different representational levels remains unclear. Some studies suggest a division of anterior and posterior regions for semantic and phonological processing, respectively. Crucially, evidence thus far only comes from correlative neuroimaging studies, but the functional relevance of the involvement of these subregions during a given task remains elusive. We applied repetitive transcranial magnetic stimulation (rTMS) over anterior and posterior IFG (aIFG/pIFG), and vertex as a control site, while participants performed a category member and a rhyme generation task. We found a functional-anatomical double dissociation between tasks and subregions. Naming latencies were significantly delayed in the semantic task when rTMS was applied to aIFG (relative to pIFG and vertex). In contrast, we observed a facilitation of naming latencies in the phonological task when rTMS was applied to pIFG (relative to aIFG and vertex). The results provide first causal evidence for the notion that anterior portions of the IFG are selectively recruited for semantic processing while posterior regions are functionally specific for phonological processing during word production. These findings shed light on the functional parcellation of the left IFG in language production.
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Affiliation(s)
- Jana Klaus
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany.,Research Group Modulation of Language Networks, Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany.,Research Group Modulation of Language Networks, Department of Neuropsychology, Max Planck Institute for Human Cognitive and Brain Sciences Leipzig, Leipzig, Germany
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14
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Verst SM, de Aguiar PHP, Joaquim MAS, Vieira VG, Sucena ABC, Maldaun MVC. Monopolar 250-500 Hz language mapping: Results of 41 patients. Clin Neurophysiol Pract 2018; 4:1-8. [PMID: 30619979 PMCID: PMC6312792 DOI: 10.1016/j.cnp.2018.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Revised: 11/05/2018] [Accepted: 11/30/2018] [Indexed: 01/17/2023] Open
Abstract
Monopolar mapping is effective for cortical and subcortical language areas. 250–500 Hz stimulation parameters are adequate and safe for speech testing. It may improve resection rate of infiltrating tumor areas involving the speech area.
Objectives To determine whether high-frequency 250–500 Hz monopolar stimulation is effective for mapping cortical and subcortical language structures during brain tumor resection. Methods Using high-frequency monopolar stimulation, we mapped the speech areas of 41 awake patients undergoing brain tumor resection in the dominant hemisphere, subject to risk of lesions in the cortical and subcortical speech tracts. Patients were tested for object naming, semantic and other language tasks. Results Mapping was positive in 22 out of 41 patients. Nine patients presented clinical worsening immediately after surgery. Only one patient did not recover after the 30-day follow-up. Nineteen patients showed negative mapping for language tracts, none of whom exhibited worsening of symptoms at the final evaluation. The applied method showed 89% sensitivity and 56% specificity rates. Conclusions The applied method was effective in identifying cortical and subcortical speech areas during the surgical resection of brain tumors. Significance Determining whether monopolar high-frequency stimulation is effective for language mapping is important, since it may be very effective in infiltrating tumor areas and nearby edema region.
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Affiliation(s)
- S M Verst
- Brain Spine Neurophysiology, Intraoperative Neurophysiology at Hospital Sirio Libanês, Rua Barão de Teffé, 1000 sala 55 Jundiai, São Paulo, SP 13208-761, Brazil
| | - P H P de Aguiar
- Neurology at Catholic Pontifica University of São Paulo, Department of Internal Medicine, Rua David Ben Gurion, 1077 apto 12, São Paulo, SP 05634-001, Brazil
| | - M A S Joaquim
- Sirio Libanês Hospital, Rua Adma Jafet, 50 cj 24, São Paulo, SP 01425-001, Brazil
| | - V G Vieira
- Department of Anesthesiology, Sirio Libanês Hospital, Rua Bagé, 97 apto 141, São Paulo, SP, Brazil
| | - A B C Sucena
- Brain Spine Neurophysiology, Rua Dr. Samuel de Castro Neves, 148 apto 154, São Paulo 04726-240, Brazil
| | - M V C Maldaun
- Sirio Libanês Hospital, Rua Barata Ribeiro, 414, cj 63, São Paulo, SP 01308-000, Brazil
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15
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Sollmann N, Ille S, Negwer C, Boeckh-Behrens T, Ringel F, Meyer B, Krieg SM. Cortical time course of object naming investigated by repetitive navigated transcranial magnetic stimulation. Brain Imaging Behav 2018; 11:1192-1206. [PMID: 27448161 DOI: 10.1007/s11682-016-9574-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Human language organization models and language time course patterns are still predominantly derived from meta-analyses of numerous single publications, which only investigated scattered cortical regions. Moreover, there is not much literature available on the exact impact of repetitive navigated transcranial magnetic stimulation (rTMS) onset times on object naming. We, therefore, used a virtual lesion-based approach by mapping various cortical areas with rTMS to investigate the time course of object naming, and to specifically provide data on the pattern of rTMS language mapping results depending on different stimulation onset times. Ten healthy, right-handed subjects were enrolled, and rTMS in combination with an object-naming task was performed with different stimulation onset times (0 ms, 100 ms, 200 ms, 300 ms, 400 ms, and 500 ms). Subsequent to language mapping, all naming errors detected were systematically classified with respect to previous literature. The majority of errors was elicited within the opercular inferior frontal gyrus (opIFG) and ventral precentral gyrus (vPrG), and the spatial distribution of naming errors changed according to the time point of naming disruption by varying onset times. For instance, immediate rTMS onset led to a widespread cortical distribution of no responses, whereas performance and hesitation errors increased with higher stimulation onset times.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,Department of Radiology, Section of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Chiara Negwer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Tobias Boeckh-Behrens
- Department of Radiology, Section of Neuroradiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
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16
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Functional brain mapping: overview of techniques and their application to neurosurgery. Neurosurg Rev 2018; 42:639-647. [DOI: 10.1007/s10143-018-1007-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Revised: 06/25/2018] [Accepted: 07/06/2018] [Indexed: 10/28/2022]
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17
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Visualization of subcortical language pathways by diffusion tensor imaging fiber tracking based on rTMS language mapping. Brain Imaging Behav 2018; 11:899-914. [PMID: 27323766 DOI: 10.1007/s11682-016-9563-0] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Diffusion tensor imaging fiber tracking (DTI FT) is used to visualize subcortical fiber tracts. Yet, there is no standard at hand to visualize language-involved subcortical fibers reliably. Thus, this study investigates the feasibility of using language-related cortical areas identified via repetitive navigated transcranial magnetic stimulation (rTMS) to seed DTI FT of subcortical language tracts. From 2011 to 2014, 37 patients with left-hemispheric perisylvian lesions were examined. Language-positive rTMS stimulation spots were integrated in the deterministic tractography software (BrainLAB, iPlanNet 3.0) as objects and used as seed regions for DTI FT. Tractography was then performed in each patient with 77 different combinations of fiber lengths (40 - 100 mm) and fractional anisotropy (FA; 0.01 - 0.5). The rTMS-based DTI FT identified all commonly known subcortical language tracts, such as the corticonuclear tract, arcuate fascicle, uncinate fascicle, superior longitudinal fascicle, inferior longitudinal fascicle, arcuate fibers, commissural fibers, corticothalamic fibers, and the fronto-occipital fascicle. In 32 patients (86.5 %), each above-named tract could be visualized, while at least 6 out of these 9 tracts were identified in each patient. A fiber length of 100 mm and an FA of 0.1 or 0.15 provided optimal visualization by revealing 125 and 61 individually tracked fibers per visualized language tract and 90 % and 73 % of all language-related tracts, respectively. This study proves the feasibility of rTMS-based DTI FT for subcortical language tracts, provides suitable settings, and shows its easy and standardizable application for the visualization of every language tract in 86.5 % of patients.
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18
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Poljak D, Cvetković M, Dorić V, Zulim I, Đogaš Z, Vidaković MR, Haueisen J, Drissi KEK. Integral Equation Formulations and Related Numerical Solution Methods in Some Biomedical Applications of Electromagnetic Fields. INTERNATIONAL JOURNAL OF E-HEALTH AND MEDICAL COMMUNICATIONS 2018. [DOI: 10.4018/ijehmc.2018010105] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
The paper reviews certain integral equation approaches and related numerical methods used in studies of biomedical applications of electromagnetic fields pertaining to transcranial magnetic stimulation (TMS) and nerve fiber stimulation. TMS is analyzed by solving the set of coupled surface integral equations (SIEs), while the numerical solution of governing equations is carried out via Method of Moments (MoM) scheme. A myelinated nerve fiber, stimulated by a current source, is represented by a straight thin wire antenna. The model is based on the corresponding homogeneous Pocklington integro-differential equation solved by means of the Galerkin Bubnov Indirect Boundary Element Method (GB-IBEM). Some illustrative numerical results for the TMS induced fields and intracellular current distribution along the myelinated nerve fiber (active and passive), respectively, are presented in the paper.
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Affiliation(s)
- Dragan Poljak
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture (FESB), University of Split, Split, Croatia
| | - Mario Cvetković
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture (FESB), University of Split, Split, Croatia
| | - Vicko Dorić
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture (FESB), University of Split, Split, Croatia
| | - Ivana Zulim
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture (FESB), University of Split, Split, Croatia
| | - Zoran Đogaš
- School of Medicine, University of Split, Split, Croatia
| | | | - Jens Haueisen
- Institute of Biomedical Engineering and Informatics, Technical University Ilmenau, Ilmenau, Germany
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Sakreida K, Lange I, Willmes K, Heim S, Binkofski F, Clusmann H, Neuloh G. High-resolution language mapping of Broca's region with transcranial magnetic stimulation. Brain Struct Funct 2017; 223:1297-1312. [PMID: 29116426 DOI: 10.1007/s00429-017-1550-8] [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: 06/09/2017] [Accepted: 10/20/2017] [Indexed: 10/18/2022]
Abstract
Broca's region, corresponding roughly to cytoarchitectonic areas 44 and 45 in the inferior frontal cortex, holds a multifunctional role in language processing, as shown, e.g., by functional imaging data. Neuro-navigated transcranial magnetic stimulation (TMS) enables complementary non-invasive mapping of cortical functions with high spatial resolution. Here, we report on detailed TMS language mapping of Broca's region in 12 healthy participants. The test protocol with an object naming task was adapted for high-resolution and semi-quantitative mapping of TMS-induced effects on speech and language performance. Hierarchical cluster analysis of normalized ratings of error frequency and severity revealed a clear focus of TMS impact at dorso-posterior target sites, close to the inferior frontal junction. Adjacent clusters of moderate and slightly affected stimulation sites yielded a posterosuperior-to-anteroinferior gradient of TMS susceptibility. Our findings indicate that the part of Broca's region most susceptible to TMS-induced language inhibition in object naming is located in the dorsal area 44.
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Affiliation(s)
- Katrin Sakreida
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.
| | - Inga Lange
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany.,Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Klaus Willmes
- Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany
| | - Stefan Heim
- Department of Psychiatry, Psychotherapy and Psychosomatics, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany.,Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1), 52425, Jülich, Germany.,JARA - Translational Brain Medicine, Aachen, Germany
| | - Ferdinand Binkofski
- Section Clinical Cognitive Sciences, Department of Neurology, Faculty of Medicine, RWTH Aachen University, 52074, Aachen, Germany.,Research Centre Jülich, Institute of Neuroscience and Medicine (INM-4), 52425, Jülich, Germany.,JARA - Translational Brain Medicine, Aachen, Germany
| | - Hans Clusmann
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
| | - Georg Neuloh
- Department of Neurosurgery, Faculty of Medicine, RWTH Aachen University, Pauwelsstr. 30, 52074, Aachen, Germany
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20
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Krieg SM, Lioumis P, Mäkelä JP, Wilenius J, Karhu J, Hannula H, Savolainen P, Lucas CW, Seidel K, Laakso A, Islam M, Vaalto S, Lehtinen H, Vitikainen AM, Tarapore PE, Picht T. Protocol for motor and language mapping by navigated TMS in patients and healthy volunteers; workshop report. Acta Neurochir (Wien) 2017; 159:1187-1195. [PMID: 28456870 DOI: 10.1007/s00701-017-3187-z] [Citation(s) in RCA: 142] [Impact Index Per Article: 20.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Accepted: 04/06/2017] [Indexed: 11/25/2022]
Abstract
INTRODUCTION Navigated transcranial magnetic stimulation (nTMS) is increasingly used for preoperative mapping of motor function, and clinical evidence for its benefit for brain tumor patients is accumulating. In respect to language mapping with repetitive nTMS, literature reports have yielded variable results, and it is currently not routinely performed for presurgical language localization. The aim of this project is to define a common protocol for nTMS motor and language mapping to standardize its neurosurgical application and increase its clinical value. METHODS The nTMS workshop group, consisting of highly experienced nTMS users with experience of more than 1500 preoperative nTMS examinations, met in Helsinki in January 2016 for thorough discussions of current evidence and personal experiences with the goal to recommend a standardized protocol for neurosurgical applications. RESULTS nTMS motor mapping is a reliable and clinically validated tool to identify functional areas belonging to both normal and lesioned primary motor cortex. In contrast, this is less clear for language-eloquent cortical areas identified by nTMS. The user group agreed on a core protocol, which enables comparison of results between centers and has an excellent safety profile. Recommendations for nTMS motor and language mapping protocols and their optimal clinical integration are presented here. CONCLUSION At present, the expert panel recommends nTMS motor mapping in routine neurosurgical practice, as it has a sufficient level of evidence supporting its reliability. The panel recommends that nTMS language mapping be used in the framework of clinical studies to continue refinement of its protocol and increase reliability.
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Affiliation(s)
- Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität Ismaninger Str. 22, 81675, Munich, Germany.
| | - Pantelis Lioumis
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, HUS, 00029, Helsinki, Finland
| | - Jyrki P Mäkelä
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, HUS, 00029, Helsinki, Finland
| | - Juha Wilenius
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, HUS, 00029, Helsinki, Finland
| | - Jari Karhu
- Nexstim Plc, Elimäenkatu 9 B, 00510, Helsinki, Finland
| | - Henri Hannula
- Nexstim Plc, Elimäenkatu 9 B, 00510, Helsinki, Finland
- Department of Biomedical Engineering and Computational Science, Aalto University, Espoo, Finland
| | | | - Carolin Weiss Lucas
- Center of Neurosurgery, University Hospital Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Kathleen Seidel
- Department of Neurosurgery Inselspital, Bern University Hospital University of Berne, 3010, Berne, Switzerland
| | - Aki Laakso
- Department of Neurosurgery, Helsinki University Hospital and Clinical Neurosciences, Neurosurgery, University of Helsinki, P.O. Box 266, Topeliuksenkatu 5, 00260, Helsinki, Finland
| | - Mominul Islam
- Department of Clinical Neurophysiology (R2:01), Karolinska University Hospital, 17176, Solna, Stockholm, Sweden
| | - Selja Vaalto
- Department of Clinical Neurophysiology, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, HUS, 00029, Helsinki, Finland
| | - Henri Lehtinen
- Epilepsy Unit, Department of Pediatric Neurology, Helsinki University Central Hospital, Lastenlinnantie 2 PL 280, HUS, 00029, Helsinki, Finland
| | - Anne-Mari Vitikainen
- BioMag Laboratory, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, P.O. Box 340, HUS, 00029, Helsinki, Finland
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, 505 Parnassus Ave, Moffitt, San Francisco, CA, 94143, USA
| | - Thomas Picht
- Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Augustenburger Platz 1, 13353, Berlin, Germany
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21
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Relationship Between Perisylvian Essential Language Sites and Arcuate Fasciculus in the Left Hemisphere of Healthy Adults. Neurosci Bull 2017; 33:616-626. [PMID: 28501904 DOI: 10.1007/s12264-017-0137-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2017] [Accepted: 04/11/2017] [Indexed: 10/19/2022] Open
Abstract
Essential language sites and the arcuate fasciculus (AF) have been extensively researched. However, the relationship between them remains insufficiently studied, especially in healthy people. Navigated transcranial magnetic stimulation (nTMS) is increasingly used in language mapping. While enjoying the advantage of non-invasiveness, it is also capable of inducing a virtual lesion in the brain. Thus, it offers the possibility of using the virtual-lesion method to study the healthy brain. This study combined nTMS and diffusion tensor imaging (DTI) tractography to investigate the relationship between essential language sites and the AF in 30 healthy right-handed volunteers. A total of 143 essential language sites were identified using nTMS, and a total of 175 AF terminations were identified using DTI tractography. Sixty-six sites had a direct correlation with the AF, accounting for 46% of the total essential language sites. Forty-seven AF terminations harbored essential language sites, accounting for 27% of the total AF terminations. Upon data rendering to the cortical parcellation system, a region-related heterogeneity of the correlation rate was found. This study provides the first data on the relationship between essential language sites and the AF in healthy adults.
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22
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Raffa G, Bährend I, Schneider H, Faust K, Germanò A, Vajkoczy P, Picht T. A Novel Technique for Region and Linguistic Specific nTMS-based DTI Fiber Tracking of Language Pathways in Brain Tumor Patients. Front Neurosci 2016; 10:552. [PMID: 27994536 PMCID: PMC5134322 DOI: 10.3389/fnins.2016.00552] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2015] [Accepted: 11/16/2016] [Indexed: 12/03/2022] Open
Abstract
Navigated transcranial magnetic stimulation (nTMS) has recently been introduced as a non-invasive tool for functional mapping of cortical language areas prior to surgery. It correlates well with intraoperative neurophysiological monitoring (IONM) findings, allowing defining the best surgical strategy to preserve cortical language areas during surgery for language-eloquent tumors. Nevertheless, nTMS allows only for cortical mapping and postoperative language deficits are often caused by injury to subcortical language pathways. Nowadays, the only way to preoperatively visualize language subcortical white matter tracts consists in DTI fiber tracking (DTI-FT). However, standard DTI-FT is based on anatomical landmarks that vary interindividually and can be obscured by the presence of the tumor itself. It has been demonstrated that combining nTMS with DTI-FT allows for a more reliable visualization of the motor pathway in brain tumor patients. Nevertheless, no description about such a combination has been reported for the language network. The aim of the present study is to describe and assess the feasibility and reliability of using cortical seeding areas defined by error type-specific nTMS language mapping (nTMS-positive spots) to perform DTI-FT in patients affected by language-eloquent brain tumors. We describe a novel technique for a nTMS-based DTI-FT to visualize the complex cortico-subcortical connections of the language network. We analyzed quantitative findings, such as fractional anisotropy values and ratios, and the number of visualized connections of nTMS-positive spots with subcortical pathways, and we compared them with results obtained by using the standard DTI-FT technique. We also analyzed the functional concordance between connected cortical nTMS-positive spots and subcortical pathways, and the likelihood of connection for nTMS-positive vs. nTMS-negative cortical spots. We demonstrated, that the nTMS-based approach, especially what we call the “single-spot” strategy, is able to provide a reliable and more detailed reconstruction of the complex cortico-subcortical language network as compared to the standard DTI-FT. We believe this technique represents a beneficial new strategy for customized preoperative planning in patients affected by tumors in presumed language eloquent location, providing anatomo-functional information to plan language-preserving surgery.
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Affiliation(s)
- Giovanni Raffa
- Department of Clinical and Experimental Medicine, University of MessinaMessina, Italy; Neurosurgical Clinic, Department of Neuroscience, University of MessinaMessina, Italy
| | - Ina Bährend
- Department of Neurosurgery, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Heike Schneider
- Department of Neurosurgery, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Katharina Faust
- Department of Neurosurgery, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Antonino Germanò
- Neurosurgical Clinic, Department of Neuroscience, University of Messina Messina, Italy
| | - Peter Vajkoczy
- Department of Neurosurgery, Charité Universitätsmedizin Berlin Berlin, Germany
| | - Thomas Picht
- Department of Neurosurgery, Charité Universitätsmedizin BerlinBerlin, Germany; Cluster of Excellence: "Image Knowledge Gestaltung: An Interdisciplinary Laboratory", Humboldt UniversityBerlin, Germany
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23
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Combining non-invasive transcranial brain stimulation with neuroimaging and electrophysiology: Current approaches and future perspectives. Neuroimage 2016; 140:4-19. [DOI: 10.1016/j.neuroimage.2016.02.012] [Citation(s) in RCA: 197] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2015] [Revised: 01/26/2016] [Accepted: 02/07/2016] [Indexed: 12/23/2022] Open
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25
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Negwer C, Sollmann N, Ille S, Hauck T, Maurer S, Kirschke JS, Ringel F, Meyer B, Krieg SM. Language pathway tracking: comparing nTMS-based DTI fiber tracking with a cubic ROIs-based protocol. J Neurosurg 2016; 126:1006-1014. [PMID: 27231977 DOI: 10.3171/2016.2.jns152382] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE Diffusion tensor imaging (DTI) fiber tracking (FT) has been widely used in glioma surgery in recent years. It can provide helpful information about subcortical structures, especially in patients with eloquent space-occupying lesions. This study compared the newly developed navigated transcranial magnetic stimulation (nTMS)-based DTI FT of language pathways with the most reproducible protocol for language pathway tractography, using cubic regions of interest (ROIs) for the arcuate fascicle. METHODS Thirty-seven patients with left-sided perisylvian lesions underwent language mapping by repetitive nTMS. DTI FT was performed using the cubic ROIs-based protocol and the authors' nTMS-based DTI FT approach. The same minimal fiber length and fractional anisotropy were chosen (50 mm and 0.2, respectively). Both protocols were performed with standard clinical tractography software. RESULTS Both methods visualized language-related fiber tracts (i.e., corticonuclear tract, arcuate fascicle, uncinate fascicle, superior longitudinal fascicle, inferior longitudinal fascicle, arcuate fibers, commissural fibers, corticothalamic fibers, and frontooccipital fascicle) in all 37 patients. Using the cubic ROIs-based protocol, 39.9% of these language-related fiber tracts were detected in the examined patients, as opposed to 76.0% when performing nTMS-based DTI FT. For specifically tracking the arcuate fascicle, however, the cubic ROIs-based approach showed better results (97.3% vs 75.7% with nTMS-based DTI FT). CONCLUSIONS The cubic ROIs-based protocol was designed for arcuate fascicle tractography, and this study shows that it is still useful for this intention. However, superior results were obtained using the nTMS-based DTI FT for visualization of other language-related fiber tracts.
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Affiliation(s)
- Chiara Negwer
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Nico Sollmann
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Sebastian Ille
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Theresa Hauck
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | | | - Jan S Kirschke
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technical University of Munich, Germany
| | | | | | - Sandro M Krieg
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
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26
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Riva M, Fava E, Gallucci M, Comi A, Casarotti A, Alfiero T, Raneri FA, Pessina F, Bello L. Monopolar high-frequency language mapping: can it help in the surgical management of gliomas? A comparative clinical study. J Neurosurg 2016; 124:1479-89. [DOI: 10.3171/2015.4.jns14333] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECT
Intraoperative language mapping is traditionally performed with low-frequency bipolar stimulation (LFBS). High-frequency train-of-five stimulation delivered by a monopolar probe (HFMS) is an alternative technique for motor mapping, with a lower reported seizure incidence. The application of HFMS in language mapping is still limited. Authors of this study assessed the efficacy and safety of HFMS for language mapping during awake surgery, exploring its clinical impact compared with that of LFBS.
METHODS
Fifty-nine patients underwent awake surgery with neuropsychological testing, and LFBS and HFMS were compared. Frequency, type, and site of evoked interference were recorded. Language was scored preoperatively and 1 week and 3 months after surgery. Extent of resection was calculated as well.
RESULTS
High-frequency monopolar stimulation induced a language disturbance when the repetition rate was set at 3 Hz. Interference with counting (p = 0.17) and naming (p = 0.228) did not vary between HFMS and LFBS. These results held true when preoperative tumor volume, lesion site, histology, and recurrent surgery were considered.
Intraoperative responses (1603) in all patients were compared. The error rate for both modalities differed from baseline values (p < 0.001) but not with one another (p = 0.06). Low-frequency bipolar stimulation sensitivity (0.458) and precision (0.665) were slightly higher than the HFMS counterparts (0.367 and 0.582, respectively). The error rate across the 3 types of language errors (articulatory, anomia, paraphasia) did not differ between the 2 stimulation methods (p = 0.279).
CONCLUSIONS
With proper setting adjustments, HFMS is a safe and effective technique for language mapping.
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Affiliation(s)
- Marco Riva
- 1Neurosurgery, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Rozzano (MI),
| | - Enrica Fava
- 1Neurosurgery, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Rozzano (MI),
- 2Unit of Neurosurgical Oncology, Humanitas Research Hospital, Rozzano (MI), and
| | | | - Alessandro Comi
- 2Unit of Neurosurgical Oncology, Humanitas Research Hospital, Rozzano (MI), and
| | | | - Tommaso Alfiero
- 1Neurosurgery, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Rozzano (MI),
| | - Fabio A. Raneri
- 1Neurosurgery, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Rozzano (MI),
| | - Federico Pessina
- 2Unit of Neurosurgical Oncology, Humanitas Research Hospital, Rozzano (MI), and
| | - Lorenzo Bello
- 1Neurosurgery, Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Rozzano (MI),
- 2Unit of Neurosurgical Oncology, Humanitas Research Hospital, Rozzano (MI), and
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Rogić Vidaković M, Jerković A, Jurić T, Vujović I, Šoda J, Erceg N, Bubić A, Zmajević Schönwald M, Lioumis P, Gabelica D, Đogaš Z. Neurophysiologic markers of primary motor cortex for laryngeal muscles and premotor cortex in caudal opercular part of inferior frontal gyrus investigated in motor speech disorder: a navigated transcranial magnetic stimulation (TMS) study. Cogn Process 2016; 17:429-442. [PMID: 27130564 DOI: 10.1007/s10339-016-0766-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 04/18/2016] [Indexed: 11/24/2022]
Abstract
Transcranial magnetic stimulation studies have so far reported the results of mapping the primary motor cortex (M1) for hand and tongue muscles in stuttering disorder. This study was designed to evaluate the feasibility of repetitive navigated transcranial magnetic stimulation (rTMS) for locating the M1 for laryngeal muscle and premotor cortical area in the caudal opercular part of inferior frontal gyrus, corresponding to Broca's area in stuttering subjects by applying new methodology for mapping these motor speech areas. Sixteen stuttering and eleven control subjects underwent rTMS motor speech mapping using modified patterned rTMS. The subjects performed visual object naming task during rTMS applied to the (a) left M1 for laryngeal muscles for recording corticobulbar motor-evoked potentials (CoMEP) from cricothyroid muscle and (b) left premotor cortical area in the caudal opercular part of inferior frontal gyrus while recording long latency responses (LLR) from cricothyroid muscle. The latency of CoMEP in control subjects was 11.75 ± 2.07 ms and CoMEP amplitude was 294.47 ± 208.87 µV, and in stuttering subjects CoMEP latency was 12.13 ± 0.75 ms and 504.64 ± 487.93 µV CoMEP amplitude. The latency of LLR in control subjects was 52.8 ± 8.6 ms and 54.95 ± 4.86 in stuttering subjects. No significant differences were found in CoMEP latency, CoMEP amplitude, and LLR latency between stuttering and control-fluent speakers. These results indicate there are probably no differences in stuttering compared to controls in functional anatomy of the pathway used for transmission of information from premotor cortex to the M1 cortices for laryngeal muscle representation and from there via corticobulbar tract to laryngeal muscles.
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Affiliation(s)
- Maja Rogić Vidaković
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia.
| | - Ana Jerković
- Faculty of Philosophy, University of Zagreb, Ivana Lučića 3, 10000, Zagreb, Croatia
| | - Tomislav Jurić
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, Department of Electronics, University of Split, R. Boškovića 32, Split, Croatia
| | - Igor Vujović
- Faculty of Maritime Studies, Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split, Ruđera-Boškovića 37, Split, Croatia
| | - Joško Šoda
- Faculty of Maritime Studies, Signal Processing, Analysis and Advanced Diagnostics Research and Education Laboratory (SPAADREL), University of Split, Ruđera-Boškovića 37, Split, Croatia
| | - Nikola Erceg
- Faculty of Humanities and Social Sciences, University of Split, Put iza nove bolnice 10 C, Split, Croatia
| | - Andreja Bubić
- Faculty of Humanities and Social Sciences, University of Split, Put iza nove bolnice 10 C, Split, Croatia
| | - Marina Zmajević Schönwald
- Clinical Medical Centre "Sisters of Mercy", Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Vinogradska 29 A, Zagreb, Croatia
| | - Pantelis Lioumis
- Bio Mag Laboratory HUS Medical Imaging center, Helsinki University Hospital, P.O. Box 340, 00029, HUS, Helsinki, Finland
| | - Dragan Gabelica
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia.,SGM Medical Monitoring, Grge Novaka 22A, 21000, Split, Croatia
| | - Zoran Đogaš
- School of Medicine, Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, University of Split, Šoltanska 2, 21000, Split, Croatia
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28
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Sollmann N, Negwer C, Ille S, Maurer S, Hauck T, Kirschke JS, Ringel F, Meyer B, Krieg SM. Feasibility of nTMS-based DTI fiber tracking of language pathways in neurosurgical patients using a fractional anisotropy threshold. J Neurosci Methods 2016; 267:45-54. [PMID: 27059128 DOI: 10.1016/j.jneumeth.2016.04.002] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2016] [Revised: 03/31/2016] [Accepted: 04/04/2016] [Indexed: 12/14/2022]
Abstract
BACKGROUND Navigated transcranial magnetic stimulation (nTMS) provides language maps in brain tumor patients. Yet, corresponding data on the visualization of language-related subcortical pathways is lacking. Therefore, this study evaluates the feasibility of nTMS-based diffusion tensor imaging fiber tracking (DTI FT) for subcortical language pathways by a fractional anisotropy (FA) protocol. NEW METHOD DTI FT was performed in 37 patients suffering from left-sided perisylvian brain lesions based on nTMS data exclusively, using the FA-based protocol originally established for the corticospinal tract (CST) by Frey et al. (2012): minimum fiber length was 110mm and the highest individual FA value leading to visualization of white matter tracts was determined as the FA threshold (FAT). Then, deterministic DTI FT using an FA value of 100%, 75%, 50%, and 25% of the individual FAT (with 25% as an additional setting to the original protocol) was performed. RESULTS Our approach visualized 9 language-related subcortical white matter pathways. By using 100% FAT, the mean percentage of visualized tracts was 13.5%, whereas DTI FT performed with 75%, 50%, and 25% FAT detected 30.6%, 61.3%, and 93.7% of language-related fiber tracts, respectively. COMPARISON WITH EXISTING METHODS nTMS language mapping alone is not able to visualize subcortical language-related pathways. CONCLUSIONS This study shows that nTMS language maps are feasible for DTI FT of language-related pathways within the scope of a FAT-based protocol. Although this approach is novel and might be helpful during scientific neuroimaging and tumor resection, intraoperative validation is needed to go beyond the level of feasibility.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Chiara Negwer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Theresa Hauck
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Jan S Kirschke
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany.
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Sollmann N, Negwer C, Tussis L, Hauck T, Ille S, Maurer S, Giglhuber K, Bauer JS, Ringel F, Meyer B, Krieg SM. Interhemispheric connectivity revealed by diffusion tensor imaging fiber tracking derived from navigated transcranial magnetic stimulation maps as a sign of language function at risk in patients with brain tumors. J Neurosurg 2016; 126:222-233. [PMID: 27035166 DOI: 10.3171/2016.1.jns152053] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE Resection of brain tumors in language-eloquent areas entails the risk of postoperative aphasia. It has been demonstrated via navigated transcranial magnetic stimulation (nTMS) that language function can partially shift to the unaffected hemisphere due to tumor-induced plasticity. Therefore, this study was designed to evaluate whether interhemispheric connectivity (IC) detected by nTMS-based diffusion tensor imaging-fiber tracking (DTI-FT) can be used to predict surgery-related aphasia in patients with brain tumors. METHODS Thirty-eight patients with left-sided perisylvian brain lesions underwent cortical language mapping of both hemispheres by nTMS prior to awake surgery. Then, nTMS-based DTI-FT was conducted with a fractional anisotropy (FA) of 0.01 and 0.2 to visualize nTMS-based IC. Receiver operating characteristics were calculated for the prediction of a postoperative (irrespective of the preoperative state) and a new surgery-related aphasia by the presence of detectable IC. RESULTS Language mapping by nTMS was possible in all patients. Seventeen patients (44.7%) suffered from surgery-related worsening of language performance (transient aphasia according to 3-month follow-up in 16 subjects [42.1%]; new permanent aphasia according to 3-month follow-up in 1 patient [2.6%]). Regarding the correlation of aphasia to nTMS-based IC, statistically significant differences were revealed for both evaluated FA values. However, better results were observed for tractography with an FA of 0.2, which led to a specificity of 93% (postoperative aphasia) and 90% (surgery-related aphasia). For postoperative aphasia, the corresponding OR was 0.1282 (95% CI 0.0143-1.1520), and for surgery-related aphasia the OR was 0.1184 (95% CI 0.0208-0.6754). CONCLUSIONS According to these results, IC detected by preoperative nTMS-based DTI-FT might be regarded as a risk factor for surgery-related aphasia, with a specificity of up to 93%. However, because the majority of enrolled patients suffered from transient aphasia postoperatively, it has to be evaluated whether this approach distinctly leads to similar results among patients with permanent language deficits. Despite this restriction, this approach might contribute to individualized patient consultation prior to tumor resection in clinical practice.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Chiara Negwer
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Lorena Tussis
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Theresa Hauck
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | - Sebastian Ille
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
| | | | | | - Jan S Bauer
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Germany
| | | | | | - Sandro M Krieg
- Department of Neurosurgery.,TUM-Neuroimaging Center, and
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Silveri MC, Incordino F, Lo Monaco R, Bizzarro A, Masullo C, Piludu F, Colosimo C. Neural substrates of the 'low-level' system for speech articulation: Evidence from primary opercular syndrome. J Neuropsychol 2016; 11:450-457. [PMID: 26852905 DOI: 10.1111/jnp.12099] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/28/2015] [Indexed: 11/30/2022]
Abstract
We describe a patient with progressive disorder of speech, without language impairment (opercular syndrome). Morphometric analysis confirmed asymmetric volume reduction of the precentral areas (>left). Diffusion imaging showed significant white matter changes in the left frontal lobe, with specific involvement of the left corticobulbar tract and connections between supplementary/pre-supplementary motor areas and the frontal operculum (frontal aslant tract). We suggest that the organization of expressive language includes a 'low level' motor system principally distributed in the left hemisphere that shows specific susceptibility to neurodegeneration, distinct from neural systems subtending praxic, and cognitive aspects of language.
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Affiliation(s)
| | | | - Rita Lo Monaco
- Centre for Medicine of Ageing, Catholic University, Rome, Italy
| | | | - Carlo Masullo
- Institute of Neurology, Catholic University, Rome, Italy
| | | | - Cesare Colosimo
- Department of Neuroimaging, Catholic University, Rome, Italy
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31
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Sollmann N, Ille S, Tussis L, Maurer S, Hauck T, Negwer C, Bauer JS, Ringel F, Meyer B, Krieg SM. Correlating subcortical interhemispheric connectivity and cortical hemispheric dominance in brain tumor patients: A repetitive navigated transcranial magnetic stimulation study. Clin Neurol Neurosurg 2016; 141:56-64. [DOI: 10.1016/j.clineuro.2015.12.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 12/14/2015] [Indexed: 12/31/2022]
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Language function distribution in left-handers: A navigated transcranial magnetic stimulation study. Neuropsychologia 2016; 82:65-73. [PMID: 26792365 DOI: 10.1016/j.neuropsychologia.2016.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Revised: 12/17/2015] [Accepted: 01/10/2016] [Indexed: 11/21/2022]
Abstract
Recent studies suggest that in left-handers, the right hemisphere (RH) is more involved in language function when compared to right-handed subjects. Since data on lesion-based approaches is lacking, we aimed to investigate language distribution of left-handers by repetitive navigated transcranial magnetic stimulation (rTMS). Thus, rTMS was applied to the left hemisphere (LH) and RH in 15 healthy left-handers during an object-naming task, and resulting naming errors were categorized. Then, we calculated error rates (ERs=number of errors per number of stimulations) for both hemispheres separately and defined a laterality score as the quotient of the LH ER - RH ER through the LH ER + RH ER (abbreviated as (L-R)/(L+R)). In this context, (L-R)/(L+R)>0 indicates that the LH is dominant, whereas (L-R)/(L+R)<0 shows that the RH is dominant. No significant difference in ERs was found between hemispheres (all errors: mean LH 18.0±11.7%, mean RH 18.1±12.2%, p=0.94; all errors without hesitation: mean LH 12.4±9.8%, mean RH 12.9±10.0%, p=0.65; no responses: mean LH 9.3±9.2%, mean RH 11.5±10.3%, p=0.84). However, a significant difference between the results of (L-R)/(L+R) of left-handers and right-handers (source data of another study) for all errors (mean 0.01±0.14 vs. 0.19±0.20, p=0.0019) and all errors without hesitation (mean -0.02±0.20 vs. 0.19±0.28, p=0.0051) was revealed, whereas the comparison for no responses did not show a significant difference (mean: -0.004±0.27 vs. 0.09±0.44, p=0.64). Accordingly, left-handers present a comparatively equal language distribution across both hemispheres with language dominance being nearly equally distributed between hemispheres in contrast to right-handers.
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Rogić Vidaković M, Gabelica D, Vujović I, Šoda J, Batarelo N, Džimbeg A, Zmajević Schönwald M, Rotim K, Đogaš Z. A novel approach for monitoring writing interferences during navigated transcranial magnetic stimulation mappings of writing related cortical areas. J Neurosci Methods 2015; 255:139-50. [PMID: 26279342 DOI: 10.1016/j.jneumeth.2015.08.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2015] [Revised: 08/03/2015] [Accepted: 08/04/2015] [Indexed: 11/29/2022]
Abstract
BACKGROUND It has recently been shown that navigated repetitive transcranial magnetic stimulation (nTMS) is useful in preoperative neurosurgical mapping of motor and language brain areas. In TMS mapping of motor cortices the evoked responses can be quantitatively monitored by electromyographic (EMG) recordings. No such setup exists for monitoring of writing during nTMS mappings of writing related cortical areas. NEW METHOD We present a novel approach for monitoring writing during nTMS mappings of motor writing related cortical areas. COMPARISON WITH EXISTING METHOD(S) To our best knowledge, this is the first demonstration of quantitative monitoring of motor evoked responses from hand by EMG, and of pen related activity during writing with our custom made pen, together with the application of chronometric TMS design and patterned protocol of rTMS. RESULTS The method was applied in four healthy subjects participating in writing during nTMS mapping of the premotor cortical area corresponding to BA 6 and close to the superior frontal sulcus. The results showed that stimulation impaired writing in all subjects. The corresponding spectra of measured signal related to writing movements was observed in the frequency band 0-20 Hz. Magnetic stimulation affected writing by suppressing normal writing frequency band. CONCLUSION The proposed setup for monitoring of writing provides additional quantitative data for monitoring and the analysis of rTMS induced writing response modifications. The setup can be useful for investigation of neurophysiologic mechanisms of writing, for therapeutic effects of nTMS, and in preoperative mapping of language cortical areas in patients undergoing brain surgery.
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Affiliation(s)
- Maja Rogić Vidaković
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia.
| | - Dragan Gabelica
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia.
| | - Igor Vujović
- Faculty of Maritime Studies, University of Split, Zrinsko-Frankopanska 38, 21000 Split, Croatia.
| | - Joško Šoda
- Faculty of Maritime Studies, University of Split, Zrinsko-Frankopanska 38, 21000 Split, Croatia.
| | - Nikolina Batarelo
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Croatia, R. Boškovića 32, 21000 Split, Croatia.
| | - Andrija Džimbeg
- Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Croatia, R. Boškovića 32, 21000 Split, Croatia.
| | - Marina Zmajević Schönwald
- Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Clinical Medical Centre "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia.
| | - Krešimir Rotim
- Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Clinical Medical Centre "Sisters of Mercy", Vinogradska cesta 29, 10000 Zagreb, Croatia.
| | - Zoran Đogaš
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, Šoltanska 2, 21000 Split, Croatia.
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Vitikainen AM, Mäkelä E, Lioumis P, Jousmäki V, Mäkelä JP. Accelerometer-based automatic voice onset detection in speech mapping with navigated repetitive transcranial magnetic stimulation. J Neurosci Methods 2015; 253:70-7. [DOI: 10.1016/j.jneumeth.2015.05.015] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2015] [Revised: 05/19/2015] [Accepted: 05/21/2015] [Indexed: 10/23/2022]
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Ille S, Sollmann N, Hauck T, Maurer S, Tanigawa N, Obermueller T, Negwer C, Droese D, Zimmer C, Meyer B, Ringel F, Krieg SM. Combined noninvasive language mapping by navigated transcranial magnetic stimulation and functional MRI and its comparison with direct cortical stimulation. J Neurosurg 2015; 123:212-25. [DOI: 10.3171/2014.9.jns14929] [Citation(s) in RCA: 80] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECT
Repetitive navigated transcranial magnetic stimulation (rTMS) is now increasingly used for preoperative language mapping in patients with lesions in language-related areas of the brain. Yet its correlation with intraoperative direct cortical stimulation (DCS) has to be improved. To increase rTMS's specificity and positive predictive value, the authors aim to provide thresholds for rTMS's positive language areas. Moreover, they propose a protocol for combining rTMS with functional MRI (fMRI) to combine the strength of both methods.
METHODS
The authors performed multimodal language mapping in 35 patients with left-sided perisylvian lesions by using rTMS, fMRI, and DCS. The rTMS mappings were conducted with a picture-to-trigger interval (PTI, time between stimulus presentation and stimulation onset) of either 0 or 300 msec. The error rates (ERs; that is, the number of errors per number of stimulations) were calculated for each region of the cortical parcellation system (CPS). Subsequently, the rTMS mappings were analyzed through different error rate thresholds (ERT; that is, the ER at which a CPS region was defined as language positive in terms of rTMS), and the 2-out-of-3 rule (a stimulation site was defined as language positive in terms of rTMS if at least 2 out of 3 stimulations caused an error). As a second step, the authors combined the results of fMRI and rTMS in a predefined protocol of combined noninvasive mapping. To validate this noninvasive protocol, they correlated its results to DCS during awake surgery.
RESULTS
The analysis by different rTMS ERTs obtained the highest correlation regarding sensitivity and a low rate of false positives for the ERTs of 15%, 20%, 25%, and the 2-out-of-3 rule. However, when comparing the combined fMRI and rTMS results with DCS, the authors observed an overall specificity of 83%, a positive predictive value of 51%, a sensitivity of 98%, and a negative predictive value of 95%.
CONCLUSIONS
In comparison with fMRI, rTMS is a more sensitive but less specific tool for preoperative language mapping than DCS. Moreover, rTMS is most reliable when using ERTs of 15%, 20%, 25%, or the 2-out-of-3 rule and a PTI of 0 msec. Furthermore, the combination of fMRI and rTMS leads to a higher correlation to DCS than both techniques alone, and the presented protocols for combined noninvasive language mapping might play a supportive role in the language-mapping assessment prior to the gold-standard intraoperative DCS.
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Affiliation(s)
| | | | | | | | - Noriko Tanigawa
- 5Faculty of Linguistics, Philology, & Phonetics, University of Oxford, United Kingdom
| | | | | | - Doris Droese
- 4Department of Anesthesiology, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; and
| | - Claus Zimmer
- 2TUM-Neuroimaging Center
- 3Section of Neuroradiology, Department of Radiology; and
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Könönen M, Tamsi N, Säisänen L, Kemppainen S, Määttä S, Julkunen P, Jutila L, Äikiä M, Kälviäinen R, Niskanen E, Vanninen R, Karjalainen P, Mervaala E. Non-invasive mapping of bilateral motor speech areas using navigated transcranial magnetic stimulation and functional magnetic resonance imaging. J Neurosci Methods 2015; 248:32-40. [DOI: 10.1016/j.jneumeth.2015.03.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2014] [Revised: 03/26/2015] [Accepted: 03/27/2015] [Indexed: 10/23/2022]
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37
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Sollmann N, Ille S, Obermueller T, Negwer C, Ringel F, Meyer B, Krieg SM. The impact of repetitive navigated transcranial magnetic stimulation coil positioning and stimulation parameters on human language function. Eur J Med Res 2015; 20:47. [PMID: 25889025 PMCID: PMC4382854 DOI: 10.1186/s40001-015-0138-0] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 03/19/2015] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Repetitive navigated transcranial magnetic stimulation (rTMS) in combination with object naming is able to elicit naming errors by stimulating language-related brain regions. However, stimulation results mainly depend on coil positioning and stimulation parameters, which have not been investigated since the implementation of neuronavigation to transcranial magnetic stimulation. Therefore, the following three parameters were systematically examined in the present study: coil angulation, stimulation frequency, and stimulation intensity. METHODS Five healthy, right-handed subjects underwent rTMS language mapping of Broca's as well as Wernicke's areas of the left hemisphere. During mapping sessions, coil angulation was changed clockwise in 45° steps, and the stimulation frequency and intensity were varied within a considerably wide range. For angulation, the anterior-posterior (ap) coil orientation was used as reference position. RESULTS An angulation of 90° to ap coil orientation led to the highest rate of naming errors within Broca's area, whereas an inhomogeneous distribution of angulations was observed during stimulation of Wernicke's area. Therefore, ap coil orientation, which is regarded as standard in rTMS language mapping, could not be approved as the optimal position. With regard to stimulation parameters, 20 Hz and 120% of the resting motor threshold (RMT) were defined as optimal. CONCLUSIONS Coil angulation, stimulation frequency, and stimulation intensity have significant impacts on language impairment during rTMS mapping. The variation of only one of these parameters already leads to a clearer disruption of language performance. Therefore, individually adapted stimulation protocols have to be determined prior to language mapping in order to improve mapping results.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Thomas Obermueller
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Chiara Negwer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
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Hauck T, Tanigawa N, Probst M, Wohlschlaeger A, Ille S, Sollmann N, Maurer S, Zimmer C, Ringel F, Meyer B, Krieg SM. Stimulation frequency determines the distribution of language positive cortical regions during navigated transcranial magnetic brain stimulation. BMC Neurosci 2015; 16:5. [PMID: 25880838 PMCID: PMC4339007 DOI: 10.1186/s12868-015-0143-9] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2014] [Accepted: 02/11/2015] [Indexed: 11/28/2022] Open
Abstract
Background Although language mapping by repetitive navigated transcranial magnetic stimulation (rTMS) gains importance in neuropsychological research and clinical utility, neuroscientists still use different mapping protocols including different stimulation frequencies. To refine the existing language protocol, we tested two different repetition rates of 5 Hz/10 pulses and 7 Hz/10 pulses with a 0 ms delay in 19 healthy subjects. We furthermore investigated differences between both frequencies in case of performance of four different language tasks: object naming, pseudoword reading, verb generation, and action naming. Results Even the small variance in frequencies revealed statistically significant differences concerning the number and type of language errors. Stimulation with 5 Hz evoked a higher number of all occurred language errors in all language tasks (error rate object naming 14% (5 Hz) vs. 12% (7 Hz); pseudoword reading 4% (5 Hz) vs. 3% (7 Hz); verb generation 13% (5 Hz) vs. 11% (7 Hz); action naming 11% (5 Hz) vs. 9% (7 Hz)), whereas 7 Hz evoked specifically more total speech arrests. Conclusion These findings suggest that the stimulation frequency has to be adapted to the aim of the rTMS language investigation.
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Affiliation(s)
- Theresa Hauck
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Noriko Tanigawa
- Faculty of Linguistics, Philology, & Phonetics, University of Oxford, Walton Street, Oxford, OX1 2HG, UK.
| | - Monika Probst
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Afra Wohlschlaeger
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Claus Zimmer
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
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Rossini PM, Burke D, Chen R, Cohen LG, Daskalakis Z, Di Iorio R, Di Lazzaro V, Ferreri F, Fitzgerald PB, George MS, Hallett M, Lefaucheur JP, Langguth B, Matsumoto H, Miniussi C, Nitsche MA, Pascual-Leone A, Paulus W, Rossi S, Rothwell JC, Siebner HR, Ugawa Y, Walsh V, Ziemann U. Non-invasive electrical and magnetic stimulation of the brain, spinal cord, roots and peripheral nerves: Basic principles and procedures for routine clinical and research application. An updated report from an I.F.C.N. Committee. Clin Neurophysiol 2015; 126:1071-1107. [PMID: 25797650 PMCID: PMC6350257 DOI: 10.1016/j.clinph.2015.02.001] [Citation(s) in RCA: 1795] [Impact Index Per Article: 199.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2014] [Revised: 01/22/2015] [Accepted: 02/01/2015] [Indexed: 12/14/2022]
Abstract
These guidelines provide an up-date of previous IFCN report on “Non-invasive electrical and magnetic stimulation of the brain, spinal cord and roots: basic principles and procedures for routine clinical application” (Rossini et al., 1994). A new Committee, composed of international experts, some of whom were in the panel of the 1994 “Report”, was selected to produce a current state-of-the-art review of non-invasive stimulation both for clinical application and research in neuroscience. Since 1994, the international scientific community has seen a rapid increase in non-invasive brain stimulation in studying cognition, brain–behavior relationship and pathophysiology of various neurologic and psychiatric disorders. New paradigms of stimulation and new techniques have been developed. Furthermore, a large number of studies and clinical trials have demonstrated potential therapeutic applications of non-invasive brain stimulation, especially for TMS. Recent guidelines can be found in the literature covering specific aspects of non-invasive brain stimulation, such as safety (Rossi et al., 2009), methodology (Groppa et al., 2012) and therapeutic applications (Lefaucheur et al., 2014). This up-dated review covers theoretical, physiological and practical aspects of non-invasive stimulation of brain, spinal cord, nerve roots and peripheral nerves in the light of more updated knowledge, and include some recent extensions and developments.
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Affiliation(s)
- P M Rossini
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy
| | - D Burke
- Department of Neurology, Royal Prince Alfred Hospital, University of Sydney, Sydney, Australia
| | - R Chen
- Division of Neurology, Toronto Western Research Institute, University of Toronto, Toronto, Ontario, Canada
| | - L G Cohen
- Human Cortical Physiology and Neurorehabilitation Section, NINDS, NIH, Bethesda, MD, USA
| | - Z Daskalakis
- Temerty Centre for Therapeutic Brain Intervention, Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, Canada
| | - R Di Iorio
- Institute of Neurology, Department of Geriatrics, Neuroscience and Orthopedics, Catholic University, Policlinic A. Gemelli, Rome, Italy.
| | - V Di Lazzaro
- Department of Neurology, University Campus Bio-medico, Rome, Italy
| | - F Ferreri
- Department of Neurology, University Campus Bio-medico, Rome, Italy; Department of Clinical Neurophysiology, University of Eastern Finland, Kuopio, Finland
| | - P B Fitzgerald
- Monash Alfred Psychiatry Research Centre, Monash University Central Clinical School and The Alfred, Melbourne, Australia
| | - M S George
- Medical University of South Carolina, Ralph H. Johnson VA Medical Center, Charleston, SC, USA
| | - M Hallett
- Human Motor Control Section, Medical Neurology Branch, NINDS, NIH, Bethesda, MD, USA
| | - J P Lefaucheur
- Department of Physiology, Henri Mondor Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France; EA 4391, Nerve Excitability and Therapeutic Team, Faculty of Medicine, Paris Est Créteil University, Créteil, France
| | - B Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg, Regensburg, Germany
| | - H Matsumoto
- Department of Neurology, Japanese Red Cross Medical Center, Tokyo, Japan
| | - C Miniussi
- Department of Clinical and Experimental Sciences University of Brescia, Brescia, Italy; IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - M A Nitsche
- Department of Clinical Neurophysiology, University Medical Center Göttingen, Georg-August-University, Göttingen, Germany
| | - A Pascual-Leone
- Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - W Paulus
- Department of Clinical Neurophysiology, Georg-August University, Göttingen, Germany
| | - S Rossi
- Brain Investigation & Neuromodulation Lab, Unit of Neurology and Clinical Neurophysiology, Department of Neuroscience, University of Siena, Siena, Italy
| | - J C Rothwell
- Institute of Neurology, University College London, London, United Kingdom
| | - H R Siebner
- Department of Neurology, Copenhagen University Hospital Bispebjerg, Copenhagen, Denmark; Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - Y Ugawa
- Department of Neurology, School of Medicine, Fukushima Medical University, Fukushima, Japan
| | - V Walsh
- Institute of Cognitive Neuroscience, University College London, London, United Kingdom
| | - U Ziemann
- Department of Neurology & Stroke, and Hertie Institute for Clinical Brain Research, Eberhard Karls University, Tübingen, Germany
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Rogić Vidaković M, Schönwald MZ, Rotim K, Jurić T, Vulević Z, Tafra R, Banožić A, Hamata Ž, Đogaš Z. Excitability of contralateral and ipsilateral projections of corticobulbar pathways recorded as corticobulbar motor evoked potentials of the cricothyroid muscles. Clin Neurophysiol 2014; 126:1570-7. [PMID: 25481338 DOI: 10.1016/j.clinph.2014.11.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 10/27/2014] [Accepted: 11/03/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study was to evaluate the excitability of contralateral and ipsilateral corticobulbar pathways, using the methodologies of navigated transcranial magnetic stimulation (nTMS) and transcranial electrical stimulation (TES). METHODS In 11 healthy subjects, the primary motor cortex (M1) for laryngeal muscles was mapped with nTMS in both hemispheres and the corticobulbar motor evoked potentials (CoMEPs) were recorded from the right cricothyroid muscle. In 15 patients undergoing left craniotomy, CoMEPs were obtained from cricothyroid muscles bilaterally, using TES over C3/Cz and C4/Cz. RESULTS In five out of 11 healthy subjects, both contralateral and ipsilateral CoMEPs were recorded from the right cricothyroid muscle. In eight out of 15 patients, contralateral and ipsilateral CoMEPs were elicited with TES over C3/Cz, while in five out of 15 patients contralateral and ipsilateral CoMEPs were elicited with TES over C4/Cz. Contralateral CoMEP amplitude responses were significantly larger compared to ipsilateral CoMEP amplitudes in both groups. CONCLUSION We obtained significantly larger amplitude responses of contralateral CoMEPs from cricothyroid muscles compared to ipsilateral CoMEP amplitude using nTMS in healthy subjects and TES in patients. This confirms the bilateral nature of corticobulbar pathway projections for laryngeal muscles, with contralateral domination. SIGNIFICANCE These findings will influence recording of CoMEPs during preoperative and intraoperative mapping of M1 for laryngeal muscle representation, and they facilitate the pathophysiologic research of motor speech disorders.
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Affiliation(s)
- Maja Rogić Vidaković
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, Split, Croatia.
| | - Marina Zmajević Schönwald
- Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Clinical Medical Centre 'Sisters of Mercy', Zagreb, Croatia
| | - Krešimir Rotim
- Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Clinical Medical Centre 'Sisters of Mercy', Zagreb, Croatia
| | - Tomislav Jurić
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Zoran Vulević
- Department of Electronics, Faculty of Electrical Engineering, Mechanical Engineering and Naval Architecture, University of Split, Split, Croatia
| | - Robert Tafra
- Department of Ear, Nose and Throat with Head and Neck surgery, Clinical Medical Centre Split, Split, Croatia
| | - Adriana Banožić
- Department of Anatomy, Embryology and Histology, University of Split School of Medicine, Split, Croatia
| | - Željko Hamata
- Department of Neurosurgery, Clinical Unit for Intraoperative Neurophysiologic Monitoring, Clinical Medical Centre 'Sisters of Mercy', Zagreb, Croatia
| | - Zoran Đogaš
- Laboratory for Human and Experimental Neurophysiology (LAHEN), Department of Neuroscience, School of Medicine, University of Split, Split, Croatia
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Neurophysiologic markers in laryngeal muscles indicate functional anatomy of laryngeal primary motor cortex and premotor cortex in the caudal opercular part of inferior frontal gyrus. Clin Neurophysiol 2014; 125:1912-22. [DOI: 10.1016/j.clinph.2014.01.023] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2013] [Revised: 01/20/2014] [Accepted: 01/24/2014] [Indexed: 11/23/2022]
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