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Zahnert F, Kräling G, Melms L, Belke M, Kleinholdermann U, Timmermann L, Hirsch M, Jansen A, Mross P, Menzler K, Habermehl L, Knake S. Diffusion magnetic resonance imaging connectome features are predictive of functional lateralization of semantic processing in the anterior temporal lobes. Hum Brain Mapp 2022; 44:496-508. [PMID: 36098483 PMCID: PMC9842893 DOI: 10.1002/hbm.26074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2022] [Revised: 07/22/2022] [Accepted: 08/18/2022] [Indexed: 01/25/2023] Open
Abstract
Assessment of regional language lateralization is crucial in many scenarios, but not all populations are suited for its evaluation via task-functional magnetic resonance imaging (fMRI). In this study, the utility of structural connectome features for the classification of language lateralization in the anterior temporal lobes (ATLs) was investigated. Laterality indices for semantic processing in the ATL were computed from task-fMRI in 1038 subjects from the Human Connectome Project who were labeled as stronger rightward lateralized (RL) or stronger leftward to bilaterally lateralized (LL) in a data-driven approach. Data of unrelated subjects (n = 432) were used for further analyses. Structural connectomes were generated from diffusion-MRI tractography, and graph theoretical metrics (node degree, betweenness centrality) were computed. A neural network (NN) and a random forest (RF) classifier were trained on these metrics to classify subjects as RL or LL. After classification, comparisons of network measures were conducted via permutation testing. Degree-based classifiers produced significant above-chance predictions both during cross-validation (NN: AUC-ROC[CI] = 0.68[0.64-0.73], accuracy[CI] = 68.34%[63-73.2%]; RF: AUC-ROC[CI] = 0.7[0.66-0.73], accuracy[CI] = 64.81%[60.9-68.5]) and testing (NN: AUC-ROC[CI] = 0.69[0.53-0.84], accuracy[CI] = 68.09[53.2-80.9]; RF: AUC-ROC[CI] = 0.68[0.53-0.84], accuracy[CI] = 68.09[55.3-80.9]). Comparison of network metrics revealed small effects of increased node degree within the right posterior middle temporal gyrus (pMTG) in subjects with RL, while degree was decreased in the right posterior cingulate cortex (PCC). Above-chance predictions of functional language lateralization in the ATL are possible based on diffusion-MRI connectomes alone. Increased degree within the right pMTG as a right-sided homologue of a known semantic hub, and decreased hubness of the right PCC may form a structural basis for rightward-lateralized semantic processing.
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Affiliation(s)
- Felix Zahnert
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Gunter Kräling
- Department of Medical TechnologyUniversity Hospital MarburgMarburgGermany
| | - Leander Melms
- Institute for Artificial IntelligenceUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Marcus Belke
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany,LOEWE Center for Personalized Translational Epilepsy Research (CePTER)Goethe‐University FrankfurtFrankfurt Am MainGermany
| | - Urs Kleinholdermann
- Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Lars Timmermann
- Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany,Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany,Core Facility Brainimaging, Faculty of MedicineUniversity of MarburgMarburgGermany
| | - Martin Hirsch
- Institute for Artificial IntelligenceUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Andreas Jansen
- Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany,Core Facility Brainimaging, Faculty of MedicineUniversity of MarburgMarburgGermany,Department for Psychiatry and PsychotherapyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Peter Mross
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Katja Menzler
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany,Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany,Core Facility Brainimaging, Faculty of MedicineUniversity of MarburgMarburgGermany
| | - Lena Habermehl
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany
| | - Susanne Knake
- Epilepsy Center Hesse, Department for NeurologyUniversity Hospital Marburg, Philipps University MarburgMarburgGermany,LOEWE Center for Personalized Translational Epilepsy Research (CePTER)Goethe‐University FrankfurtFrankfurt Am MainGermany,Center for Mind, Brain and Behavior (CMBB)Philipps‐University MarburgMarburgGermany,Core Facility Brainimaging, Faculty of MedicineUniversity of MarburgMarburgGermany
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Wu D, Zhang M, Geng J, Chen X. Noninvasive Prediction of Language Lateralization Through Arcuate Fasciculus Tractography in Patients With Low-Grade Gliomas: Correlation With The Wada Test. Front Oncol 2022; 12:936228. [PMID: 35936675 PMCID: PMC9354698 DOI: 10.3389/fonc.2022.936228] [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: 05/05/2022] [Accepted: 06/15/2022] [Indexed: 11/13/2022] Open
Abstract
Language lateralization is unique to humans, so clarifying dominant side is helpful for removing gliomas involving language areas. This study investigated the arcuate fasciculus (AF) reconstructed by diffusion tensor imaging–based tractography (DTT) in predicting language lateralization in patients with low-grade gliomas. Wada test was performed to determine the language Dominant Hemisphere (DH) and the Contralateral Hemisphere. DTI data [1.5-T magnetic resonance imaging (MRI)] was used to reconstruct AF by two independent operators using a DTT method. Fiber number, volume, and fractional anisotropy (FA) of bilateral reconstructed AF were measured. Lateralization indexes (LIs), including Number Index (NI), Volume Index (VI), and FA Index (FI), were accordingly calculated by mean values. A total of 21 patients with WHO Grade II gliomas in the left hemisphere were included. Every patient received a successful Wada test and reconstruction of bilateral AF. DTT metrics of reconstructed AF, such as fiber number, volume, and FA, showed significantly asymmetric between hemispheres. All the LI (NI, VI, and FI) values were statistically higher in the DH determined by the Wada test. No discrepancy was found between the prediction using the cutoff values of DTT metrics and the results of WADA test. The Kappa values were 0.829, 0.696, and 0.611, indicating NI and VI as more reliable predictor than FI although FI itself may also be feasible. Compared with the Wada test, we consider that DTT of AF is a non-invasive, simple, relatively accurate, and feasible method in predicting language lateralization in patients with low-grade gliomas.
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Affiliation(s)
- Dongdong Wu
- Department of Neurosurgery, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Meng Zhang
- Department of Neurosurgery, The Second Hospital of Southern Theater of Chinese Navy, Sanya, China
| | - Jiefeng Geng
- Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University, Zhengzhou, China
| | - Xiaolei Chen
- Department of Neurosurgery, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
- *Correspondence: Xiaolei Chen,
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Yazbek S, Hage S, Mallak I, Smayra T. Tractography of the arcuate fasciculus in healthy right-handed and left-handed multilingual subjects and its relation to language lateralization on functional MRI. Sci Rep 2021; 11:20936. [PMID: 34686728 PMCID: PMC8536719 DOI: 10.1038/s41598-021-00490-5] [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: 05/09/2021] [Accepted: 10/13/2021] [Indexed: 11/10/2022] Open
Abstract
Functional MRI (fMRI) enables evaluation of language cortical organization and plays a central role in surgical planning. Diffusion Tensor Imaging (DTI) or Tractography, allows evaluation of the white matter fibers involved in language. Unlike fMRI, DTI does not rely on the patient’s cooperation. In monolinguals, there is a significant correlation between the lateralization of language on fMRI and on DTI. Our objective is to delineate the arcuate fasciculus (AF) in right- and left-handed trilinguals and determine if the AF laterality on DTI is correlated to language lateralization on fMRI. 15 right and 15 left-handed trilingual volunteers underwent fMRI and DTI. Laterality Index was determined on fMRI (fMRI-LI). Mean Diffusivity, Fractional Anisotropy (FA), Number of Fibers, Fiber Length, Fiber Volume and Laterality Index (DTI-LI) of the AF were calculated on DTI. 28 of the 30 subjects presented a bilateral AF. Most subjects (52%) were found to have a bilateral language lateralization of the AF on DTI. Only 4 subjects had bilateral lateralization of language on fMRI. The right AF demonstrated lower diffusivity than the left AF in the total participants, the right-handed, and the left-handed subjects. FA, Volume and Length of the AF were not significantly different between the two hemispheres. No correlation was found between the DTI-LI of the AF and the fMRI-LI. A prominent role of the right AF and a bilateral structural organization of the AF was present in our multilingual population regardless of their handedness. While in prior studies DTI was able to determine language lateralization in monolingual subjects, this was not possible in trilingual highly educated subjects.
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Affiliation(s)
- Sandrine Yazbek
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Stephanie Hage
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Iyad Mallak
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon
| | - Tarek Smayra
- Medical School, Hotel-Dieu de France Hospital, Saint Joseph University, Boulevard Alfred Naccache, Achrafieh, PO Box 166830, Beirut, Lebanon.
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Di Cristofori A, Basso G, de Laurentis C, Mauri I, Sirtori MA, Ferrarese C, Isella V, Giussani C. Perspectives on (A)symmetry of Arcuate Fasciculus. A Short Review About Anatomy, Tractography and TMS for Arcuate Fasciculus Reconstruction in Planning Surgery for Gliomas in Language Areas. Front Neurol 2021; 12:639822. [PMID: 33643213 PMCID: PMC7902861 DOI: 10.3389/fneur.2021.639822] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Accepted: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
Gliomas are brain tumors that are treated with surgical resection. Prognosis is influenced by the extent of resection and postoperative neurological status. As consequence, given the extreme interindividual and interhemispheric variability of subcortical white matter (WM) surgical planning requires to be patient's tailored. According to the “connectionist model,” there is a huge variability among both cortical areas and subcortical WM in all human beings, and it is known that brain is able to reorganize itself and to adapt to WM lesions. Brain magnetic resonance imaging diffusion tensor imaging (DTI) tractography allows visualization of WM bundles. Nowadays DTI tractography is widely available in the clinical setting for presurgical planning. Arcuate fasciculus (AF) is a long WM bundle that connects the Broca's and Wernicke's regions with a complex anatomical architecture and important role in language functions. Thus, its preservation is important for the postoperative outcome, and DTI tractography is usually performed for planning surgery within the language-dominant hemisphere. High variability among individuals and an asymmetrical pattern has been reported for this WM bundle. However, the functional relevance of AF in the contralateral non-dominant hemisphere in case of tumoral or surgical lesion of the language-dominant AF is unclear. This review focuses on AF anatomy with special attention to its asymmetry in both normal and pathological conditions and how it may be explored with preoperative tools for planning surgery on gliomas in language areas. Based on the findings available in literature, we finally speculate about the potential role of preoperative evaluation of the WM contralateral to the surgical site.
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Affiliation(s)
| | - Gianpaolo Basso
- Neurosurgery Unit, San Gerardo Hospital, ASST Monza, Monza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,Neuroradiology Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Camilla de Laurentis
- Neurosurgery Unit, San Gerardo Hospital, ASST Monza, Monza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
| | - Ilaria Mauri
- Neurology Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | | | - Carlo Ferrarese
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,Neurology Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Valeria Isella
- School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.,Neurology Unit, San Gerardo Hospital, ASST Monza, Monza, Italy
| | - Carlo Giussani
- Neurosurgery Unit, San Gerardo Hospital, ASST Monza, Monza, Italy.,School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy
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