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Schnaufer L, Gschaidmeier A, Heimgärtner M, Driever PH, Hauser TK, Wilke M, Lidzba K, Staudt M. Atypical language organization following perinatal infarctions of the left hemisphere is associated with structural changes in right-hemispheric grey matter. Dev Med Child Neurol 2024; 66:353-361. [PMID: 37691416 DOI: 10.1111/dmcn.15751] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/25/2022] [Revised: 08/04/2023] [Accepted: 08/09/2023] [Indexed: 09/12/2023]
Abstract
AIM To assess how atypical language organization after early left-hemispheric brain lesions affects grey matter in the contralesional hemisphere. METHOD This was a cross-sectional study with between-group comparisons of 14 patients (six female, 8-26 years) with perinatal left-hemispheric brain lesions (two arterial ischemic strokes, 11 periventricular haemorrhagic infarctions, one without classification) and 14 typically developing age-matched controls (TDC) with functional magnetic resonance imaging (fMRI) documented left-hemispheric language organization (six female, 8-28 years). MRI data were analysed with SPM12, CAT12, and custom scripts. Language lateralization indices were determined by fMRI within a prefrontal mask and right-hemispheric grey matter group differences by voxel-based morphometry (VBM). RESULTS FMRI revealed left-dominance in seven patients with typical language organization (TYP) and right-dominance in seven patients with atypical language organization (ATYP) of 14 patients. VBM analysis of all patients versus controls showed grey matter reductions in the middle temporal gyrus of patients. A comparison between the two patient subgroups revealed an increase of grey matter in the middle frontal gyrus in the ATYP group. Voxel-based regression analysis confirmed that grey matter increases in the middle frontal gyrus were correlated with atypical language organization. INTERPRETATION Compatible with a non-specific lesion effect, we found areas of grey matter reduction in patients as compared to TDC. The grey matter increase in the middle frontal gyrus seems to reflect a specific compensatory effect in patients with atypical language organization. WHAT THIS PAPER ADDS Perinatal stroke leads to decreased grey matter in the contralesional hemisphere. Atypical language organization is associated with grey matter increases in contralesional language areas.
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Affiliation(s)
- Lukas Schnaufer
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
- Experimental Paediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | - Alisa Gschaidmeier
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
- Centre for Paediatric Neurology, Neurorehabilitation and Epileptology, Schön Klinik, Vogtareuth, Germany
| | - Magdalena Heimgärtner
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
| | - Pablo Hernáiz Driever
- Department of Paediatric Oncology and Haematology, Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin, Humboldt-Universität zu Berlin and Berlin Institute of Health, Berlin, Germany
| | - Till-Karsten Hauser
- Department of Diagnostic and Interventional Neuroradiology, University Hospital, Tübingen, Germany
| | - Marko Wilke
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
- Experimental Paediatric Neuroimaging, Children's Hospital and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | - Karen Lidzba
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
- Division of Neuropaediatrics, Development and Rehabilitation, University Children's Hospital Inselspital, Bern University Hospital, University of Bern, Switzerland
| | - Martin Staudt
- Department of Paediatric Neurology and Developmental Medicine, University Children's Hospital, Tübingen, Germany
- Centre for Paediatric Palliative Care, University Children's Hospital, Ludwig-Maximilians-University Munich, Munich, Germany
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Al-Arfaj HK, Al-Sharydah AM, AlSuhaibani SS, Alaqeel S, Yousry T. Task-Based and Resting-State Functional MRI in Observing Eloquent Cerebral Areas Personalized for Epilepsy and Surgical Oncology Patients: A Review of the Current Evidence. J Pers Med 2023; 13:jpm13020370. [PMID: 36836604 PMCID: PMC9964201 DOI: 10.3390/jpm13020370] [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: 12/10/2022] [Revised: 01/23/2023] [Accepted: 02/15/2023] [Indexed: 02/22/2023] Open
Abstract
Functional magnetic resonance imaging (fMRI) is among the newest techniques of advanced neuroimaging that offer the opportunity for neuroradiologists, neurophysiologists, neuro-oncologists, and neurosurgeons to pre-operatively plan and manage different types of brain lesions. Furthermore, it plays a fundamental role in the personalized evaluation of patients with brain tumors or patients with an epileptic focus for preoperative planning. While the implementation of task-based fMRI has increased in recent years, the existing resources and evidence related to this technique are limited. We have, therefore, conducted a comprehensive review of the available resources to compile a detailed resource for physicians who specialize in managing patients with brain tumors and seizure disorders. This review contributes to the existing literature because it highlights the lack of studies on fMRI and its precise role and applicability in observing eloquent cerebral areas in surgical oncology and epilepsy patients, which we believe is underreported. Taking these considerations into account would help to better understand the role of this advanced neuroimaging technique and, ultimately, improve patient life expectancy and quality of life.
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Affiliation(s)
| | - Abdulaziz Mohammad Al-Sharydah
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
- Correspondence: ; Fax: +966-013-8676697
| | - Sari Saleh AlSuhaibani
- Diagnostic and Interventional Radiology Department, King Fahd Hospital of the University, Imam Abdulrahman Bin Faisal University, Dammam 34221, Saudi Arabia
| | - Soliman Alaqeel
- Medical Imaging Department, Dammam Medical Complex, Ministry of Health, Dammam 11176, Saudi Arabia
| | - Tarek Yousry
- Division of Neuroradiology and Neurophysics, Lysholm Department of Neuroradiology, UCL IoN, UCLH, London NW1 2BU, UK
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Holloway T, Leach JL, Tenney JR, Byars AW, Horn PS, Greiner HM, Mangano FT, Holland KD, Arya R. Functional MRI and electrical stimulation mapping for language localization: A comparative meta-analysis. Clin Neurol Neurosurg 2022; 222:107417. [DOI: 10.1016/j.clineuro.2022.107417] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 08/13/2022] [Accepted: 08/17/2022] [Indexed: 11/15/2022]
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Herfurth K, Harpaz Y, Roesch J, Mueller N, Walther K, Kaltenhaeuser M, Pauli E, Goldstein A, Hamer H, Buchfelder M, Doerfler A, Prell J, Rampp S. Localization of beta power decrease as measure for lateralization in pre-surgical language mapping with magnetoencephalography, compared with functional magnetic resonance imaging and validated by Wada test. Front Hum Neurosci 2022; 16:996989. [PMID: 36393988 PMCID: PMC9644652 DOI: 10.3389/fnhum.2022.996989] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 10/04/2022] [Indexed: 11/04/2023] Open
Abstract
Objective: Atypical patterns of language lateralization due to early reorganizational processes constitute a challenge in the pre-surgical evaluation of patients with pharmaco-resistant epilepsy. There is no consensus on an optimal analysis method used for the identification of language dominance in MEG. This study examines the concordance between MEG source localization of beta power desynchronization and fMRI with regard to lateralization and localization of expressive and receptive language areas using a visual verb generation task. Methods: Twenty-five patients with pharmaco-resistant epilepsy, including six patients with atypical language lateralization, and ten right-handed controls obtained MEG and fMRI language assessment. Fourteen patients additionally underwent the Wada test. We analyzed MEG beta power desynchronization in sensor (controls) and source space (patients and controls). Beta power decrease between 13 and 35 Hz was localized applying Dynamic Imaging of Coherent Sources Beamformer technique. Statistical inferences were grounded on cluster-based permutation testing for single subjects. Results: Event-related desynchronization of beta power in MEG was seen within the language-dominant frontal and temporal lobe and within the premotor cortex. Our analysis pipeline consistently yielded left language dominance with high laterality indices in controls. Language lateralization in MEG and Wada test agreed in all 14 patients for inferior frontal, temporal and parietal language areas (Cohen's Kappa = 1, p < 0.001). fMRI agreed with Wada test in 12 out of 14 cases (85.7%) for Broca's area (Cohen's Kappa = 0.71, p = 0.024), while the agreement for temporal and temporo-parietal language areas were non-significant. Concordance between MEG and fMRI laterality indices was highest within the inferior frontal gyrus, with an agreement in 19/24 cases (79.2%), and non-significant for Wernicke's area. Spatial agreement between fMRI and MEG varied considerably between subjects and brain regions with the lowest Euclidean distances within the inferior frontal region of interest. Conclusion: Localizing the desynchronization of MEG beta power using a verb generation task is a promising tool for the identification of language dominance in the pre-surgical evaluation of epilepsy patients. The overall agreement between MEG and fMRI was lower than expected and might be attributed to differences within the baseline condition. A larger sample size and an adjustment of the experimental designs are needed to draw further conclusions.
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Affiliation(s)
- Kirsten Herfurth
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Yuval Harpaz
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Julie Roesch
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Nadine Mueller
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Katrin Walther
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | | | - Elisabeth Pauli
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Abraham Goldstein
- The Gonda Multidisciplinary Brain Research Center, Bar-Ilan University, Ramat Gan, Israel
| | - Hajo Hamer
- Epilepsy Center, Department of Neurology, University Hospital Erlangen, Erlangen, Germany
| | - Michael Buchfelder
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
| | - Arnd Doerfler
- Department of Neuroradiology, University Hospital Erlangen, Erlangen, Germany
| | - Julian Prell
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
| | - Stefan Rampp
- Department of Neurosurgery, University Hospital Erlangen, Erlangen, Germany
- Department of Neurosurgery, University Hospital Halle, Halle (Saale), Germany
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Massot-Tarrús A, Mirsattari SM. Roles of fMRI and Wada tests in the presurgical evaluation of language functions in temporal lobe epilepsy. Front Neurol 2022; 13:884730. [PMID: 36247757 PMCID: PMC9562037 DOI: 10.3389/fneur.2022.884730] [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: 02/26/2022] [Accepted: 08/26/2022] [Indexed: 11/21/2022] Open
Abstract
Surgical treatment of pharmacoresistant temporal lobe epilepsy (TLE) carries risks for language function that can significantly affect the quality of life. Predicting the risks of decline in language functions before surgery is, consequently, just as important as predicting the chances of becoming seizure-free. The intracarotid amobarbital test, generally known as the Wada test (WT), has been traditionally used to determine language lateralization and to estimate their potential decline after surgery. However, the test is invasive and it does not localize the language functions. Therefore, other noninvasive methods have been proposed, of which functional magnetic resonance (fMRI) has the greatest potential. Functional MRI allows localization of language areas. It has good concordance with the WT for language lateralization, and it is of predictive value for postsurgical naming outcomes. Consequently, fMRI has progressively replaced WT for presurgical language evaluation. The objective of this manuscript is to review the most relevant aspects of language functions in TLE and the current role of fMRI and WT in the presurgical evaluation of language. First, we will provide context by revising the language network distribution and the effects of TLE on them. Then, we will assess the functional outcomes following various forms of TLE surgery and measures to reduce postoperative language decline. Finally, we will discuss the current indications for WT and fMRI and the potential usefulness of the resting-state fMRI technique.
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Affiliation(s)
| | - Seyed M. Mirsattari
- Department of Clinical Neurological Sciences, Western University, London, ON, Canada
- Department of Medical Biophysics, Western University, London, ON, Canada
- Department of Medical Imaging, Western University, London, ON, Canada
- Department of Psychology, Western University, London, ON, Canada
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Leveraging manifold learning techniques to explore white matter anomalies: An application of the TractLearn pipeline in epilepsy. Neuroimage Clin 2022; 36:103209. [PMID: 36162235 PMCID: PMC9668609 DOI: 10.1016/j.nicl.2022.103209] [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: 05/22/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 12/14/2022]
Abstract
An accurate description of brain white matter anatomy in vivo remains a challenge. However, technical progress allows us to analyze structural variations in an increasingly sophisticated way. Current methods of processing diffusion MRI data now make it possible to correct some limiting biases. In addition, the development of statistical learning algorithms offers the opportunity to analyze the data from a new perspective. We applied newly developed tractography models to extract quantitative white matter parameters in a group of patients with chronic temporal lobe epilepsy. Furthermore, we implemented a statistical learning workflow optimized for the MRI diffusion data - the TractLearn pipeline - to model inter-individual variability and predict structural changes in patients. Finally, we interpreted white matter abnormalities in the context of several other parameters reflecting clinical status, as well as neuronal and cognitive functioning for these patients. Overall, we show the relevance of such a diffusion data processing pipeline for the evaluation of clinical populations. The "global to fine scale" funnel statistical approach proposed in this study also contributes to the understanding of neuroplasticity mechanisms involved in refractory epilepsy, thus enriching previous findings.
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Elin K, Malyutina S, Bronov O, Stupina E, Marinets A, Zhuravleva A, Dragoy O. A New Functional Magnetic Resonance Imaging Localizer for Preoperative Language Mapping Using a Sentence Completion Task: Validity, Choice of Baseline Condition, and Test–Retest Reliability. Front Hum Neurosci 2022; 16:791577. [PMID: 35431846 PMCID: PMC9006995 DOI: 10.3389/fnhum.2022.791577] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2021] [Accepted: 03/04/2022] [Indexed: 11/24/2022] Open
Abstract
To avoid post-neurosurgical language deficits, intraoperative mapping of the language function in the brain can be complemented with preoperative mapping with functional magnetic resonance imaging (fMRI). The validity of an fMRI “language localizer” paradigm crucially depends on the choice of an optimal language task and baseline condition. This study presents a new fMRI “language localizer” in Russian using overt sentence completion, a task that comprehensively engages the language function by involving both production and comprehension at the word and sentence level. The paradigm was validated in 18 neurologically healthy volunteers who participated in two scanning sessions, for estimating test–retest reliability. For the first time, two baseline conditions for the sentence completion task were compared. At the group level, the paradigm significantly activated both anterior and posterior language-related regions. Individual-level analysis showed that activation was elicited most consistently in the inferior frontal regions, followed by posterior temporal regions and the angular gyrus. Test–retest reliability of activation location, as measured by Dice coefficients, was moderate and thus comparable to previous studies. Test–retest reliability was higher in the frontal than temporo-parietal region and with the most liberal statistical thresholding compared to two more conservative thresholding methods. Lateralization indices were expectedly left-hemispheric, with greater lateralization in the frontal than temporo-parietal region, and showed moderate test-retest reliability. Finally, the pseudoword baseline elicited more extensive and more reliable activation, although the syllable baseline appears more feasible for future clinical use. Overall, the study demonstrated the validity and reliability of the sentence completion task for mapping the language function in the brain. The paradigm needs further validation in a clinical sample of neurosurgical patients. Additionally, the study contributes to general evidence on test–retest reliability of fMRI.
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Affiliation(s)
- Kirill Elin
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Svetlana Malyutina
- Center for Language and Brain, HSE University, Moscow, Russia
- *Correspondence: Svetlana Malyutina,
| | - Oleg Bronov
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | | | - Aleksei Marinets
- Department of Radiology, National Medical and Surgical Center Named After N.I. Pirogov, Moscow, Russia
| | - Anna Zhuravleva
- Center for Language and Brain, HSE University, Moscow, Russia
| | - Olga Dragoy
- Center for Language and Brain, HSE University, Moscow, Russia
- Institute of Linguistics, Russian Academy of Sciences, Moscow, Russia
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Samson S, Denos M. Neuropsychology of temporal lobe epilepsies. HANDBOOK OF CLINICAL NEUROLOGY 2022; 187:519-529. [PMID: 35964990 DOI: 10.1016/b978-0-12-823493-8.00012-2] [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
This chapter focuses on the neuropsychology of adults with temporal lobe epilepsy (TLE). First, a thorough description of the brain-behavior relationship characterizing focal TLE with and without hippocampal sclerosis is presented. Then, the aim and the specificity of the NPA in the care of epilepsy are described. Considering the high frequency of medically intractable TLE that can be treated by surgery, an assessment carried out in the context of pre- and postoperative evaluation is presented and discussed in light of insights from functional neuroimaging findings. Finally, we propose concluding remarks about the place of neuropsychology in the care of epilepsy in improving our understanding of the cognitive and emotional phenotypes associated with TLE.
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Affiliation(s)
- Séverine Samson
- Department of Psychology, University of Lille, Lille, France; Epilepsy Unit, Neurosciences Department, Hôpital de la Pitié-Salpêtrière, Paris, France.
| | - Marisa Denos
- Rehabilitation Unit, Neurosciences Department, Hôpital de la Pitié-Salpêtrière, Paris, France
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Clinical Speech fMRI in Children and Adolescents : Development of an Optimal Protocol and Analysis Algorithm. Clin Neuroradiol 2021; 32:185-196. [PMID: 34613421 PMCID: PMC8894226 DOI: 10.1007/s00062-021-01097-z] [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: 12/12/2020] [Accepted: 08/31/2021] [Indexed: 11/28/2022]
Abstract
Purpose In patients with drug-resistant focal epilepsy, surgical resection is often the only treatment option to achieve long-term seizure control. Prior to brain surgery involving potential language areas, identification of hemispheric language dominance is crucial. Our group developed and validated a functional magnetic resonance imaging (fMRI) battery of four pediatric language tasks. The present study aimed at optimizing fMRI data acquisition and analysis using these tasks. Methods We retrospectively analyzed speech fMRI examinations of 114 neuropediatric patients (age range 5.8–17.8 years) who were examined prior to possible epilepsy surgery. In order to evaluate hemispheric language dominance, 1–4 language tasks (vowel identification task VIT, word-chain task WCT, beep-story task BST, synonym task SYT) were measured. Results Language dominance was classified using fMRI activation in the 13 validly lateralizing ROIs (VLR) in frontal, temporal and parietal lobes and cerebellum of the recent validation study from our group: 47/114 patients were classified as left-dominant, 34/114 as bilateral and 6/114 as right-dominant. In an attempt to enlarge the set of VLR, we then compared for each task agreement of these ROI activations with the classified language dominance. We found four additional task-specific ROIs showing concordant activation and activation in ≥ 10 sessions, which we termed validly lateralizing (VLRnew). The new VLRs were: for VIT the temporal language area and for SYT the middle frontal gyrus, the intraparietal sulcus and cerebellum. Finally, in order to find the optimal sequence of measuring the different tasks, we analyzed the success rates of single tasks and all possible task combinations. The sequence 1) VIT 2) WCT 3) BST 4) SYT was identified as the optimal sequence, yielding the highest chance to obtain reliable results even when the fMRI examination has to be stopped, e.g., due to lack of cooperation. Conclusion Our suggested task order together with the enlarged set of VLRnew may contribute to optimize pediatric speech fMRI in a clinical setting. Supplementary Information The online version of this article (10.1007/s00062-021-01097-z) contains supplementary material, which is available to authorized users.
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Maruyama S. [Activation Dynamics Analysis of Language-related Areas with High Temporal Resolution fMRI]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2021; 77:941-946. [PMID: 34544918 DOI: 10.6009/jjrt.2021_jsrt_77.9.941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
PURPOSE To investigate the activation dynamics of language-related areas from multiple activation maps by performing analysis while shifting the signal change model from the actual stimulation timing along the temporal axis using high temporal resolution fMRI data. METHODS High temporal resolution fMRI data were obtained using 3T MRI. Ten healthy right-handed volunteers participated in the study. Task paradigm was block design to carry out two sets of the rest periods and word-generation tasks. Data analysis was performed using SPM 12 software. We created several different activation maps of different phases by shifting the signal change model along the temporal axis, and the activation dynamics of activation areas were analyzed. RESULTS In the activation dynamics analysis, there was a tendency for activation to become stronger in the order of bilateral superior temporal gyrus and supplementary motor area, left angular gyrus with slight delay, and then left middle and inferior frontal gyrus. This result was considered to reflect the processing process in the brain during the word-generation task. CONCLUSIONS It was suggested that this analysis method is useful for activation dynamics analysis.
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Affiliation(s)
- Sumito Maruyama
- Department of Radiological Sciences, School of Health Sciences, International University of Health and Welfare
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Koop JI, Credille K, Wang Y, Loman M, Marashly A, Kim I, Lew SM, Maheshwari M. Determination of language dominance in pediatric patients with epilepsy for clinical decision-making: Correspondence of intracarotid amobarbitol procedure and fMRI modalities. Epilepsy Behav 2021; 121:108041. [PMID: 34082317 DOI: 10.1016/j.yebeh.2021.108041] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/04/2021] [Accepted: 05/04/2021] [Indexed: 11/29/2022]
Abstract
Identification of the language dominant hemisphere is an essential part of the evaluation of potential pediatric epilepsy surgery patients. Historically, language dominance has been determined using the intracarotid amobarbitol procedure (IAP), but use of functional Magnetic Resonance Imaging (fMRI) scanning is becoming more common. Few studies examine the correspondence between fMRI and IAP in pediatric samples. The current study examined the agreement of hemispheric lateralization as determined by fMRI and IAP in a consecutive sample of 10 pediatric patients with epilepsy evaluated for epilepsy surgery. Data showed a strong correlation between IAP and fMRI lateralilty indices (r=.91) and 70% agreement in determination of hemispheric dominance, despite increased demonstration of bilateral or atypical language representation in this pediatric sample. Clinical implications and interpretation challenges are discussed.
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Affiliation(s)
- Jennifer I Koop
- Department of Neurology (Neuropsychology), Medical College of Wisconsin, Milwaukee, WI, United States.
| | - Kevin Credille
- Medical College of Wisconsin, Milwaukee, WI, United States
| | - Yang Wang
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Michelle Loman
- Department of Neurology (Neuropsychology), Medical College of Wisconsin, Milwaukee, WI, United States
| | - Ahmad Marashly
- Division of Pediatric Neurology, University of Washington/Seattle Children's Hospital, Seattle, WA, United States
| | - Irene Kim
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Sean M Lew
- Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, United States
| | - Mohit Maheshwari
- Department of Radiology, Medical College of Wisconsin, Milwaukee, WI, United States
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Beyond the Wada: An updated approach to pre-surgical language and memory testing: An updated review of available evaluation techniques and recommended workflow to limit Wada test use to essential clinical cases. Epilepsy Res 2021; 174:106673. [PMID: 34082393 DOI: 10.1016/j.eplepsyres.2021.106673] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Revised: 04/27/2021] [Accepted: 05/13/2021] [Indexed: 11/21/2022]
Abstract
The Intracarotid amobarbital test (IAT), also called Wada test, is considered the "gold standard" for lateralizing language dominance in the pre-surgical evaluation of patients with epilepsy. In addition, it has been further modified to assess the postoperative risk of amnesia in patients undergoing temporal lobectomy. Since then it has been utilized to lateralize language and assess pre-surgical memory function. Over the years, its popularity has declined due to several limitations and availability of alternative procedures like fMRI and MEG. A survey of its use in the pre-surgical evaluation for epilepsy surgery has not been performed since the 2008 international survey by Baxendale et al. and it was heavily skewed due to data from European and North American countries. Only approximately 12% of the epilepsy centers indicated that they used the Wada test in every patient to assess preoperative memory function and language lateralization before temporal lobectomy. Nowadays, we have many functional mapping tools at our disposal. It has become somewhat unsuitable to have epilepsy patients undergo an invasive test such as the Wada test for the risks associated with it outweigh the benefits. Our objective is to review the Wada Test and alternative methods of assessing language and memory dominance, as it is past its prime and should only be used in specific circumstances.
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Youssofzadeh V, Stout J, Ustine C, Gross WL, Conant LL, Humphries CJ, Binder JR, Raghavan M. Mapping language from MEG beta power modulations during auditory and visual naming. Neuroimage 2020; 220:117090. [DOI: 10.1016/j.neuroimage.2020.117090] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2020] [Revised: 06/06/2020] [Accepted: 06/23/2020] [Indexed: 01/22/2023] Open
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Ma S, Li Y, Liu Y, Xu C, Li H, Yao Q, Wang Y, Yang Z, Zuo P, Yang M, Mo X. Changes in Cortical Thickness Are Associated With Cognitive Ability in Postoperative School-Aged Children With Tetralogy of Fallot. Front Neurol 2020; 11:691. [PMID: 32765405 PMCID: PMC7380078 DOI: 10.3389/fneur.2020.00691] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Accepted: 06/09/2020] [Indexed: 11/25/2022] Open
Abstract
In children with tetralogy of Fallot (TOF), there is a risk of brain injury even if intracardiac deformities are corrected. This population follow-up study aimed to identify the correlation between cerebral morphology changes and cognition in postoperative school-aged children with TOF. Resting-state functional magnetic resonance imaging (rs-fMRI) and the Wechsler Intelligence Scale for Children–Chinese revised edition (WISC-CR) were used to assess the difference between children with TOF and healthy children (HCs). Multiple linear regression showed that the TOF group had a lower verbal intelligence quotient (VIQ, 95.000 ± 13.433, p = 0.001) than the HC group and that VIQ had significant positive correlations with the cortical thickness of both the left precuneus (p < 0.05) and the right caudal middle frontal gyrus (p < 0.05) after adjustment for preoperative SpO2, preoperative systolic blood pressure (SBP), preoperative diastolic blood pressure (DBP) and time of aortic override (AO). Our results suggested that brain injury induced by TOF would exert lasting effects on cortical and cognitive development at least to school age. This study provides direct evidence of the relationship between cortical thickness and VIQ and of the need for strengthened verbal training in school-aged TOF patients after corrective surgery.
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Affiliation(s)
- Siyu Ma
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yaping Li
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Yuting Liu
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Cheng Xu
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Huijun Li
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Qiong Yao
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ying Wang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Zhaocong Yang
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Pengcheng Zuo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Ming Yang
- Department of Radiology, Children's Hospital of Nanjing Medical University, Nanjing, China
| | - Xuming Mo
- Department of Cardiothoracic Surgery, Children's Hospital of Nanjing Medical University, Nanjing, China
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15
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Rolinski R, You X, Gonzalez‐Castillo J, Norato G, Reynolds RC, Inati SK, Theodore WH. Language lateralization from task-based and resting state functional MRI in patients with epilepsy. Hum Brain Mapp 2020; 41:3133-3146. [PMID: 32329951 PMCID: PMC7336139 DOI: 10.1002/hbm.25003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2019] [Revised: 03/20/2020] [Accepted: 03/23/2020] [Indexed: 02/05/2023] Open
Abstract
We compared resting state (RS) functional connectivity and task‐based fMRI to lateralize language dominance in 30 epilepsy patients (mean age = 33; SD = 11; 12 female), a measure used for presurgical planning. Language laterality index (LI) was calculated from task fMRI in frontal, temporal, and frontal + temporal regional masks using LI bootstrap method from SPM12. RS language LI was assessed using two novel methods of calculating RS language LI from bilateral Broca's area seed based connectivity maps across regional masks and multiple thresholds (p < .05, p < .01, p < .001, top 10% connections). We compared LI from task and RS fMRI continuous values and dominance classifications. We found significant positive correlations between task LI and RS LI when functional connectivity thresholds were set to the top 10% of connections. Concordance of dominance classifications ranged from 20% to 30% for the intrahemispheric resting state LI method and 50% to 63% for the resting state LI intra‐ minus interhemispheric difference method. Approximately 40% of patients left dominant on task showed RS bilateral dominance. There was no difference in LI concordance between patients with right‐sided and left‐sided resections. Early seizure onset (<6 years old) was not associated with atypical language dominance during task‐based or RS fMRI. While a relationship between task LI and RS LI exists in patients with epilepsy, language dominance is less lateralized on RS than task fMRI. Concordance of language dominance classifications between task and resting state fMRI depends on brain regions surveyed and RS LI calculation method.
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Affiliation(s)
- Rachel Rolinski
- National Institute of Neurological Disorders and StrokeClinical Epilepsy SectionBethesdaMarylandUSA
| | - Xiaozhen You
- National Institute of Neurological Disorders and StrokeClinical Epilepsy SectionBethesdaMarylandUSA
- Children's National Medical CenterDepartment of NeurologyWashingtonDistrict of ColumbiaUSA
| | | | - Gina Norato
- National Institute of Neurological Disorders and StrokeClinical Trials UnitBethesdaMarylandUSA
| | - Richard C. Reynolds
- National Institute of Mental HealthScientific and Statistical Computing CoreBethesdaMarylandUSA
| | - Sara K. Inati
- National Institute of Neurological Disorders and StrokeElectroencephalography SectionBethesdaMarylandUSA
| | - William H. Theodore
- National Institute of Neurological Disorders and StrokeClinical Epilepsy SectionBethesdaMarylandUSA
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16
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Jakola AS, Sagberg LM, Gulati S, Solheim O. Advancements in predicting outcomes in patients with glioma: a surgical perspective. Expert Rev Anticancer Ther 2020; 20:167-177. [PMID: 32114857 DOI: 10.1080/14737140.2020.1735367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Introduction: Diffuse glioma is a challenging neurosurgical entity. Although surgery does not provide a cure, it may greatly influence survival, brain function, and quality of life. Surgical treatment is by nature highly personalized and outcome prediction is very complex. To engage and succeed in this balancing act it is important to make best use of the information available to the neurosurgeon.Areas covered: This narrative review provides an update on advancements in predicting outcomes in patients with glioma that are relevant to neurosurgeons.Expert opinion: The classical 'gut feeling' is notoriously unreliable and better prediction strategies for patients with glioma are warranted. There are numerous tools readily available for the neurosurgeon in predicting tumor biology and survival. Predicting extent of resection, functional outcome, and quality of life remains difficult. Although machine-learning approaches are currently not readily available in daily clinical practice, there are several ongoing efforts with the use of big data sets that are likely to create new prediction models and refine the existing models.
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Affiliation(s)
- Asgeir Store Jakola
- Department of Clinical Neuroscience, Institute of Physiology and Neuroscience, Sahlgrenska Academy, Gothenburg, Sweden.,Department of Neurosurgery, Sahlgrenska University Hospital, Gothenburg, Sweden.,Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
| | - Lisa Millgård Sagberg
- Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway.,Department of Public Health and Nursing, NTNU, Trondheim, Norway
| | - Sasha Gulati
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.,Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway
| | - Ole Solheim
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.,Department of Neurosurgery, St.Olavs Hospital, Trondheim, Norway
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17
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Leung LWL, Unadkat P, Bertotti MM, Bi WL, Essayed WI, Bunevicius A, Chavakula V, Rigolo L, Fumagalli L, Tie Z, Golby AJ, Tie Y. Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors. J Neuroimaging 2020; 30:175-183. [PMID: 32037662 DOI: 10.1111/jon.12690] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2019] [Revised: 01/17/2020] [Accepted: 01/21/2020] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND AND PURPOSE Previous literature has demonstrated disparity in the postoperative recovery of first and second language function of bilingual neurosurgical patients. However, it is unclear to whether preoperative brain mapping of both languages is needed. In this study, we aimed to evaluate the clinical utility of language task functional MRI (fMRI) implemented in both languages in bilingual patients. METHODS We retrospectively examined fMRI data of 13 bilingual brain tumor patients (age: 23 to 59 years) who performed antonym generation task-based fMRIs in English and non-English language. The usefulness of bilingual language mapping was evaluated using a structured survey administered to 5 neurosurgeons. Additionally, quantitative comparison between the brain activation maps of both languages was performed. RESULTS Survey responses revealed differences in raters' surgical approach, including asleep versus awake surgery and extent of resection, after viewing the language fMRI maps. Additional non-English fMRI led to changes in surgical decision-making and bettered localization of language areas. Quantitative analysis revealed an increase in laterality index (LI) in non-English fMRI compared to English fMRI. The Dice coefficient demonstrated fair overlap (.458 ± .160) between the activation maps. CONCLUSION Bilingual fMRI mapping of bilingual patients allows to better appreciate functionally active language areas that may be neglected in single language mapping. Utility of bilingual mapping was supported by changes in both surgical approach and LI measurements, suggesting its benefit on preoperative language mapping.
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Affiliation(s)
- Lok Wa Laura Leung
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong
| | - Prashin Unadkat
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Melina More Bertotti
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Hospital Unimed São José, Brazil
| | - Wenya Linda Bi
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Walid Ibn Essayed
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Adomas Bunevicius
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Vamsidhar Chavakula
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Laura Rigolo
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Luca Fumagalli
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Neurocenter of Southern Switzerland, Neurosurgery Clinic, Lugano, Switzerland
| | - Ziyun Tie
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Psychology, University of California, San Diego, CA
| | - Alexandra J Golby
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA.,Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
| | - Yanmei Tie
- Department of Neurosurgery, Brigham and Women's Hospital, Harvard Medical School, Boston, MA
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18
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Meinhold T, Hofer W, Pieper T, Kudernatsch M, Staudt M. Presurgical Language fMRI in Children, Adolescents and Young Adults : A Validation Study. Clin Neuroradiol 2020; 30:691-704. [PMID: 31960077 DOI: 10.1007/s00062-019-00852-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Accepted: 10/27/2019] [Indexed: 10/25/2022]
Abstract
PURPOSE To validate four established, child-friendly functional magnetic resonance imaging (fMRI) language tasks (word chain task [WCT], vowel identification task [VIT], synonym task [SYT] and beep story task [BST]) in a predominantly pediatric cohort. METHODS Intracarotid amobarbital procedures (IAP) (n = 17) and unchanged language after hemispherotomy (n = 6) were used as gold standards. The fMRI activations of nine regions of interest (ROI) in the frontal, temporal and parietal lobes as well as in the cerebellum were visually assessed in 23 fMRI examinations (in total 117 fMRI task sessions) of 23 patients (age range 10.0-23.0 years) with drug-refractory epilepsies. RESULTS The ROIs were considered valid when they showed activation in more than 25% of all sessions for the respective task and never showed false lateralization (in comparison to gold standards). Thus, 13 valid, task-specific ROIs were identified: 5 ROIs for the WCT (frontal operculum, inferior frontal gyrus, middle frontal gyrus, intraparietal sulcus, cerebellum), 3 ROIs for the VIT (frontal operculum, inferior frontal gyrus, middle frontal gyrus), 3 ROIs for the SYT (frontal operculum, inferior frontal gyrus, temporal language area) and 2 ROIs for the BST (inferior frontal gyrus, middle frontal gyrus). CONCLUSION Clinical fMRI using the battery of four tasks is a valid tool for lateralizing language in children, adolescents and young adults. Each task proved to be specifically useful, which confirms that applying different tasks increases the probability of diagnosing language dominance in presurgical candidates.
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Affiliation(s)
- Theresa Meinhold
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic Vogtareuth, Krankenhausstraße 20, 83569, Vogtareuth, Germany. .,Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University of Tübingen, Tübingen, Germany.
| | - Wiebke Hofer
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic Vogtareuth, Krankenhausstraße 20, 83569, Vogtareuth, Germany
| | - Tom Pieper
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic Vogtareuth, Krankenhausstraße 20, 83569, Vogtareuth, Germany
| | - Manfred Kudernatsch
- Center for Neurosurgery and Epilepsy Surgery, Schön Klinik Vogtareuth, Vogtareuth, Germany.,Research Institute "Rehabilitation, Transition, Palliation", PMU Salzburg, Salzburg, Austria
| | - Martin Staudt
- Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schön Clinic Vogtareuth, Krankenhausstraße 20, 83569, Vogtareuth, Germany.,Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, University of Tübingen, Tübingen, Germany
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19
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García-Casares N, Alfaro-Rubio F, Ramos-Rodríguez JR, Ocaña-Ledesma Á, Márquez-Márquez B, Fernández-Sánchez VE, Ibáñez-Botella G, Arráez-Sánchez MÁ, Serrano-Castro PJ. Preoperative evaluation by functional magnetic resonance imaging in patients with dysembryoplastic neuroepithelial tumours: A case series. Neurocirugia (Astur) 2019; 31:158-164. [PMID: 31784351 DOI: 10.1016/j.neucir.2019.09.004] [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: 05/21/2019] [Revised: 09/01/2019] [Accepted: 09/21/2019] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Dysembryoplastic neuroepithelial tumours (DNET) are a type of benign glioneuronal neoplasia of typically temporal location that produce drug-resistant epileptic seizures in children and young adults. OBJECTIVE This work aims to assess the usefulness of functional magnetic resonance imaging (fMRI) in the preoperative study in four patients with DNET. A Philips Intera 3.0 Tesla magnetic resonance imaging scanner and the Blood-Oxygen-Level-Dependent (BOLD) technique were used to obtain the images, making it possible to locate the eloquent areas for language and motor areas through the application of specific paradigms. RESULTS In one case the tumour was adjacent to Broca's area, in two cases it coincided with Wernicke's area, in one patient it was<1cm from the motor area for the hand and in another close to memory. Only two of the patients were operated on, without postoperative functional deficit. Hemispheric activation contralateral to the tumour suggestive of neuroplasticity was observed in one of the patients. CONCLUSIONS fMRI is a non-invasive method that allows us to assess the proximity of lesions to eloquent areas, which is key in the evaluation of surgical risk. In addition, it allowed the detection of probable neuroplasticity in one case, which guaranteed the success of the surgery.
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Affiliation(s)
- Natalia García-Casares
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, España; Centro de Investigaciones Médico-Sanitarias (CIMES). Universidad de Málagaa, Málaga, España; Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España.
| | - Francisco Alfaro-Rubio
- Centro de Investigaciones Médico-Sanitarias (CIMES). Universidad de Málagaa, Málaga, España
| | | | - Álvaro Ocaña-Ledesma
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, España
| | - Bernarda Márquez-Márquez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España; Departamento de Neurocirugía, Hospital Regional de Málaga, Málaga, España
| | - Victoria E Fernández-Sánchez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España; Departamento de Neurología, Hospital Regional de Málaga, Málaga, España
| | - Guillermo Ibáñez-Botella
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España; Departamento de Neurocirugía, Hospital Regional de Málaga, Málaga, España
| | - Miguel Ángel Arráez-Sánchez
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España; Departamento de Neurocirugía, Hospital Regional de Málaga, Málaga, España
| | - Pedro J Serrano-Castro
- Instituto de Investigación Biomédica de Málaga (IBIMA), Málaga, España; Departamento de Neurología, Hospital Regional de Málaga, Málaga, España
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20
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Mapping critical hubs of receptive and expressive language using MEG: A comparison against fMRI. Neuroimage 2019; 201:116029. [PMID: 31325641 DOI: 10.1016/j.neuroimage.2019.116029] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2019] [Revised: 07/08/2019] [Accepted: 07/16/2019] [Indexed: 01/22/2023] Open
Abstract
The complexity of the widespread language network makes it challenging for accurate localization and lateralization. Using large-scale connectivity and graph-theoretical analyses of task-based magnetoencephalography (MEG), we aimed to provide robust representations of receptive and expressive language processes, comparable with spatial profiles of corresponding functional magnetic resonance imaging (fMRI). We examined MEG and fMRI data from 12 healthy young adults (age 20-37 years) completing covert auditory word-recognition task (WRT) and covert auditory verb-generation task (VGT). For MEG language mapping, broadband (3-30 Hz) beamformer sources were estimated, voxel-level connectivity was quantified using phase locking value, and highly connected hubs were characterized using eigenvector centrality graph measure. fMRI data were analyzed using a classic general linear model approach. A laterality index (LI) was computed for 20 language-specific frontotemporal regions for both MEG and fMRI. MEG network analysis showed bilateral and symmetrically distributed hubs within the left and right superior temporal gyrus (STG) during WRT and predominant hubs in left inferior prefrontal gyrus (IFG) during VGT. MEG and fMRI localization maps showed high correlation values within frontotemporal regions during WRT and VGT (r = 0.63, 0.74, q < 0.05, respectively). Despite good concordance in localization, notable discordances were observed in lateralization between MEG and fMRI. During WRT, MEG favored a left-hemispheric dominance of left STG (LI = 0.25 ± 0.22) whereas fMRI supported a bilateral representation of STG (LI = 0.08 ± 0.2). Laterality of MEG and fMRI during VGT consistently showed a strong asymmetry in left IFG regions (MEG-LI = 0.45 ± 0.35 and fMRI-LI = 0.46 ± 0.13). Our results demonstrate the utility of a large-scale connectivity and graph theoretical analyses for robust identification of language-specific regions. MEG hubs are in great agreement with the literature in revealing with canonical and extra-canonical language sites, thus providing additional support for the underlying topological organization of receptive and expressive language cortices. Discordances in lateralization may emphasize the need for multimodal integration of MEG and fMRI to obtain an excellent predictive value in a heterogeneous healthy population and patients with neurosurgical conditions.
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21
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Balter S, Lin G, Leyden KM, Paul BM, McDonald CR. Neuroimaging correlates of language network impairment and reorganization in temporal lobe epilepsy. BRAIN AND LANGUAGE 2019; 193:31-44. [PMID: 27393391 PMCID: PMC5215985 DOI: 10.1016/j.bandl.2016.06.002] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 02/27/2016] [Accepted: 06/15/2016] [Indexed: 06/02/2023]
Abstract
Advanced, noninvasive imaging has revolutionized our understanding of language networks in the brain and is reshaping our approach to the presurgical evaluation of patients with epilepsy. Functional magnetic resonance imaging (fMRI) has had the greatest impact, unveiling the complexity of language organization and reorganization in patients with epilepsy both pre- and postoperatively, while volumetric MRI and diffusion tensor imaging have led to a greater appreciation of structural and microstructural correlates of language dysfunction in different epilepsy syndromes. In this article, we review recent literature describing how unimodal and multimodal imaging has advanced our knowledge of language networks and their plasticity in epilepsy, with a focus on the most frequently studied epilepsy syndrome in adults, temporal lobe epilepsy (TLE). We also describe how new analytic techniques (i.e., graph theory) are leading to a refined characterization of abnormal brain connectivity, and how subject-specific imaging profiles combined with clinical data may enhance the prediction of both seizure and language outcomes following surgical interventions.
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Affiliation(s)
- S Balter
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - G Lin
- Palo Alto University, Palo Alto, CA, United States
| | - K M Leyden
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States
| | - B M Paul
- Department of Neurology, University of California, San Francisco, CA, United States; UCSF Comprehensive Epilepsy Center, United States
| | - C R McDonald
- Multimodal Imaging Laboratory, University of California, San Diego, CA, United States; Department of Psychiatry, University of California, San Diego, CA, United States.
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22
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Unadkat P, Fumagalli L, Rigolo L, Vangel MG, Young GS, Huang R, Mukundan S, Golby A, Tie Y. Functional MRI Task Comparison for Language Mapping in Neurosurgical Patients. J Neuroimaging 2019; 29:348-356. [PMID: 30648771 PMCID: PMC6506353 DOI: 10.1111/jon.12597] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Revised: 12/07/2018] [Accepted: 12/10/2018] [Indexed: 11/27/2022] Open
Abstract
BACKGROUND AND PURPOSE Language task-based functional MRI (fMRI) is increasingly used for presurgical planning in patients with brain lesions. Different paradigms elicit activations of different components of the language network. The aim of this study is to optimize fMRI clinical usage by comparing the effectiveness of three language tasks for language lateralization and localization in a large group of patients with brain lesions. METHODS We analyzed fMRI data from a sequential retrospective cohort of 51 patients with brain lesions who underwent presurgical fMRI language mapping. We compared the effectiveness of three language tasks (Antonym Generation, Sentence Completion (SC), and Auditory Naming) for lateralizing language function and for activating cortex within patient-specific regions-of-interest representing eloquent language areas, and assessed the degree of spatial overlap of the areas of activation elicited by each task. RESULTS The tasks were similarly effective for lateralizing language within the anterior language areas. The SC task produced higher laterality indices within the posterior language areas and had a significantly higher agreement with the clinical report. Dice coefficients between the task pairs were in the range of .351-.458, confirming substantial variation in the components of the language network activated by each task. CONCLUSIONS SC task consistently produced large activations within the dominant hemisphere and was more effective for lateralizing language within the posterior language areas. The low degree of spatial overlap among the tasks strongly supports the practice of using a battery of tasks to help the surgeon to avoid eloquent language areas.
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Affiliation(s)
| | | | - Laura Rigolo
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Mark G. Vangel
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Geoffrey S. Young
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Raymond Huang
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Srinivasan Mukundan
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Alexandra Golby
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
| | - Yanmei Tie
- From the Department of Neurosurgery, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, LF, LR, AG, YT); Department of Radiology, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA (PU, MGV, GSY, RH, SM, AG); School of Medicine and Surgery, Universitá degli Studi di Milano-Bicocca, Milan, Italy (LF); and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA (MGV)
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Lateralisation of the white matter microstructure associated with the hemispheric spatial attention dominance. PLoS One 2019; 14:e0216032. [PMID: 31026280 PMCID: PMC6485922 DOI: 10.1371/journal.pone.0216032] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/13/2019] [Indexed: 11/19/2022] Open
Abstract
Objectives Healthy people have a slight leftward bias of spatial attention as measured on the Landmark task. Former studies indicated that lateralisation of brain activation contributes to this attentional bias. In this study we hypothesised that if the spatial bias was consistent over several measurements there would be structural background of it. Methods Reproducibility of the spatial bias of visuo-spatial attention was measured in twenty healthy subject in a Landmark task over three consecutive days. In order to evaluate the correlation between the spatial attentional bias and the white matter microstructure high angular resolution diffusion MRI was acquired for each subjects. The Track Based Spatial Statistics method was used to measure the hemispheric differences of the white matter microstructure. Probabilistic tractography was used to reveal the connection of the identified regions. Results The analysis showed correlation between the behavioural scores and the lateralisation of the white matter microstructure in the parietal white matter (p<0.05, corrected for multiple correlations). Higher FA values on the left are associated to rightward bias. The parietal cluster showed connectivity along the superior longitudinal fascicle on one end to posterior parietal cortex and anteriorly to the putative frontal eye field. From the frontal eye field some of the fibres run towards the nodes of the dorsal attention network to the intraparietal suclus, while some of the fibres travelled toward to ventral attention network to the temporo-parietal junction. Conclusions These results indicate that the structural integrity dorsal fronto-parietal network and the connection between the dorsal and ventral attention networks are responsible for the attentional bias in normal healthy controls.
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24
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Gohel S, Laino ME, Rajeev-Kumar G, Jenabi M, Peck K, Hatzoglou V, Tabar V, Holodny AI, Vachha B. Resting-State Functional Connectivity of the Middle Frontal Gyrus Can Predict Language Lateralization in Patients with Brain Tumors. AJNR Am J Neuroradiol 2019; 40:319-325. [PMID: 30630835 DOI: 10.3174/ajnr.a5932] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Accepted: 11/12/2018] [Indexed: 01/28/2023]
Abstract
BACKGROUND AND PURPOSE A recent study using task-based fMRI demonstrated that the middle frontal gyrus is comparable with Broca's area in its ability to determine language laterality using a measure of verbal fluency. This study investigated whether the middle frontal gyrus can be used as an indicator for language-hemispheric dominance in patients with brain tumors using task-free resting-state fMRI. We hypothesized that no significant difference in language lateralization would occur between the middle frontal gyrus and Broca area and that the middle frontal gyrus can serve as a simple and reliable means of measuring language laterality. MATERIALS AND METHODS Using resting-state fMRI, we compared the middle frontal gyrus with the Broca area in 51 patients with glial neoplasms for voxel activation, the language laterality index, and the effect of tumor grade on the laterality index. The laterality index derived by resting-state fMRI and task-based fMRI was compared in a subset of 40 patients. RESULTS Voxel activations in the left middle frontal gyrus and left Broca area were positively correlated (r = 0.47, P < .001). Positive correlations were seen between the laterality index of the Broca area and middle frontal gyrus regions (r = 0.56, P < .0005). Twenty-seven of 40 patients (67.5%) showed concordance of the laterality index based on the Broca area using resting-state fMRI and the laterality index based on a language task. Thirty of 40 patients (75%) showed concordance of the laterality index based on the middle frontal gyrus using resting-state fMRI and the laterality index based on a language task. CONCLUSIONS The middle frontal gyrus is comparable with the Broca area in its ability to determine hemispheric dominance for language using resting-state fMRI. Our results suggest the addition of resting-state fMRI of the middle frontal gyrus to the list of noninvasive modalities that could be used in patients with gliomas to evaluate hemispheric dominance of language before tumor resection. In patients who cannot participate in traditional task-based fMRI, resting-state fMRI offers a task-free alternate to presurgically map the eloquent cortex.
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Affiliation(s)
- S Gohel
- From the Department of Health Informatics (S.G.), Rutgers University School of Health Professions, Newark, New Jersey
| | - M E Laino
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.).,Department of Radiology (M.E.L.), Catholic University of the Sacred Heart, Rome, Italy
| | - G Rajeev-Kumar
- Icahn School of Medicine at Mount Sinai (G.R.-K.), New York, New York
| | - M Jenabi
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.)
| | - K Peck
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.).,Medical Physics (K.P.)
| | - V Hatzoglou
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.)
| | - V Tabar
- Neurosurgery (V.T.), Memorial Sloan Kettering Cancer Center, New York, New York
| | - A I Holodny
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.)
| | - B Vachha
- Departments of Radiology (M.E.L., M.J., K.P., V.H., A.I.H., B.V.)
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Ardila A, Bernal B, Rosselli M. Executive Functions Brain System: An Activation Likelihood Estimation Meta-analytic Study. Arch Clin Neuropsychol 2018; 33:379-405. [PMID: 28961762 DOI: 10.1093/arclin/acx066] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2017] [Accepted: 07/01/2017] [Indexed: 01/05/2023] Open
Abstract
Background and objective To characterize commonalities and differences between two executive functions: reasoning and inhibitory control. Methods A total of 5,974 participants in 346 fMRI experiments of inhibition or reasoning were selected. First level analysis consisted of Analysis of Likelihood Estimation (ALE) studies performed in two pooled data groups: (a) brain areas involved in reasoning and (b) brain areas involved in inhibition. Second level analysis consisted of two contrasts: (i) brain areas involved in reasoning but not in inhibition and (ii) brain areas involved in inhibition but not in reasoning. Lateralization Indexes were calculated. Results Four brain areas appear as the most critical: the dorsolateral aspect of the frontal lobes, the superior parietal lobules, the mesial aspect of the premotor area (supplementary motor area), and some subcortical areas, particularly the putamen and the thalamus. ALE contrasts showed significant differentiation of the networks, with the reasoning > inhibition-contrast showing a predominantly leftward participation, and the inhibition > reasoning-contrast, a clear right advantage. Conclusion Executive functions are mediated by sizable brain areas including not only cortical, but also involving subcortical areas in both hemispheres. The strength of activation shows dissociation between the hemispheres for inhibition (rightward) and reasoning (leftward) functions.
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Affiliation(s)
- Alfredo Ardila
- Department of Communication Sciences and Disorders, Florida International University, Miami, FL, USA
| | - Byron Bernal
- Department of Radiology/Brain Institute, Nicklaus Children's Hospital, Miami, FL, USA
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
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Mathon B, Amelot A, Clemenceau S, Carpentier A, Boch AL. Commentary: La Pitié-Salpêtrière Hospital in Paris: the Historic Cradle of Neurosurgery. Neurosurgery 2018; 82:164-174. [DOI: 10.1093/neuros/nyy115] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 03/08/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
- Bertrand Mathon
- Assistance Publique - Hopitaux de Paris, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
- Sorbonne University, Pierre et Marie Curie School of Medicine, Paris, France
| | - Aymeric Amelot
- Assistance Publique - Hopitaux de Paris, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
- Sorbonne University, Pierre et Marie Curie School of Medicine, Paris, France
| | - Stéphane Clemenceau
- Assistance Publique - Hopitaux de Paris, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
| | - Alexandre Carpentier
- Assistance Publique - Hopitaux de Paris, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
- Sorbonne University, Pierre et Marie Curie School of Medicine, Paris, France
| | - Anne-Laure Boch
- Assistance Publique - Hopitaux de Paris, Department of Neurosurgery, La Pitié-Salpêtrière University Hospital, Paris, France
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Anyanwu C, Motamedi GK. Diagnosis and Surgical Treatment of Drug-Resistant Epilepsy. Brain Sci 2018; 8:E49. [PMID: 29561756 PMCID: PMC5924385 DOI: 10.3390/brainsci8040049] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Revised: 03/12/2018] [Accepted: 03/16/2018] [Indexed: 11/29/2022] Open
Abstract
Despite appropriate trials of at least two antiepileptic drugs, about a third of patients with epilepsy remain drug resistant (intractable; refractory). Epilepsy surgery offers a potential cure or significant improvement to those with focal onset drug-resistant seizures. Unfortunately, epilepsy surgery is still underutilized which might be in part because of the complexity of presurgical evaluation. This process includes classifying the seizure type, lateralizing and localizing the seizure onset focus (epileptogenic zone), confirming the safety of the prospective brain surgery in terms of potential neurocognitive deficits (language and memory functions), before devising a surgical plan. Each one of the above steps requires special tests. In this paper, we have reviewed the process of presurgical evaluation in patients with drug-resistant focal onset epilepsy.
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Affiliation(s)
- Chinekwu Anyanwu
- Department of Neurology, Virginia Tech Carilion School of Medicine, Roanoke, VA 24016, USA.
| | - Gholam K Motamedi
- Department of Neurology, Georgetown University Medical Center, Washington, DC 20007, USA.
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Preziosa P, Pagani E, Mesaros S, Riccitelli GC, Dackovic J, Drulovic J, Filippi M, Rocca MA. Progression of regional atrophy in the left hemisphere contributes to clinical and cognitive deterioration in multiple sclerosis: A 5-year study. Hum Brain Mapp 2017; 38:5648-5665. [PMID: 28792103 DOI: 10.1002/hbm.23755] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2017] [Revised: 06/22/2017] [Accepted: 07/25/2017] [Indexed: 01/18/2023] Open
Abstract
In this longitudinal study, we investigated the regional patterns of focal lesions accumulation, and gray (GM) and white matter (WM) atrophy progression over a five-year follow-up (FU) in multiple sclerosis (MS) patients and their association with clinical and cognitive deterioration. Neurological, neuropsychological and brain MRI (dual-echo and 3D T1-weighted sequences) assessments were prospectively performed at baseline (T0) and after a median FU of 4.9 years from 66 MS patients (including relapse-onset and primary progressive MS) and 16 matched controls. Lesion probability maps were obtained. Longitudinal changes of GM and WM volumes and their association with clinical and cognitive deterioration were assessed using tensor-based morphometry and SPM12. At FU, 36/66 (54.5%) MS patients showed a significant disability worsening, 14/66 (21.2%) evolved to a worse clinical phenotype, and 18/63 (28.6%) developed cognitive deterioration. At T0, compared to controls, MS patients showed a widespread pattern of GM atrophy, involving cortex, deep GM and cerebellum, and atrophy of the majority of WM tracts, which further progressed at FU (P < 0.001, uncorrected). Compared to stable patients, those with clinical and cognitive worsening showed a left-lateralized pattern of GM and WM atrophy, involving deep GM, fronto-temporo-parieto-occipital regions, cerebellum, and several WM tracts (P < 0.001, uncorrected).GM and WM atrophy of relevant brain regions occur in MS after 5 years. A different vulnerability of the two brain hemispheres to irreversible structural damage may be among the factors contributing to clinical and cognitive worsening in these patients. Hum Brain Mapp 38:5648-5665, 2017. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
- Paolo Preziosa
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Elisabetta Pagani
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Sarlota Mesaros
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Gianna C Riccitelli
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Jelena Dackovic
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Jelena Drulovic
- Neurology Clinic, Clinical Centre of Serbia, Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
| | - Maria A Rocca
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.,Department of Neurology, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Gębska-Kośla K, Bryszewski B, Jaskólski DJ, Fortuniak J, Niewodniczy M, Stefańczyk L, Majos A. Reorganization of language centers in patients with brain tumors located in eloquent speech areas - A pre- and postoperative preliminary fMRI study. Neurol Neurochir Pol 2017; 51:403-410. [PMID: 28780063 DOI: 10.1016/j.pjnns.2017.07.010] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Revised: 03/06/2017] [Accepted: 07/06/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION The aim of this study was to determine in pre- and postsurgical fMRI studies the rearrangement of the Broca's and Wernicke's areas and the lateralization index for these areas in patients with brain tumors located near speech centers. Impact of the surgical treatment on the brain plasticity was evaluated. MATERIALS AND METHODS Pre- and postoperative fMRI examinations were performed in 10 patients with low grade glial, left-sided brain tumors located close to the Broca's (5 patients) or Wernicke's area (5 patients). BOLD signal was recorded in regions of interest: Broca's and Wernicke's areas, and their anatomic right-sided homologues. RESULTS In the preoperative fMRI study the left Broca's area was activated in all cases. The right Broca's area was activated in all the patients with no speech disorders. In the postoperative fMRI the activation of both Broca's areas increased in two cases. In other two cases activation of one of the Broca's area increased along with the decrease in the contralateral hemisphere. In all patients with temporal lobe tumors, the right Wernicke's area was activated in the pre- and postsurgical fMRI. After the operation, in two patients with speech disorder, the activation of both Broca's areas decreased and the activation of one of the Wernicke's areas increased. CONCLUSIONS In the cases of tumors localized near the left Broca's area, a transfer of the function to the healthy hemisphere seems to take place. Resection of tumors located near Broca's or Wernicke's areas may lead to relocation of the brain language centers.
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Affiliation(s)
- Katarzyna Gębska-Kośla
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Central Clinical Hospital, Czechoslowacka 8/10, 92-216 Lodz, Poland.
| | - Bartosz Bryszewski
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Dariusz J Jaskólski
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Jan Fortuniak
- Department of Neurosurgery, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Maciej Niewodniczy
- Institute of Health Sciences, University of Social Sciences, Gdańska 121, 90-508 Łódź, Poland.
| | - Ludomir Stefańczyk
- Department of Radiology and Diagnostic Imaging, Medical University of Łódź, Kopcińskiego 22, 90-153 Łódź, Poland.
| | - Agata Majos
- Department of Radiological and Isotopic Diagnosis and Therapy, Medical University of Lodz, Central Clinical Hospital, Czechoslowacka 8/10, 92-216 Lodz, Poland.
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Comparing the Intracarotid Amobarbital Test and Functional MRI for the Presurgical Evaluation of Language in Epilepsy. Curr Neurol Neurosci Rep 2017. [DOI: 10.1007/s11910-017-0763-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Labudda K, Mertens M, Kalbhenn T, Schulz R, Woermann FG. Partial resection of presurgical fMRI activation is associated with a postsurgical loss of language function after frontal lobe epilepsy surgery. Neurocase 2017; 23:239-248. [PMID: 28952404 DOI: 10.1080/13554794.2017.1383445] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We describe five patients with frontal lobe epilepsy who underwent electrocortical stimulation (ES) for language localization and language functional magnetic resonance imaging (fMRI) prior to epilepsy surgery. Six months after surgery, three patients suffered from a drop of verbal fluency. In all of them, frontal areas with presurgical language fMRI activity were resected. Our results suggest that resection in regions of areas with presurgical fMRI activation is not without risk for a postsurgical loss of function, even when ES results were negative for language function in these areas. Using fMRI activations might be specifically helpful to plan the resection when ES delivered inconclusive results.
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Affiliation(s)
- Kirsten Labudda
- a Department of Psychology, Clinical Neuropsychology and Epilepsy Research , University of Bielefeld , Bielefeld , Germany.,b Epilepsy Center Bethel , Bielefeld , Germany
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Austermuehle A, Cocjin J, Reynolds R, Agrawal S, Sepeta L, Gaillard WD, Zaghloul K, Inati S, Theodore WH. Language functional MRI and direct cortical stimulation in epilepsy preoperative planning. Ann Neurol 2017; 81:526-537. [PMID: 28220524 PMCID: PMC5401636 DOI: 10.1002/ana.24899] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 02/13/2017] [Accepted: 02/13/2017] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Presurgical language assessment can help minimize damage to eloquent cortex during resective epilepsy surgery. Two methods for presurgical language mapping are functional MRI (fMRI) and direct cortical stimulation (DCS) of implanted subdural electrodes. We compared fMRI results to DCS to help optimize noninvasive language localization and assess its validity. METHODS We studied 19 patients referred for presurgical evaluation of drug-resistant epilepsy. Patients completed four language tasks during preoperative fMRI. After subdural electrode implantation, we used DCS to localize language areas. For each stimulation site, we determined whether language positive electrode pairs intersected with significant fMRI activity clusters for language tasks. RESULTS Sensitivity and specificity depended on electrode region of interest radii and statistical thresholding. For patients with at least one language positive stimulation site, an auditory description decision task provided the best trade-off between sensitivity and specificity. For patients with no language positive stimulation sites, fMRI was a dependable method of excluding eloquent language processing. INTERPRETATION Language fMRI is an effective tool for determining language lateralization before electrode implantation and is especially useful for excluding unexpected critical language areas. It can help guide subdural electrode implantation and narrow the search for eloquent cortical areas by DCS. Ann Neurol 2017;81:526-537.
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Affiliation(s)
- Alison Austermuehle
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke
| | - John Cocjin
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke
| | - Richard Reynolds
- Scientific and Statistical Computing Core, National Institute of Mental Health
| | - Shubhi Agrawal
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke
| | - Leigh Sepeta
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke
| | - William D. Gaillard
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke
| | - Kareem Zaghloul
- Surgical Neurology Branch, National Institute of Neurological Disorders and Stroke
| | - Sara Inati
- Electroencephalography Section, National Institute of Neurological Disorders and Stroke
| | - William H. Theodore
- Clinical Epilepsy Section, National Institute of Neurological Disorders and Stroke
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Multi-factorial modulation of hemispheric specialization and plasticity for language in healthy and pathological conditions: A review. Cortex 2017; 86:314-339. [DOI: 10.1016/j.cortex.2016.05.013] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Revised: 02/16/2016] [Accepted: 05/13/2016] [Indexed: 12/16/2022]
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Ishikawa T, Muragaki Y, Maruyama T, Abe K, Kawamata T. Roles of the Wada Test and Functional Magnetic Resonance Imaging in Identifying the Language-dominant Hemisphere among Patients with Gliomas Located near Speech Areas. Neurol Med Chir (Tokyo) 2016; 57:28-34. [PMID: 27980284 PMCID: PMC5243162 DOI: 10.2176/nmc.oa.2016-0042] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
This study examined the accuracy of functional magnetic resonance imaging (fMRI) in identifying the language-dominant hemisphere and the situations in which the Wada test can be skipped among patients with gliomas located near speech areas. We examined 74 patients [48 men (64.9%); mean ± standard deviation age of 42.7 ± 13.6 years (range: 13 to 70 years); 71 right-handed, 2 left-handed, and 1 ambidextrous] with gliomas located near speech areas. All patients underwent the Wada test and fMRI, and 34 patients underwent awake surgery. The “last-and-first” task was administered during fMRI. The Wada test was successful in determining the language-dominant hemisphere in 73 patients (98.6%): left hemisphere in 68 patients (91.9%), right hemisphere in 4 patients (5.4%), and bilateral in 1 patient (1.4%). The dominant hemisphere for right-handed patients (n = 71) was the left hemisphere in 67 patients (94.3%), right hemisphere in 3 patients (4.2%), and undetectable in 1 patient (1.4%). The fMRI was successful in determining the language-dominant hemisphere in 53 patients (71.6%). The results of the Wada test and fMRI were inconsistent in 5 patients (8.6%), of which 3 (5.2%) exhibited dominance in opposite hemispheres. Furthermore, 2 of these 3 cases (2.7%) were contralateral false positive cases, whereby fMRI identified the right-hemisphere as language dominant for right-handed individuals with tumors in the left hemisphere. Based on these findings, we concluded that the Wada test can be skipped if language dominancy can be detected by fMRI.
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Teghipco A, Hussain A, Tivarus ME. Disrupted functional connectivity affects resting state based language lateralization. NEUROIMAGE-CLINICAL 2016; 12:910-927. [PMID: 27882297 PMCID: PMC5114586 DOI: 10.1016/j.nicl.2016.10.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/28/2016] [Revised: 09/10/2016] [Accepted: 10/20/2016] [Indexed: 12/01/2022]
Abstract
Pre-operative assessment of language localization and lateralization is critical to preserving brain function after lesion or epileptogenic tissue resection. Task fMRI (t-fMRI) has been extensively and reliably used to this end, but resting state fMRI (rs-fMRI) is emerging as an alternative pre-operative brain mapping method that is independent of a patient's ability to comply with a task. We sought to evaluate if language lateralization obtained from rs-fMRI can replace standard assessment using t-fMRI. In a group of 43 patients scheduled for pre-operative fMRI brain mapping and 17 healthy controls, we found that existing methods of determining rs-fMRI lateralization by considering interhemispheric and intrahemispheric functional connectivity are inadequate compared to t-fMRI when applied to the language network. We determined that this was attributable to widespread but nuanced disturbances in the functional connectivity of the language network in patients. We found changes in interhemispheric and intrahemispheric functional connectivity that were dependent on lesion location, and particularly impacted patients with lesions in the left temporal lobe. We then tested whether a simpler measure of functional connectivity to the language network has a better relation to t-fMRI based language lateralization. Remarkably, we found that functional connectivity between the language network and the frontal pole, and superior frontal gyrus, as well as the supramarginal gyrus, significantly correlated to task based language lateralization indices in both patients and healthy controls. These findings are consistent with prior work with epilepsy patients, and provide a framework for evaluating language lateralization at rest. Existing methods of determining rs-fMRI lateralization are inadequate for language. Functional connectivity to language network correlates with task lateralization. Lesion location affects functional connectivity. Lesions exhibit some interhemispheric hyperconnectivity within language network.
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Affiliation(s)
- Alex Teghipco
- Rochester Center for Brain Imaging, University of Rochester, USA
| | - Ali Hussain
- Department of Imaging Sciences, University of Rochester, USA
| | - Madalina E Tivarus
- Rochester Center for Brain Imaging, University of Rochester, USA; Department of Imaging Sciences, University of Rochester, USA
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Language Mapping Using fMRI and Direct Cortical Stimulation for Brain Tumor Surgery: The Good, the Bad, and the Questionable. Top Magn Reson Imaging 2016; 25:1-10. [PMID: 26848555 DOI: 10.1097/rmr.0000000000000074] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Language functional magnetic resonance imaging for neurosurgical planning is a useful but nuanced technique. Consideration of primary and secondary language anatomy, task selection, and data analysis choices all impact interpretation. In the following chapter, we consider practical considerations and nuances alike for language functional magnetic resonance imaging in the support of and comparison with the neurosurgical gold standard, direct cortical stimulation. Pitfalls and limitations are discussed.
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Batouli SAH, Hasani N, Gheisari S, Behzad E, Oghabian MA. Evaluation of the factors influencing brain language laterality in presurgical planning. Phys Med 2016; 32:1201-1209. [PMID: 27742256 DOI: 10.1016/j.ejmp.2016.06.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 06/07/2016] [Accepted: 06/17/2016] [Indexed: 10/20/2022] Open
Abstract
Brain lesions cause functional deficits, and one treatment for this condition is lesion resection. In most cases, presurgical planning (PSP) and the information from laterality indices are necessary for maximum preservation of the critical functions after surgery. Language laterality index (LI) is reliably estimated using functional magnetic resonance imaging (fMRI); however, this measure is under the influence of some external factors. In this study, we investigated the influence of a number of factors on language LI, using data from 120 patients (mean age=35.65 (±13.4) years) who underwent fMRI for PSP. Using two proposed language tasks from our previous works, brain left hemisphere was showed to be dominant for the language function, although a higher LI was obtained using the "Word Generation" task, compared to the "Reverse Word Reading". In addition, decline of LIs with age, and lower LI when the lesion invaded brain language area were observed. Meanwhile, gender, lesion side (affected hemisphere), LI calculation strategy, and fMRI analysis Z-values did not statistically show any influences on the LIs. Although fMRI is widely used to estimate language LI, it is shown here that in order to present a reliable language LI and to correctly select the dominant hemisphere of the brain, the influence of external factors should be carefully considered.
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Affiliation(s)
- Seyed Amir Hossein Batouli
- Neuroimaging and Analysis Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Hasani
- Neuroimaging and Analysis Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Sara Gheisari
- Neuroimaging and Analysis Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran
| | - Ebrahim Behzad
- School of Advanced Technologies in Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Ali Oghabian
- Neuroimaging and Analysis Group, Research Center for Cellular and Molecular Imaging, Tehran University of Medical Sciences, Tehran, Iran.
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Determination of hemispheric language dominance using functional magnetic resonance imaging and the Shiritori (Japanese word chain) task in patients with epilepsy: Comparison with the Wada test. Epilepsy Res 2016; 124:16-22. [DOI: 10.1016/j.eplepsyres.2016.04.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Revised: 12/04/2015] [Accepted: 04/21/2016] [Indexed: 11/20/2022]
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Gazit T, Andelman F, Glikmann-Johnston Y, Gonen T, Solski A, Shapira-Lichter I, Ovadia M, Kipervasser S, Neufeld MY, Fried I, Hendler T, Perry D. Probabilistic machine learning for the evaluation of presurgical language dominance. J Neurosurg 2016; 125:481-93. [DOI: 10.3171/2015.7.jns142568] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE
Providing a reliable assessment of language lateralization is an important task to be performed prior to neurosurgery in patients with epilepsy. Over the last decade, functional MRI (fMRI) has emerged as a useful noninvasive tool for language lateralization, supplementing or replacing traditional invasive methods. In standard practice, fMRI-based language lateralization is assessed qualitatively by visual inspection of fMRI maps at a specific chosen activation threshold. The purpose of this study was to develop and evaluate a new computational technique for providing the probability of each patient to be left, right, or bilateral dominant in language processing.
METHODS
In 76 patients with epilepsy, a language lateralization index was calculated using the verb-generation fMRI task over a wide range of activation thresholds (from a permissive threshold, analyzing all brain regions, to a harsh threshold, analyzing only the strongest activations). The data were classified using a probabilistic logistic regression method.
RESULTS
Concordant results between fMRI and Wada lateralization were observed in 89% of patients. Bilateral and right-dominant groups showed similar fMRI lateralization patterns differentiating them from the left-dominant group but still allowing classification in 82% of patients.
CONCLUSIONS
These findings present the utility of a semi-supervised probabilistic learning approach for presurgical language-dominance mapping, which may be extended to other cognitive domains such as memory and attention.
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Affiliation(s)
| | - Fani Andelman
- 2Functional Neurosurgery Unit, Department of Neurosurgery and
| | | | - Tal Gonen
- 1Functional Brain Center,
- 6School of Psychological Sciences and
| | | | - Irit Shapira-Lichter
- 1Functional Brain Center,
- 3Department of Neurology, Tel Aviv Souraksy Medical Center
| | | | - Svetlana Kipervasser
- 2Functional Neurosurgery Unit, Department of Neurosurgery and
- 3Department of Neurology, Tel Aviv Souraksy Medical Center
- 4Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
| | - Miriam Y. Neufeld
- 3Department of Neurology, Tel Aviv Souraksy Medical Center
- 4Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
| | - Itzhak Fried
- 2Functional Neurosurgery Unit, Department of Neurosurgery and
- 4Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
- 5Department of Neurosurgery, David Geffen School of Medicine and Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, California
- 7Sagol School of Neuroscience,
| | - Talma Hendler
- 1Functional Brain Center,
- 4Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; and
- 6School of Psychological Sciences and
- 7Sagol School of Neuroscience,
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Maladaptive Plasticity in Aphasia: Brain Activation Maps Underlying Verb Retrieval Errors. Neural Plast 2016; 2016:4806492. [PMID: 27429808 PMCID: PMC4939358 DOI: 10.1155/2016/4806492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2015] [Revised: 04/25/2016] [Accepted: 05/05/2016] [Indexed: 11/18/2022] Open
Abstract
Anomia, or impaired word retrieval, is the most widespread symptom of aphasia, an acquired language impairment secondary to brain damage. In the last decades, functional neuroimaging techniques have enabled studying the neural basis underlying anomia and its recovery. The present study aimed to explore maladaptive plasticity in persistent verb anomia, in three male participants with chronic nonfluent aphasia. Brain activation maps associated with semantic verb paraphasia occurring within an oral picture-naming task were identified with an event-related fMRI paradigm. These maps were compared with those obtained in our previous study examining adaptive plasticity (i.e., successful verb naming) in the same participants. The results show that activation patterns related to semantic verb paraphasia and successful verb naming comprise a number of common areas, contributing to both maladaptive and adaptive neuroplasticity mechanisms. This finding suggests that the segregation of brain areas provides only a partial view of the neural basis of verb anomia and successful verb naming. Therefore, it indicates the importance of network approaches which may better capture the complexity of maladaptive and adaptive neuroplasticity mechanisms in anomia recovery.
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Combined DTI Tractography and Functional MRI Study of the Language Connectome in Healthy Volunteers: Extensive Mapping of White Matter Fascicles and Cortical Activations. PLoS One 2016; 11:e0152614. [PMID: 27029050 PMCID: PMC4814138 DOI: 10.1371/journal.pone.0152614] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 03/16/2016] [Indexed: 11/23/2022] Open
Abstract
Despite a better understanding of brain language organization into large-scale cortical networks, the underlying white matter (WM) connectivity is still not mastered. Here we combined diffusion tensor imaging (DTI) fiber tracking (FT) and language functional magnetic resonance imaging (fMRI) in twenty healthy subjects to gain new insights into the macroscopic structural connectivity of language. Eight putative WM fascicles for language were probed using a deterministic DTI-FT technique: the arcuate fascicle (AF), superior longitudinal fascicle (SLF), uncinate fascicle (UF), temporo-occipital fascicle, inferior fronto-occipital fascicle (IFOF), middle longitudinal fascicle (MdLF), frontal aslant fascicle and operculopremotor fascicle. Specific measurements (i.e. volume, length, fractional anisotropy) and precise cortical terminations were derived for each WM fascicle within both hemispheres. Connections between these WM fascicles and fMRI activations were studied to determine which WM fascicles are related to language. WM fascicle volumes showed asymmetries: leftward for the AF, temporoparietal segment of SLF and UF, and rightward for the frontoparietal segment of the SLF. The lateralization of the AF, IFOF and MdLF extended to differences in patterns of anatomical connections, which may relate to specific hemispheric abilities. The leftward asymmetry of the AF was correlated to the leftward asymmetry of fMRI activations, suggesting that the lateralization of the AF is a structural substrate of hemispheric language dominance. We found consistent connections between fMRI activations and terminations of the eight WM fascicles, providing a detailed description of the language connectome. WM fascicle terminations were also observed beyond fMRI-confirmed language areas and reached numerous cortical areas involved in different functional brain networks. These findings suggest that the reported WM fascicles are not exclusively involved in language and might be related to other cognitive functions such as visual recognition, spatial attention, executive functions, memory, and processing of emotional and behavioral aspects.
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de Pesters A, Taplin AM, Adamo MA, Ritaccio AL, Schalk G. Electrocorticographic mapping of expressive language function without requiring the patient to speak: A report of three cases. EPILEPSY & BEHAVIOR CASE REPORTS 2016; 6:13-8. [PMID: 27408803 PMCID: PMC4925928 DOI: 10.1016/j.ebcr.2016.02.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 02/25/2016] [Accepted: 02/26/2016] [Indexed: 01/24/2023]
Abstract
Objective Patients requiring resective brain surgery often undergo functional brain mapping during perioperative planning to localize expressive language areas. Currently, all established protocols to perform such mapping require substantial time and patient participation during verb generation or similar tasks. These issues can make language mapping impractical in certain clinical circumstances (e.g., during awake craniotomies) or with certain populations (e.g., pediatric patients). Thus, it is important to develop new techniques that reduce mapping time and the requirement for active patient participation. Several neuroscientific studies reported that the mere auditory presentation of speech stimuli can engage not only receptive but also expressive language areas. Here, we tested the hypothesis that submission of electrocorticographic (ECoG) recordings during a short speech listening task to an appropriate analysis procedure can identify eloquent expressive language cortex without requiring the patient to speak. Methods Three patients undergoing temporary placement of subdural electrode grids passively listened to stories while we recorded their ECoG activity. We identified those sites whose activity in the broadband gamma range (70–170 Hz) changed immediately after presentation of the speech stimuli with respect to a prestimulus baseline. Results Our analyses revealed increased broadband gamma activity at distinct locations in the inferior frontal cortex, superior temporal gyrus, and/or perisylvian areas in all three patients and premotor and/or supplementary motor areas in two patients. The sites in the inferior frontal cortex that we identified with our procedure were either on or immediately adjacent to locations identified using electrical cortical stimulation (ECS) mapping. Conclusions The results of this study provide encouraging preliminary evidence that it may be possible that a brief and practical protocol can identify expressive language areas without requiring the patient to speak. This protocol could provide the clinician with a map of expressive language cortex within a few minutes. This may be useful as an adjunct to ECS interrogation or as an alternative to mapping using functional magnetic resonance imaging (fMRI). In conclusion, with further development and validation in more subjects, the approach presented here could help in identifying expressive language areas in situations where patients cannot speak in response to task instructions.
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Affiliation(s)
- Adriana de Pesters
- National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA
| | - AmiLyn M Taplin
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA
| | - Matthew A Adamo
- Department of Neurosurgery, Albany Medical College, Albany, NY, USA
| | | | - Gerwin Schalk
- National Center for Adaptive Neurotechnologies, Wadsworth Center, New York State Department of Health, Albany, NY, USA; Department of Biomedical Sciences, State University of New York at Albany, Albany, NY, USA; Department of Neurology, Albany Medical College, Albany, NY, USA
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Dong JW, Brennan NMP, Izzo G, Peck KK, Holodny AI. fMRI activation in the middle frontal gyrus as an indicator of hemispheric dominance for language in brain tumor patients: a comparison with Broca's area. Neuroradiology 2016; 58:513-20. [PMID: 26847705 DOI: 10.1007/s00234-016-1655-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Accepted: 01/29/2016] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Functional MRI (fMRI) can assess language lateralization in brain tumor patients; however, this can be limited if the primary language area-Broca's area (BA)-is affected by the tumor. We hypothesized that the middle frontal gyrus (MFG) can be used as a clinical indicator of hemispheric dominance for language during presurgical workup. METHODS Fifty-two right-handed subjects with solitary left-hemispheric primary brain tumors were retrospectively studied. Subjects performed a verbal fluency task during fMRI. The MFG was compared to BA for fMRI voxel activation, language laterality index (LI), and the effect of tumor grade on the LI. RESULTS Language fMRI (verbal fluency) activated more voxels in MFG than in BA (MFG = 315, BA = 216, p < 0.001). Voxel activations in the left-hemispheric MFG and BA were positively correlated (r = 0.69, p < 0.001). Mean LI in the MFG was comparable to that in BA (MFG = 0.48, BA = 0.39, p = 0.06). LIs in MFG and BA were positively correlated (r = 0.62, p < 0.001). Subjects with high-grade tumors demonstrate lower language lateralization than those with low-grade tumors in both BA and MFG (p = 0.02, p = 0.02, respectively). CONCLUSION MFG is comparable to BA in its ability to indicate hemispheric dominance for language using a measure of verbal fluency and may be an adjunct measure in the clinical determination of language laterality for presurgical planning.
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Affiliation(s)
- Jian W Dong
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
- New York University School of Medicine, New York, NY, USA
| | - Nicole M Petrovich Brennan
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
| | - Giana Izzo
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
- Department of Bioimaging and Radiological Sciences, Catholic University of Rome, A. Gemelli Hospital, Rome, Italy
| | - Kyung K Peck
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA
- Department of Medical Physics and the Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan Kettering Cancer Center, 1275 York Ave, New York, NY, 10065, USA.
- Department of Medical Physics and the Brain Tumor Center, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
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Abstract
The advances in diffusion-weighted imaging (DWI), diffusion tensor imaging (DTI), and functional magnetic resonance imaging (fMRI) over the last 20 years have vastly contributed to improving the understanding of the brain structure and function in patients with many diseases of the central nervous system (CNS). DWI is commonly used, for instance, in the diagnostic workup of stroke, CNS neoplasia, and rapidly progressive dementia cases. The new DTI methods provide more specific information about the most destructive aspects of tumors, neurodegenerative dementia, and multiple sclerosis pathology and give a more complete picture of the complex pathologic mechanisms of these conditions. More recently, fMRI has provided insight to the mechanisms of brain adaptation and plasticity to damage related to many neurologic conditions and has further extended our ability to understand the functional significance of pathologic changes in these diseases. Although at present fMRI does not have a role in the diagnosis, routine assessment, and monitoring of neurologic diseases, significant efforts are under way in order to achieve harmonization of both acquisition and postprocessing procedures, which are likely to contribute to a significant change of the clinical scenario.
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Affiliation(s)
- Massimo Filippi
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy.
| | - Federica Agosta
- Neuroimaging Research Unit, Institute of Experimental Neurology, Division of Neuroscience, San Raffaele Scientific Institute, Vita-Salute San Raffaele University, Milan, Italy
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Stylianou P, Kimchi G, Hoffmann C, Blat I, Harnof S. Neuroimaging for patient selection for medial temporal lobe epilepsy surgery: Part 2 functional neuroimaging. J Clin Neurosci 2016; 23:23-33. [DOI: 10.1016/j.jocn.2015.04.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2015] [Revised: 04/11/2015] [Accepted: 04/18/2015] [Indexed: 11/17/2022]
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van Dun K, De Witte E, Van Daele W, Van Hecke W, Manto M, Mariën P. Atypical cerebral and cerebellar language organisation: a case study. CEREBELLUM & ATAXIAS 2015; 2:18. [PMID: 26693029 PMCID: PMC4676095 DOI: 10.1186/s40673-015-0036-9] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Accepted: 12/04/2015] [Indexed: 01/01/2023]
Abstract
Background In the majority of right-handed subjects, language processing is subserved by a close interplay between the left cerebral hemisphere and right cerebellum. Within this network, the dominant fronto-insular region and the contralateral posterior cerebellum are crucially implicated in oral language production. Case Presentation We report atypical anatomoclinical findings in a right-handed patient with an extensive right cerebellar infarction and an older left fronto-insular stroke. Standardised neurolinguistic and neurocognitive test batteries were performed. In addition, fMRI, DTI, and SPECT results are reported. In this patient, disruption of the cerebellocerebral language network due to vascular damage in the left fronto-insular region and right posterior inferior cerebellar artery (PICA) territory did not induce any speech or language deficits. By contrast, executive and behavioural disturbances were found after the right cerebellar stroke. Evidence from fMRI and DTI suggests atypical bilateral language representation (Laterality Index = +0,11). At the cerebellar level, fMRI showed more activated voxels in the left than in the right hemisphere (Laterality Index = +0,66). Conclusion We hypothesise congenital bilateral language representation in this patient which might be more advantageous than a typically lateralised distribution of linguistic functions to compensate acute damage to critical language regions. The more activated left cerebellum possibly compensated the functional loss in the right cerebellum after acute damage due to bilateral organisation of language function. However, more research is needed to confirm this hypothesis.
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Affiliation(s)
- Kim van Dun
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Brussels, Belgium
| | - Elke De Witte
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Brussels, Belgium
| | - Wendy Van Daele
- Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital, Lindendreef 1, B-2020 Antwerp, Belgium
| | - Wim Van Hecke
- icoMetrix, Tervuursesteenweg 244, B-3001 Leuven, Belgium
| | - Mario Manto
- Unité d'Étude du Mouvement, FNRS Neurologie, ULB Erasme, Brussels, Belgium
| | - Peter Mariën
- Clinical and Experimental Neurolinguistics, CLIN, Vrije Universiteit Brussel, Brussels, Belgium ; Department of Neurology and Memory Clinic, ZNA Middelheim General Hospital, Lindendreef 1, B-2020 Antwerp, Belgium
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Perrone-Bertolotti M, Girard C, Cousin E, Vidal JR, Pichat C, Kahane P, Baciu M. NEREC, an effective brain mapping protocol for combined language and long-term memory functions. Epilepsy Behav 2015; 53:140-8. [PMID: 26575255 DOI: 10.1016/j.yebeh.2015.09.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2015] [Revised: 08/26/2015] [Accepted: 09/14/2015] [Indexed: 11/16/2022]
Abstract
Temporal lobe epilepsy can induce functional plasticity in temporoparietal networks involved in language and long-term memory processing. Previous studies in healthy subjects have revealed the relative difficulty for this network to respond effectively across different experimental designs, as compared to more reactive regions such as frontal lobes. For a protocol to be optimal for clinical use, it has to first show robust effects in a healthy cohort. In this study, we developed a novel experimental paradigm entitled NEREC, which is able to reveal the robust participation of temporoparietal networks in a uniquely combined language and memory task, validated in an fMRI study with healthy subjects. Concretely, NEREC is composed of two runs: (a) an intermixed language-memory task (confrontation naming associated with encoding in nonverbal items, NE) to map language (i.e., word retrieval and lexico-semantic processes) combined with simultaneous long-term verbal memory encoding (NE items named but also explicitly memorized) and (b) a memory retrieval task of items encoded during NE (word recognition, REC) intermixed with new items. Word recognition is based on both perceptual-semantic familiarity (feeling of 'know') and accessing stored memory representations (remembering). In order to maximize the remembering and recruitment of medial temporal lobe structures, we increased REC difficulty by changing the modality of stimulus presentation (from nonverbal during NE to verbal during REC). We report that (a) temporoparietal activation during NE was attributable to both lexico-semantic (language) and memory (episodic encoding and semantic retrieval) processes; that (b) encoding activated the left hippocampus, bilateral fusiform, and bilateral inferior temporal gyri; and that (c) task recognition (recollection) activated the right hippocampus and bilateral but predominant left fusiform gyrus. The novelty of this protocol consists of (a) combining two tasks in one (language and long-term memory encoding/recall) instead of applying isolated tasks to map temporoparietal regions, (b) analyzing NE data based on performances recorded during REC, (c) double-mapping networks involved in naming and in long-term memory encoding and retrieval, (d) focusing on remembering with hippocampal activation and familiarity judgment with lateral temporal cortices activation, and (e) short duration of examination and feasibility. These aspects are of particular interest in patients with TLE, who frequently show impairment of these cognitive functions. Here, we show that the novel protocol is suited for this clinical evaluation.
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Affiliation(s)
| | - Cléa Girard
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Emilie Cousin
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France; UMS IRMaGe, IRM 3T Recherche, CHU Grenoble, Univ. Grenoble Alpes, F-38043 Grenoble, France
| | - Juan Ricardo Vidal
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Cédric Pichat
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France
| | - Philippe Kahane
- Neurology Department & Inserm U836-UJF-CEA, Grenoble University Hospital, France
| | - Monica Baciu
- Univ. Grenoble Alpes, LPNC, F-38040 Grenoble, France; CNRS, LPNC UMR 5105, F-38040 Grenoble, France.
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Lyo JK, Arevalo-Perez J, Petrovich Brennan N, Peck KK, Holodny AI. Pre-operative fMRI localization of the supplementary motor area and its relationship with postoperative speech deficits. Neuroradiol J 2015; 28:281-8. [PMID: 26246097 DOI: 10.1177/1971400915589681] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Neurosurgery of the supplementary motor area (SMA) is associated with transient speech defects. We investigated whether SMA laterality correlates with postoperative speech defects. MATERIALS AND METHODS The authors reviewed 17 patients with SMA-area lesion resection and preoperative language fMRI. SMA laterality was calculated by comparison of voxel activation in paired SMAs by hand-drawn regions of interest (ROIs) (drawn by a neuroradiologist), and compared with qualitative assessment by two neuroradiologists. Postoperative speech defects before and after surgery were assessed by chart review. RESULTS Six patients developed new speech defects that resolved within several months. Two of the patients had a pre-existing speech defect that had developed after prior SMA-area surgery. All these patients had left-sided lesions, while none of the four patients with a right-sided lesion developed a speech defect. Neuroradiologists' assessment of SMA laterality agreed with ROI calculation for the SMAs that were lateralized. However, for the SMAs in the "codominant" range by ROI, the neuroradiologists felt that all but one of the cases clearly lateralized, with the exception deemed indeterminate or codominant. No correlation between laterality of SMA and speech defect was identified. Twelve patients showed lateralization contralateral to the lesion. CONCLUSIONS fMRI lateralization does not correlate with transient speech defects that developed from SMA-area surgery. Qualitative/visual assessment of SMA laterality was superior to ROI calculation because of the close proximity and possible overlap of signal from midline SMA. A majority of patients showed SMA lateralization contralateral to the SMA lesion.
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Affiliation(s)
- John K Lyo
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA
| | | | - Nicole Petrovich Brennan
- Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA
| | - Kyung K Peck
- Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, USA
| | - Andrei I Holodny
- Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA
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Baciu M, Perrone-Bertolotti M. What do patients with epilepsy tell us about language dynamics? A review of fMRI studies. Rev Neurosci 2015; 26:323-41. [PMID: 25741734 DOI: 10.1515/revneuro-2014-0074] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2014] [Accepted: 11/20/2014] [Indexed: 11/15/2022]
Abstract
The objective of this review is to resume major neuroimaging findings on language organization and plasticity in patients with focal and refractory epilepsy, to discuss the effect of modulatory variables that should be considered alongside patterns of reorganization, and to propose possible models of language reorganization. The focal and refractory epilepsy provides a real opportunity to investigate various types of language reorganization in different conditions. The 'chronic' condition (induced by the epileptogenic zone or EZ) is associated with either recruitment of homologous regions of the opposite hemisphere or recruitment of intrahemispheric, nonlinguistic regions. In the 'acute' condition (neurosurgery and EZ resection), the initial interhemispheric shift (induced by the chronic EZ) could follow a reverse direction, back to the initial hemisphere. These different patterns depend on several modulatory factors and are associated with various levels of language performance. As a neuroimaging tool, functional magnetic resonance imaging enables the detailed investigation of both hemispheres simultaneously and allows for comparison with healthy controls, potentially creating a more comprehensive and more realistic picture of brain-language relations. Importantly, functional neuroimaging approaches demonstrate a good degree of concordance on a theoretical level, but also a considerable degree of individual variability, attesting to the clinical importance with these methods to establish, empirically, language localization in individual patients. Overall, the unique features of epilepsy, combined with ongoing advances in technology, promise further improvement in understanding of language substrate.
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Máté A, Lidzba K, Hauser TK, Staudt M, Wilke M. A "one size fits all" approach to language fMRI: increasing specificity and applicability by adding a self-paced component. Exp Brain Res 2015; 234:673-84. [PMID: 26514810 DOI: 10.1007/s00221-015-4473-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 10/10/2015] [Indexed: 11/28/2022]
Abstract
We have previously established an fMRI task battery suitable for mapping the language processing network in children. Among the tasks used, the synonyms and the vowel identification task induced robust task-related activations in children with average language abilities; however, the fixed presentation time seems to be a drawback in participants with above- or below-average language abilities. This feasibility study in healthy adults (n = 20) was aimed at adapting these tasks to the individual level of each patient by implementing a self-paced stimulus presentation. The impact of using a block- versus an event-related statistical approach was also evaluated. The self-paced modification allowed our participants with above-average language abilities to process stimuli much faster than originally implemented, likely increasing task adherence. A higher specificity of the event-related analysis was confirmed by stronger left inferior frontal and crossed cerebellar activations. We suggest that self-paced paradigms and event-related analyses may both increase specificity and applicability.
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Affiliation(s)
- Adrienn Máté
- Department of Neurosurgery, Faculty of Medicine, University of Szeged, Szeged, Hungary.,Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany.,Experimental Pediatric Neuroimaging Group, Pediatric Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | - Karen Lidzba
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany.,Experimental Pediatric Neuroimaging Group, Pediatric Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | | | - Martin Staudt
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany.,Clinic for Neuropediatrics and Neurorehabilitation, Epilepsy Center for Children and Adolescents, Schön Klinik, Vogtareuth, Germany
| | - Marko Wilke
- Department of Pediatric Neurology and Developmental Medicine, Children's Hospital, Hoppe-Seyler-Str. 1, 72076, Tübingen, Germany. .,Experimental Pediatric Neuroimaging Group, Pediatric Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany.
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