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Han Y, Jing Y, Li X, Zhou H, Deng F. Clinical characteristics of post-stroke basal ganglia aphasia and the study of language-related white matter tracts based on diffusion spectrum imaging. Neuroimage 2024; 295:120664. [PMID: 38825217 DOI: 10.1016/j.neuroimage.2024.120664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 05/12/2024] [Accepted: 05/30/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Stroke often damages the basal ganglia, leading to atypical and transient aphasia, indicating that post-stroke basal ganglia aphasia (PSBGA) may be related to different anatomical structural damage and functional remodeling rehabilitation mechanisms. The basal ganglia contain dense white matter tracts (WMTs). Hence, damage to the functional tract may be an essential anatomical structural basis for the development of PSBGA. METHODS We first analyzed the clinical characteristics of PSBGA in 28 patients and 15 healthy controls (HCs) using the Western Aphasia Battery and neuropsychological test batteries. Moreover, we investigated white matter injury during the acute stage using diffusion magnetic resonance imaging scans for differential tractography. Finally, we used multiple regression models in correlation tractography to analyze the relationship between various language functions and quantitative anisotropy (QA) of WMTs. RESULTS Compared with HCs, patients with PSBGA showed lower scores for fluency, comprehension (auditory word recognition and sequential commands), naming (object naming and word fluency), reading comprehension of sentences, Mini-Mental State Examination, and Montreal Cognitive Assessment, along with increased scores in Hamilton Anxiety Scale-17 and Hamilton Depression Scale-17 within 7 days after stroke onset (P < 0.05). Differential tractography revealed that patients with PSBGA had damaged fibers, including in the body fibers of the corpus callosum, left cingulum bundles, left parietal aslant tracts, bilateral superior longitudinal fasciculus II, bilateral thalamic radiation tracts, left fornix, corpus callosum tapetum, and forceps major, compared with HCs (FDR < 0.02). Correlation tractography highlighted that better comprehension was correlated with a higher QA of the left inferior fronto-occipital fasciculus (IFOF), corpus callosum forceps minor, and left extreme capsule (FDR < 0.0083). Naming was positively associated with the QA of the left IFOF, forceps minor, left arcuate fasciculus, and uncinate fasciculus (UF) (FDR < 0.0083). Word fluency of naming was also positively associated with the QA of the forceps minor, left IFOF, and thalamic radiation tracts (FDR < 0.0083). Furthermore, reading was positively correlated with the QA of the forceps minor, left IFOF, and UF (FDR < 0.0083). CONCLUSION PSBGA is primarily characterized by significantly impaired word fluency of naming and preserved repetition abilities, as well as emotional and cognitive dysfunction. Damaged limbic pathways, dorsally located tracts in the left hemisphere, and left basal ganglia pathways are involved in PSBGA pathogenesis. The results of connectometry analysis further refine the current functional localization model of higher-order neural networks associated with language functions.
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Affiliation(s)
- Yue Han
- Department of Neurology, The First Hospital of Jilin University, Changchun, PR China
| | - Yuanyuan Jing
- Department of Neurology, The First Hospital of Jilin University, Changchun, PR China
| | - Xuewei Li
- Department of Radiology, The First Hospital of Jilin University, Changchun, PR China
| | - Hongwei Zhou
- Department of Radiology, The First Hospital of Jilin University, Changchun, PR China.
| | - Fang Deng
- Department of Neurology, The First Hospital of Jilin University, Changchun, PR China.
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Bastiaanse R, Ohlerth AK. Presurgical Language Mapping: What Are We Testing? J Pers Med 2023; 13:jpm13030376. [PMID: 36983558 PMCID: PMC10055827 DOI: 10.3390/jpm13030376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 02/09/2023] [Accepted: 02/17/2023] [Indexed: 02/24/2023] Open
Abstract
Gliomas are brain tumors infiltrating healthy cortical and subcortical areas that may host cognitive functions, such as language. If these areas are damaged during surgery, the patient might develop word retrieval or articulation problems. For this reason, many glioma patients are operated on awake, while their language functions are tested. For this practice, quite simple tests are used, for example, picture naming. This paper describes the process and timeline of picture naming (noun retrieval) and shows the timeline and localization of the distinguished stages. This is relevant information for presurgical language testing with navigated Magnetic Stimulation (nTMS). This novel technique allows us to identify cortical involved in the language production process and, thus, guides the neurosurgeon in how to approach and remove the tumor. We argue that not only nouns, but also verbs should be tested, since sentences are built around verbs, and sentences are what we use in daily life. This approach’s relevance is illustrated by two case studies of glioma patients.
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Affiliation(s)
- Roelien Bastiaanse
- University of Groningen, P.O. Box 716, 9700 AS Groningen, The Netherlands
- Correspondence:
| | - Ann-Katrin Ohlerth
- Neurobiology of Language Department, Max Planck Institute for Psycholinguistics, P.O. Box 310, 6500 AH Nijmegen, The Netherlands
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Qu X, Wang Z, Cheng Y, Xue Q, Li Z, Li L, Feng L, Hartwigsen G, Chen L. Neuromodulatory effects of transcranial magnetic stimulation on language performance in healthy participants: Systematic review and meta-analysis. Front Hum Neurosci 2022; 16:1027446. [PMID: 36545349 PMCID: PMC9760723 DOI: 10.3389/fnhum.2022.1027446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background The causal relationships between neural substrates and human language have been investigated by transcranial magnetic stimulation (TMS). However, the robustness of TMS neuromodulatory effects is still largely unspecified. This study aims to systematically examine the efficacy of TMS on healthy participants' language performance. Methods For this meta-analysis, we searched PubMed, Web of Science, PsycINFO, Scopus, and Google Scholar from database inception until October 15, 2022 for eligible TMS studies on language comprehension and production in healthy adults published in English. The quality of the included studies was assessed with the Cochrane risk of bias tool. Potential publication biases were assessed by funnel plots and the Egger Test. We conducted overall as well as moderator meta-analyses. Effect sizes were estimated using Hedges'g (g) and entered into a three-level random effects model. Results Thirty-seven studies (797 participants) with 77 effect sizes were included. The three-level random effects model revealed significant overall TMS effects on language performance in healthy participants (RT: g = 0.16, 95% CI: 0.04-0.29; ACC: g = 0.14, 95% CI: 0.04-0.24). Further moderator analyses indicated that (a) for language tasks, TMS induced significant neuromodulatory effects on semantic and phonological tasks, but didn't show significance for syntactic tasks; (b) for cortical targets, TMS effects were not significant in left frontal, temporal or parietal regions, but were marginally significant in the inferior frontal gyrus in a finer-scale analysis; (c) for stimulation parameters, stimulation sites extracted from previous studies, rTMS, and intensities calibrated to the individual resting motor threshold are more prone to induce robust TMS effects. As for stimulation frequencies and timing, both high and low frequencies, online and offline stimulation elicited significant effects; (d) for experimental designs, studies adopting sham TMS or no TMS as the control condition and within-subject design obtained more significant effects. Discussion Overall, the results show that TMS may robustly modulate healthy adults' language performance and scrutinize the brain-and-language relation in a profound fashion. However, due to limited sample size and constraints in the current meta-analysis approach, analyses at a more comprehensive level were not conducted and results need to be confirmed by future studies. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=366481], identifier [CRD42022366481].
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Affiliation(s)
- Xingfang Qu
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zichao Wang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Yao Cheng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Qingwei Xue
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zimu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Lu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Liping Feng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Luyao Chen
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China,*Correspondence: Luyao Chen,
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Natalizi F, Piras F, Vecchio D, Spalletta G, Piras F. Preoperative Navigated Transcranial Magnetic Stimulation: New Insight for Brain Tumor-Related Language Mapping. J Pers Med 2022; 12:1589. [PMID: 36294728 PMCID: PMC9604795 DOI: 10.3390/jpm12101589] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 09/19/2022] [Accepted: 09/20/2022] [Indexed: 08/30/2023] Open
Abstract
Preoperative brain mapping methods are particularly important in modern neuro-oncology when a tumor affects eloquent language areas since damage to parts of the language circuits can cause significant impairments in daily life. This narrative review examines the literature regarding preoperative and intraoperative language mapping using repetitive navigated transcranial magnetic stimulation (rnTMS) with or without direct electrical stimulation (DES) in adult patients with tumors in eloquent language areas. The literature shows that rnTMS is accurate in detecting preexisting language disorders and positive intraoperative mapping regions. In terms of the region extent and clinical outcomes, rnTMS has been shown to be accurate in identifying positive sites to guide resection, reducing surgery duration and craniotomy size and thus improving clinical outcomes. Before incorporating rnTMS into the neurosurgical workflow, the refinement of protocols and a consensus within the neuro-oncology community are required.
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Affiliation(s)
- Federica Natalizi
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
- Department of Psychology, “Sapienza” University of Rome, Via dei Marsi 78, 00185 Rome, Italy
- PhD Program in Behavioral Neuroscience, Sapienza University of Rome, 00161 Rome, Italy
| | - Federica Piras
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Daniela Vecchio
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Gianfranco Spalletta
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
| | - Fabrizio Piras
- Laboratory of Neurophychiatry, IRCSS Santa Lucia Fundation, Via Ardeatina 306, 00134 Rome, Italy
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Wang Z, Xi Q, Zhang H, Song Y, Cao S. Different Neural Activities for Actions and Language within the Shared Brain Regions: Evidence from Action and Verb Generation. Behav Sci (Basel) 2022; 12:bs12070243. [PMID: 35877314 PMCID: PMC9312291 DOI: 10.3390/bs12070243] [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: 05/23/2022] [Revised: 07/11/2022] [Accepted: 07/19/2022] [Indexed: 01/27/2023] Open
Abstract
The Inferior Frontal Gyrus, Premotor Cortex and Inferior Parietal Lobe were suggested to be involved in action and language processing. However, the patterns of neural activities in the shared neural regions are still unclear. This study designed an fMRI experiment to analyze the neural activity associations between action and verb generation for object nouns. Using noun reading as a control task, we compared the differences and similarities of brain regions activated by action and verb generation. The results showed that the action generation task activated more in the dorsal Premotor Cortex (PMC), parts of the midline of PMC and the left Inferior Parietal Lobe (IPL) than the verb generation task. Subregions in the bilateral Supplementary Motor Area (SMA) and the left Inferior Frontal Gyrus (IFG) were found to be shared by action and verb generation. Then, mean activation level analysis and multi-voxel pattern analysis (MVPA) were performed in the overlapping activation regions of two generation tasks in the shared regions. The bilateral SMA and the left IFG were found to have overlapping activations with action and verb generation. All the shared regions were found to have different activation patterns, and the mean activation levels of the shared regions in the bilateral of SMA were significantly higher in the action generation. Based on the function of these brain regions, it can be inferred that the shared regions in the bilateral SMA and the left IFG process action and language generation in a task-specific and intention-specific manner, respectively.
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Affiliation(s)
- Zijian Wang
- School of Computer Science and Technology, Donghua University, Shanghai 200051, China
- Correspondence:
| | - Qian Xi
- Department of Radiology, Shanghai East Hospital, Tongji University School of Medicine, Shanghai 200120, China;
| | - Hong Zhang
- Department of Computer Science and Technology, Taiyuan Normal University, Taiyuan 030000, China;
| | - Yalin Song
- School of Software, Henan University, Kaifeng 475000, China;
| | - Shiqi Cao
- Department of Orthopaedics, the Fourth Medical Center, Chinese PLA General Hospital, Beijing 100048, China;
- Department of Orthopaedics of TCM Clinical Unit, the Sixth Medical Center, Chinese PLA General Hospital, Beijing 100048, China
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Ohlerth AK, Bastiaanse R, Nickels L, Neu B, Zhang W, Ille S, Sollmann N, Krieg SM. Dual-Task nTMS Mapping to Visualize the Cortico-Subcortical Language Network and Capture Postoperative Outcome-A Patient Series in Neurosurgery. Front Oncol 2022; 11:788122. [PMID: 35127493 PMCID: PMC8814635 DOI: 10.3389/fonc.2021.788122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Perioperative assessment of language function in brain tumor patients commonly relies on administration of object naming during stimulation mapping. Ample research, however, points to the benefit of adding verb tasks to the testing paradigm in order to delineate and preserve postoperative language function more comprehensively. This research uses a case series approach to explore the feasibility and added value of a dual-task protocol that includes both a noun task (object naming) and a verb task (action naming) in perioperative delineation of language functions. Materials and Methods Seven neurosurgical cases underwent perioperative language assessment with both object and action naming. This entailed preoperative baseline testing, preoperative stimulation mapping with navigated Transcranial Magnetic Stimulation (nTMS) with subsequent white matter visualization, intraoperative mapping with Direct Electrical Stimulation (DES) in 4 cases, and postoperative imaging and examination of language change. Results We observed a divergent pattern of language organization and decline between cases who showed lesions close to the delineated language network and hence underwent DES mapping, and those that did not. The latter displayed no new impairment postoperatively consistent with an unharmed network for the neural circuits of both object and action naming. For the cases who underwent DES, on the other hand, a higher sensitivity was found for action naming over object naming. Firstly, action naming preferentially predicted the overall language state compared to aphasia batteries. Secondly, it more accurately predicted intraoperative positive language areas as revealed by DES. Thirdly, double dissociations between postoperatively unimpaired object naming and impaired action naming and vice versa indicate segregated skills and neural representation for noun versus verb processing, especially in the ventral stream. Overlaying postoperative imaging with object and action naming networks revealed that dual-task nTMS mapping can explain the drop in performance in those cases where the network appeared in proximity to the resection cavity. Conclusion Using a dual-task protocol for visualization of cortical and subcortical language areas through nTMS mapping proved to be able to capture network-to-deficit relations in our case series. Ultimately, adding action naming to clinical nTMS and DES mapping may help prevent postoperative deficits of this seemingly segregated skill.
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Affiliation(s)
- Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, Groningen, Netherlands.,International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, and Macquarie University), Sydney, NSW, Australia
| | - Roelien Bastiaanse
- Center for Language and Brain, Higher School of Economics, National Research University, Moscow, Russia
| | - Lyndsey Nickels
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Beate Neu
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wei Zhang
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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