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Ille S, Zhang H, Stassen N, Schwendner M, Schröder A, Wiestler B, Meyer B, Krieg SM. Noninvasive- and invasive mapping reveals similar language network centralities - A function-based connectome analysis. Cortex 2024; 174:189-200. [PMID: 38569257 DOI: 10.1016/j.cortex.2024.01.013] [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: 06/14/2023] [Revised: 09/11/2023] [Accepted: 01/23/2024] [Indexed: 04/05/2024]
Abstract
BACKGROUND Former comparisons between direct cortical stimulation (DCS) and navigated transcranial magnetic stimulation (nTMS) only focused on cortical mapping. While both can be combined with diffusion tensor imaging, their differences in the visualization of subcortical and even network levels remain unclear. Network centrality is an essential parameter in network analysis to measure the importance of nodes identified by mapping. Those include Degree centrality, Eigenvector centrality, Closeness centrality, Betweenness centrality, and PageRank centrality. While DCS and nTMS have repeatedly been compared on the cortical level, the underlying network identified by both has not been investigated yet. METHOD 27 patients with brain lesions necessitating preoperative nTMS and intraoperative DCS language mapping during awake craniotomy were enrolled. Function-based connectome analysis was performed based on the cortical nodes obtained through the two mapping methods, and language-related network centralities were compared. RESULTS Compared with DCS language mapping, the positive predictive value of cortical nTMS language mapping is 74.1%, with good consistency of tractography for the arcuate fascicle and superior longitudinal fascicle. Moreover, network centralities did not differ between the two mapping methods. However, ventral stream tracts can be better traced based on nTMS mappings, demonstrating its strengths in acquiring language-related networks. In addition, it showed lower centralities than other brain areas, with decentralization as an indicator of language function loss. CONCLUSION This study deepens the understanding of language-related functional anatomy and proves that non-invasive mapping-based network analysis is comparable to the language network identified via invasive cortical mapping.
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Affiliation(s)
- Sebastian Ille
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Haosu Zhang
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Nina Stassen
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Maximilian Schwendner
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
| | - Axel Schröder
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TranslaTUM (Zentralinstitut für translationale Krebsforschung der Technischen Universität München), Munich, Germany.
| | - Bernhard Meyer
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany.
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich, Germany; TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany; Department of Neurosurgery, Heidelberg University Hospital, Heidelberg, Germany.
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Cai G, Xu J, Ding Q, Lin T, Chen H, Wu M, Li W, Chen G, Xu G, Lan Y. Electroencephalography oscillations can predict the cortical response following theta burst stimulation. Brain Res Bull 2024; 208:110902. [PMID: 38367675 DOI: 10.1016/j.brainresbull.2024.110902] [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: 11/30/2023] [Revised: 01/28/2024] [Accepted: 02/14/2024] [Indexed: 02/19/2024]
Abstract
BACKGROUND Continuous theta burst stimulation and intermittent theta burst stimulation are clinically popular models of repetitive transcranial magnetic stimulation. However, they are limited by high variability between individuals in cortical excitability changes following stimulation. Although electroencephalography oscillations have been reported to modulate the cortical response to transcranial magnetic stimulation, their association remains unclear. This study aims to explore whether machine learning models based on EEG oscillation features can predict the cortical response to transcranial magnetic stimulation. METHOD Twenty-three young, healthy adults attended two randomly assigned sessions for continuous and intermittent theta burst stimulation. In each session, ten minutes of resting-state electroencephalography were recorded before delivering brain stimulation. Participants were classified as responders or non-responders based on changes in resting motor thresholds. Support vector machines and multi-layer perceptrons were used to establish predictive models of individual responses to transcranial magnetic stimulation. RESULT Among the evaluated algorithms, support vector machines achieved the best performance in discriminating responders from non-responders for intermittent theta burst stimulation (accuracy: 91.30%) and continuous theta burst stimulation (accuracy: 95.66%). The global clustering coefficient and global characteristic path length in the beta band had the greatest impact on model output. CONCLUSION These findings suggest that EEG features can serve as markers of cortical response to transcranial magnetic stimulation. They offer insights into the association between neural oscillations and variability in individuals' responses to transcranial magnetic stimulation, aiding in the optimization of individualized protocols.
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Affiliation(s)
- Guiyuan Cai
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Jiayue Xu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Qian Ding
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 519041 China
| | - Tuo Lin
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Hongying Chen
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Manfeng Wu
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Wanqi Li
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China
| | - Gengbin Chen
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Postgraduate Research Institute, Guangzhou Sport University, Guangzhou, 510500 China
| | - Guangqing Xu
- Department of Rehabilitation Medicine, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, 519041 China.
| | - Yue Lan
- Department of Rehabilitation Medicine, the Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, 510013 China; Guangzhou Key Laboratory of Aging Frailty and Neurorehabilitation, Guangzhou 510013, China.
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Eibl T, Schrey M, Liebert A, Ritter L, Lange R, Steiner HH, Schebesch KM. Influence of clinical and tumor-specific factors on the resting motor threshold in navigated transcranial magnetic stimulation. Neurophysiol Clin 2023; 53:102920. [PMID: 37944292 DOI: 10.1016/j.neucli.2023.102920] [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: 08/25/2023] [Revised: 10/27/2023] [Accepted: 10/28/2023] [Indexed: 11/12/2023] Open
Abstract
OBJECTIVE Preoperative non-invasive mapping of motor function with navigated transcranial magnetic stimulation (nTMS) has become a widely used diagnostic procedure. Determination of the patient-individual resting motor threshold (rMT) is of great importance to achieve reliable results when conducting nTMS motor mapping. Factors which contribute to differences in rMT of brain tumor patients have not been fully investigated. METHODS We included adult patients with all types of de novo and recurrent intracranial lesions, suspicious for intra-axial brain tumors. The outcome measure was the rMT of the upper extremity, defined as the stimulation intensity eliciting motor evoked potentials with amplitudes greater than 50µV in 50 % of applied stimulations. RESULTS Eighty nTMS examinations in 75 patients (37.5 % female) aged 57.9 ± 14.9 years were evaluated. In non-parametric testing, rMT values were higher in patients with upper extremity paresis (p = 0.024) and lower in patients with high grade gliomas (HGG) (p = 0.001). rMT inversely correlated with patient age (rs=-0.28, p = 0.013) and edema volume (rs=-0.28, p = 0.012) In regression analysis, infiltration of the precentral gyrus (p<0.001) increased rMT values. Values of rMT were reduced in high grade gliomas (p<0.001), in patients taking Levetiracetam (p = 0.019) and if perilesional edema infiltrated motor eloquent brain (p<0.001). Subgroup analyses of glioma patients revealed similar results. Values of rMT did not differ between hand and forearm muscles. CONCLUSION Most factors confounding rMT in our study were specific to the lesion. These factors contributed to the variability in cortical excitability and must be considered in clinical work with nTMS to achieve reliable results with nTMS motor mapping.
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Affiliation(s)
- Thomas Eibl
- Department of Neurosurgery, Paracelsus Medical University Nuremberg, Germany.
| | - Michael Schrey
- Department of Neurosurgery, Paracelsus Medical University Nuremberg, Germany
| | - Adrian Liebert
- Department of Neurosurgery, Paracelsus Medical University Nuremberg, Germany
| | - Leonard Ritter
- Department of Neurosurgery, Paracelsus Medical University Nuremberg, Germany
| | - Rüdiger Lange
- Department of Neurology, Paracelsus Medical University Nuremberg, Germany
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Sollmann N, Zhang H, Kloth C, Zimmer C, Wiestler B, Rosskopf J, Kreiser K, Schmitz B, Beer M, Krieg SM. Modern preoperative imaging and functional mapping in patients with intracranial glioma. ROFO-FORTSCHR RONTG 2023; 195:989-1000. [PMID: 37224867 DOI: 10.1055/a-2083-8717] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Magnetic resonance imaging (MRI) in therapy-naïve intracranial glioma is paramount for neuro-oncological diagnostics, and it provides images that are helpful for surgery planning and intraoperative guidance during tumor resection, including assessment of the involvement of functionally eloquent brain structures. This study reviews emerging MRI techniques to depict structural information, diffusion characteristics, perfusion alterations, and metabolism changes for advanced neuro-oncological imaging. In addition, it reflects current methods to map brain function close to a tumor, including functional MRI and navigated transcranial magnetic stimulation with derived function-based tractography of subcortical white matter pathways. We conclude that modern preoperative MRI in neuro-oncology offers a multitude of possibilities tailored to clinical needs, and advancements in scanner technology (e. g., parallel imaging for acceleration of acquisitions) make multi-sequence protocols increasingly feasible. Specifically, advanced MRI using a multi-sequence protocol enables noninvasive, image-based tumor grading and phenotyping in patients with glioma. Furthermore, the add-on use of preoperatively acquired MRI data in combination with functional mapping and tractography facilitates risk stratification and helps to avoid perioperative functional decline by providing individual information about the spatial location of functionally eloquent tissue in relation to the tumor mass. KEY POINTS:: · Advanced preoperative MRI allows for image-based tumor grading and phenotyping in glioma.. · Multi-sequence MRI protocols nowadays make it possible to assess various tumor characteristics (incl. perfusion, diffusion, and metabolism).. · Presurgical MRI in glioma is increasingly combined with functional mapping to identify and enclose individual functional areas.. · Advancements in scanner technology (e. g., parallel imaging) facilitate increasing application of dedicated multi-sequence imaging protocols.. CITATION FORMAT: · Sollmann N, Zhang H, Kloth C et al. Modern preoperative imaging and functional mapping in patients with intracranial glioma. Fortschr Röntgenstr 2023; 195: 989 - 1000.
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Affiliation(s)
- Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, München, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, München, Germany
- Department of Radiology and Biomedical Imaging, University of California San Francisco, San Francisco, United States
| | - Haosu Zhang
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, München, Germany
| | - Christopher Kloth
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Claus Zimmer
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, München, Germany
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, München, Germany
| | - Benedikt Wiestler
- Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, München, Germany
- TranslaTUM - Central Institute for Translational Cancer Research, Klinikum rechts der Isar, Technical University of Munich, München, Germany
| | - Johannes Rosskopf
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Section of Neuroradiology, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Kornelia Kreiser
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Department of Radiology and Neuroradiology, Universitäts- und Rehabilitationskliniken Ulm, Ulm, Germany
| | - Bernd Schmitz
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
- Section of Neuroradiology, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Meinrad Beer
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany
| | - Sandro M Krieg
- TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, München, Germany
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, München, Germany
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Vasileiadi M, Schuler AL, Woletz M, Linhardt D, Windischberger C, Tik M. Functional connectivity explains how neuronavigated TMS of posterior temporal subregions differentially affect language processing. Brain Stimul 2023; 16:1062-1071. [PMID: 37390891 DOI: 10.1016/j.brs.2023.06.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 05/25/2023] [Accepted: 06/21/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND "Wernicke's area" is most often used to describe the posterior superior temporal gyrus (STG) and refers to a region traditionally thought to support language comprehension. However, the posterior STG additionally plays a critical role in language production. The purpose of the current study was to determine to what extent regions within the posterior STG are selectively recruited during language production. METHODS 23 healthy right-handed participants completed an auditory fMRI localizer task, resting-state fMRI and underwent neuronavigated TMS language mapping. We applied repetitive TMS bursts during a picture naming paradigm to probe speech disruptions of different categories (anomia, speech arrest, semantic paraphasia and phonological paraphasia). We combined an in-house built high precision stimulation software suite with E-field modeling to map the naming errors to cortical regions and revealed a dissociation of language functions within the temporal gyrus. Resting state fMRI was used to explain how E-field peaks of different categories differentially affected language production. RESULTS Peaks for phonological and semantic errors were found in the STG while those for anomia and speech arrest were located in the MTG. Seed-based connectivity analysis revealed a local connectivity pattern for phonological and semantic errors, while anomia and speech arrest seeds resulted in a larger network between IFG and posterior MTG. CONCLUSIONS Our study provides important insights into the functional neuroanatomy of language production and might help to increase the current understanding of specific language production difficulties on a causal level.
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Affiliation(s)
- Maria Vasileiadi
- Center for Medical Physics and BME, Medical University of Vienna, Vienna, Austria
| | - Anna-Lisa Schuler
- Center for Medical Physics and BME, Medical University of Vienna, Vienna, Austria
| | - Michael Woletz
- Center for Medical Physics and BME, Medical University of Vienna, Vienna, Austria
| | - David Linhardt
- Center for Medical Physics and BME, Medical University of Vienna, Vienna, Austria
| | | | - Martin Tik
- Center for Medical Physics and BME, Medical University of Vienna, Vienna, Austria; Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA.
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Qu X, Wang Z, Cheng Y, Xue Q, Li Z, Li L, Feng L, Hartwigsen G, Chen L. Neuromodulatory effects of transcranial magnetic stimulation on language performance in healthy participants: Systematic review and meta-analysis. Front Hum Neurosci 2022; 16:1027446. [PMID: 36545349 PMCID: PMC9760723 DOI: 10.3389/fnhum.2022.1027446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 11/17/2022] [Indexed: 12/12/2022] Open
Abstract
Background The causal relationships between neural substrates and human language have been investigated by transcranial magnetic stimulation (TMS). However, the robustness of TMS neuromodulatory effects is still largely unspecified. This study aims to systematically examine the efficacy of TMS on healthy participants' language performance. Methods For this meta-analysis, we searched PubMed, Web of Science, PsycINFO, Scopus, and Google Scholar from database inception until October 15, 2022 for eligible TMS studies on language comprehension and production in healthy adults published in English. The quality of the included studies was assessed with the Cochrane risk of bias tool. Potential publication biases were assessed by funnel plots and the Egger Test. We conducted overall as well as moderator meta-analyses. Effect sizes were estimated using Hedges'g (g) and entered into a three-level random effects model. Results Thirty-seven studies (797 participants) with 77 effect sizes were included. The three-level random effects model revealed significant overall TMS effects on language performance in healthy participants (RT: g = 0.16, 95% CI: 0.04-0.29; ACC: g = 0.14, 95% CI: 0.04-0.24). Further moderator analyses indicated that (a) for language tasks, TMS induced significant neuromodulatory effects on semantic and phonological tasks, but didn't show significance for syntactic tasks; (b) for cortical targets, TMS effects were not significant in left frontal, temporal or parietal regions, but were marginally significant in the inferior frontal gyrus in a finer-scale analysis; (c) for stimulation parameters, stimulation sites extracted from previous studies, rTMS, and intensities calibrated to the individual resting motor threshold are more prone to induce robust TMS effects. As for stimulation frequencies and timing, both high and low frequencies, online and offline stimulation elicited significant effects; (d) for experimental designs, studies adopting sham TMS or no TMS as the control condition and within-subject design obtained more significant effects. Discussion Overall, the results show that TMS may robustly modulate healthy adults' language performance and scrutinize the brain-and-language relation in a profound fashion. However, due to limited sample size and constraints in the current meta-analysis approach, analyses at a more comprehensive level were not conducted and results need to be confirmed by future studies. Systematic review registration [https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=366481], identifier [CRD42022366481].
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Affiliation(s)
- Xingfang Qu
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zichao Wang
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Yao Cheng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Qingwei Xue
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Zimu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Lu Li
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Liping Feng
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China
| | - Gesa Hartwigsen
- Lise Meitner Research Group Cognition and Plasticity, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Luyao Chen
- Max Planck Partner Group, School of International Chinese Language Education, Beijing Normal University, Beijing, China,*Correspondence: Luyao Chen,
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Bolgina T, Somashekarappa V, Cappa SF, Cherkasova Z, Feurra M, Malyutina S, Sapuntsova A, Shtyrov Y, Dragoy O. Repetitive transcranial magnetic stimulation modulates action naming over the left but not right inferior frontal gyrus. Brain Struct Funct 2022; 227:2797-2808. [PMID: 36194276 DOI: 10.1007/s00429-022-02574-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Accepted: 09/20/2022] [Indexed: 11/24/2022]
Abstract
fMRI language mapping studies report right-hemispheric contribution to language in healthy individuals. However, it remains unclear whether these right-hemispheric patterns of activity are critical for language, which is highly relevant for clinical preoperative language mapping. The available findings are controversial. In this study, we first measured individual patterns of language lateralization with an fMRI language localizer in healthy participants with different handedness (N = 31). Then, the same participants received rTMS over the individual coordinates of peak fMRI-based activation in the left and right inferior frontal gyri. During rTMS, participants performed a picture naming task. It included both objects and actions to test whether naming of nouns and verbs would be equally modulated by rTMS. Stimulation of the left inferior frontal gyrus resulted in accuracy facilitation of verb production regardless of individual language lateralization. No modulation of object naming was found at any stimulation site in terms of accuracy nor reaction time. This study causally confirmed the critical contribution of the left, but not the right hemisphere to verb production regardless of the language lateralization patterns observed with fMRI. Also, the results stress that action rather than object naming is the task of choice for mapping language in the frontal lobe.
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Affiliation(s)
- Tatiana Bolgina
- Centre for Brain and Language, HSE University, 3 Krivokolenny pereulok, Moscow, Russia, 101000.
| | - Vidya Somashekarappa
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia, 101000
| | - Stefano F Cappa
- IUSS Cognitive Neuroscience Centre, Institute of Advanced Study, Pavia, Italy
| | - Zoya Cherkasova
- Centre for Brain and Language, HSE University, 3 Krivokolenny pereulok, Moscow, Russia, 101000
| | - Matteo Feurra
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia, 101000
| | - Svetlana Malyutina
- Centre for Brain and Language, HSE University, 3 Krivokolenny pereulok, Moscow, Russia, 101000
| | | | - Yury Shtyrov
- Centre for Cognition and Decision Making, Institute for Cognitive Neuroscience, HSE University, Moscow, Russia, 101000.,Center of Functionally Integrative Neuroscience, Aarhus University, Aarhus, Denmark
| | - Olga Dragoy
- Centre for Brain and Language, HSE University, 3 Krivokolenny pereulok, Moscow, Russia, 101000.,Institute of Linguistics, Russian Academy of Sciences, Moscow, Russia
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Ohlerth AK, Bastiaanse R, Nickels L, Neu B, Zhang W, Ille S, Sollmann N, Krieg SM. Dual-Task nTMS Mapping to Visualize the Cortico-Subcortical Language Network and Capture Postoperative Outcome-A Patient Series in Neurosurgery. Front Oncol 2022; 11:788122. [PMID: 35127493 PMCID: PMC8814635 DOI: 10.3389/fonc.2021.788122] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Accepted: 12/13/2021] [Indexed: 11/16/2022] Open
Abstract
Background Perioperative assessment of language function in brain tumor patients commonly relies on administration of object naming during stimulation mapping. Ample research, however, points to the benefit of adding verb tasks to the testing paradigm in order to delineate and preserve postoperative language function more comprehensively. This research uses a case series approach to explore the feasibility and added value of a dual-task protocol that includes both a noun task (object naming) and a verb task (action naming) in perioperative delineation of language functions. Materials and Methods Seven neurosurgical cases underwent perioperative language assessment with both object and action naming. This entailed preoperative baseline testing, preoperative stimulation mapping with navigated Transcranial Magnetic Stimulation (nTMS) with subsequent white matter visualization, intraoperative mapping with Direct Electrical Stimulation (DES) in 4 cases, and postoperative imaging and examination of language change. Results We observed a divergent pattern of language organization and decline between cases who showed lesions close to the delineated language network and hence underwent DES mapping, and those that did not. The latter displayed no new impairment postoperatively consistent with an unharmed network for the neural circuits of both object and action naming. For the cases who underwent DES, on the other hand, a higher sensitivity was found for action naming over object naming. Firstly, action naming preferentially predicted the overall language state compared to aphasia batteries. Secondly, it more accurately predicted intraoperative positive language areas as revealed by DES. Thirdly, double dissociations between postoperatively unimpaired object naming and impaired action naming and vice versa indicate segregated skills and neural representation for noun versus verb processing, especially in the ventral stream. Overlaying postoperative imaging with object and action naming networks revealed that dual-task nTMS mapping can explain the drop in performance in those cases where the network appeared in proximity to the resection cavity. Conclusion Using a dual-task protocol for visualization of cortical and subcortical language areas through nTMS mapping proved to be able to capture network-to-deficit relations in our case series. Ultimately, adding action naming to clinical nTMS and DES mapping may help prevent postoperative deficits of this seemingly segregated skill.
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Affiliation(s)
- Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, Groningen, Netherlands.,International Doctorate in Experimental Approaches to Language and Brain (IDEALAB, Universities of Groningen, Potsdam, Newcastle, and Macquarie University), Sydney, NSW, Australia
| | - Roelien Bastiaanse
- Center for Language and Brain, Higher School of Economics, National Research University, Moscow, Russia
| | - Lyndsey Nickels
- School of Psychological Sciences, Faculty of Medicine, Health and Human Sciences, Macquarie University, Sydney, NSW, Australia
| | - Beate Neu
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Wei Zhang
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Nico Sollmann
- Department of Diagnostic and Interventional Radiology, University Hospital Ulm, Ulm, Germany.,Department of Diagnostic and Interventional Neuroradiology, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, School of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
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9
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Zhang H, Ille S, Sogerer L, Schwendner M, Schröder A, Meyer B, Wiestler B, Krieg SM. Elucidating the structural-functional connectome of language in glioma-induced aphasia using nTMS and DTI. Hum Brain Mapp 2021; 43:1836-1849. [PMID: 34951084 PMCID: PMC8933329 DOI: 10.1002/hbm.25757] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 12/01/2021] [Accepted: 12/01/2021] [Indexed: 12/24/2022] Open
Abstract
Glioma‐induced aphasia (GIA) is frequently observed in patients with newly diagnosed gliomas. Previous studies showed an impact of gliomas not only on local brain regions but also on the functionality and structure of brain networks. The current study used navigated transcranial magnetic stimulation (nTMS) to localize language‐related regions and to explore language function at the network level in combination with connectome analysis. Thirty glioma patients without aphasia (NA) and 30 patients with GIA were prospectively enrolled. Tumors were located in the vicinity of arcuate fasciculus‐related cortical and subcortical regions. The visualized ratio (VR) of each tract was calculated based on their respective fractional anisotropy (FA) and maximal FA. Using a thresholding method of each tract at 25% VR and 50% VR, DTI‐based tractography was performed to construct structural brain networks for graph‐based connectome analysis, containing functional data acquired by nTMS. The average degree of left hemispheric networks (Mleft) was higher in the NA group than in the GIA group for both VR thresholds. Differences of global and local efficiency between 25% and 50% VR thresholds were significantly lower in the NA group than in the GIA group. Aphasia levels correlated with connectome properties in Mleft and networks based on positive nTMS mapping regions (Mpos). A more substantial relation to language performance was found in Mpos and Mleft compared to the network of negative mapping regions (Mneg). Gliomas causing deterioration of language are related to various cerebral networks. In NA patients, mainly Mneg was impacted, while Mpos was impacted in GIA patients.
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Affiliation(s)
- Haosu Zhang
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany
| | - Lisa Sogerer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany
| | - Maximilian Schwendner
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany
| | - Axel Schröder
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany
| | - Benedikt Wiestler
- School of Medicine, Technical University of Munich, Munich, Germany.,Department of Diagnostic and Interventional Neuroradiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,Center for Translational Cancer Research of the TUM (TranslaTUM), Technical University of Munich, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany.,School of Medicine, Technical University of Munich, Munich, Germany.,TUM-Neuroimaging Center, Technical University of Munich, Munich, Germany
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10
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Tani K, Hirata A, Gomez-Tames J, Tanaka S. Coil orientation affects pain sensation during single-pulse transcranial magnetic stimulation over Broca's area. Clin Neurophysiol Pract 2021; 6:234-238. [PMID: 34466758 PMCID: PMC8382968 DOI: 10.1016/j.cnp.2021.07.003] [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: 01/19/2021] [Revised: 07/05/2021] [Accepted: 07/15/2021] [Indexed: 10/29/2022] Open
Abstract
Objective Pain sensation at the site of stimulation is a side effect of transcranial magnetic stimulation (TMS). The purpose of this study was to investigate how or whether the coil orientation affected TMS-induced pain on Broca's area (BA) or primary motor cortex (M1). Methods In Experiment 1, we measured pain thresholds during single-pulse TMS delivered over BA or left M1 at seven coil orientation angles (-90° to 90°, in 30° increments) relative to the posterior-anterior (PA) orientation. In Experiment 2, we evaluated subjective pain intensity when delivering TMS at an intensity of 110% of the resting motor threshold, which is commonly used in conventional TMS studies. Results In Experiment 1, we found a significant relationship between coil orientation and pain thresholds during BA stimulation but not M1 stimulation. During BA stimulation, pain thresholds were significantly lower when the coil orientation was 30° upward (-30° condition) relative to the PA orientation compared with 60° downward (60° condition). In Experiment 2, pain sensations were significantly stronger in the -30° condition compared with those in the 60° condition. We also confirmed that the averaged location of pain on the head in both conditions were more than 25 mm from the left lateral orbital rim. Conclusions The coil orientation of TMS over BA affects pain sensations. This might be attributable to the activation of nociceptors and nociceptive fibers in the muscle tissues above BA, rather than the orbicularis oculi muscle. Significance Although the influence of coil orientation on the TMS efficacy is unclear, this study suggests that manipulating the orientation of the TMS coil may be helpful in reducing pain when applying TMS to BA.
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Affiliation(s)
- Keisuke Tani
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3125, Japan.,Faculty of Psychology, Otemon Gakuin University, 2-1-15 Nishi-Ai, Ibaraki, Osaka 567-8502, Japan
| | - Akimasa Hirata
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Jose Gomez-Tames
- Department of Electrical and Mechanical Engineering, Nagoya Institute of Technology, Gokiso-cho, Showa-ku, Nagoya, Aichi 466-8555, Japan
| | - Satoshi Tanaka
- Laboratory of Psychology, Hamamatsu University School of Medicine, 1-20-1 Handayama, Higashi-ku, Hamamatsu, Shizuoka 431-3125, Japan
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11
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Nettekoven C, Pieczewski J, Neuschmelting V, Jonas K, Goldbrunner R, Grefkes C, Weiss Lucas C. Improving the efficacy and reliability of rTMS language mapping by increasing the stimulation frequency. Hum Brain Mapp 2021; 42:5309-5321. [PMID: 34387388 PMCID: PMC8519874 DOI: 10.1002/hbm.25619] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Revised: 07/14/2021] [Accepted: 07/27/2021] [Indexed: 11/08/2022] Open
Abstract
Repetitive TMS (rTMS) with a frequency of 5–10 Hz is widely used for language mapping. However, it may be accompanied by discomfort and is limited in the number and reliability of evoked language errors. We, here, systematically tested the influence of different stimulation frequencies (i.e., 10, 30, and 50 Hz) on tolerability, number, reliability, and cortical distribution of language errors aiming at improved language mapping. 15 right‐handed, healthy subjects (m = 8, median age: 29 yrs) were investigated in two sessions, separated by 2–5 days. In each session, 10, 30, and 50 Hz rTMS were applied over the left hemisphere in a randomized order during a picture naming task. Overall, 30 Hz rTMS evoked significantly more errors (20 ± 12%) compared to 50 Hz (12 ± 8%; p <.01), whereas error rates were comparable between 30/50 and 10 Hz (18 ± 11%). Across all conditions, a significantly higher error rate was found in Session 1 (19 ± 13%) compared to Session 2 (13 ± 7%, p <.05). The error rate was poorly reliable between sessions for 10 (intraclass correlation coefficient, ICC = .315) and 30 Hz (ICC = .427), whereas 50 Hz showed a moderate reliability (ICC = .597). Spatial reliability of language errors was low to moderate with a tendency toward increased reliability for higher frequencies, for example, within frontal regions. Compared to 10 Hz, both, 30 and 50 Hz were rated as less painful. Taken together, our data favor the use of rTMS‐protocols employing higher frequencies for evoking language errors reliably and with reduced discomfort, depending on the region of interest.
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Affiliation(s)
- Charlotte Nettekoven
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Julia Pieczewski
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Volker Neuschmelting
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Kristina Jonas
- Faculty of Human Sciences, Department of Rehabilitation and Special Education, University of Cologne, Cologne, Germany
| | - Roland Goldbrunner
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
| | - Christian Grefkes
- Faculty of Medicine and University Hospital, Department of Neurology, University of Cologne, Cologne, Germany.,Juelich Research Centre, Institute of Neuroscience and Medicine (INM-3), Juelich, Germany
| | - Carolin Weiss Lucas
- Faculty of Medicine and University Hospital, Center for Neurosurgery, Department of General Neurosurgery, University of Cologne, Cologne, Germany
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12
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The cortical distribution of first and second language in the right hemisphere of bilinguals - an exploratory study by repetitive navigated transcranial magnetic stimulation. Brain Imaging Behav 2021; 14:1034-1049. [PMID: 30868405 DOI: 10.1007/s11682-019-00082-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
First language (L1) and second language (L2) processing in bilinguals is not yet fully understood, especially not when considering the non-dominant hemisphere. Ten healthy, right-handed volunteers underwent language mapping of the right hemisphere by repetitive navigated transcranial magnetic stimulation and an object-naming task in their L1 and L2. All elicited naming errors together, no responses, and all errors without hesitation were analyzed separately for cortical distributions of error rates (ERs: number of errors divided by the number of applied stimulations). No significant differences (p > 0.05) were found in ERs between the L1 and L2 for all errors (L1 20.6 ± 14.8%, L2 15.4 ± 11.2%), no responses (L1 13.5 ± 10.9%, L2 9.2 ± 10.8%), and all errors without hesitation (L1 14.4 ± 11.2%, L2 10.8 ± 10.0%). The areas that showed high ERs for the L1 included the dorsal precentral and middle precentral gyrus, whereas the triangular inferior frontal gyrus showed high ERs for the L2. When focusing on error distributions per single stimulation points, differences in ERs between the L1 and L2 were initially observed for stimulation within the angular and middle middle frontal gyrus, but did not withstand correction for the false discovery rate (FDR-corrected p > 0.05). In conclusion, this exploratory study shows the feasibility of rTMS to the right hemisphere for language mapping and reveals cortical areas involved in L1 and L2 processing, but has to be followed up by larger studies enrolling more homogeneous cohorts.
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13
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Sanada T, Kapeller C, Jordan M, Grünwald J, Mitsuhashi T, Ogawa H, Anei R, Guger C. Multi-modal Mapping of the Face Selective Ventral Temporal Cortex-A Group Study With Clinical Implications for ECS, ECoG, and fMRI. Front Hum Neurosci 2021; 15:616591. [PMID: 33828468 PMCID: PMC8020907 DOI: 10.3389/fnhum.2021.616591] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Accepted: 02/22/2021] [Indexed: 12/29/2022] Open
Abstract
Face recognition is impaired in patients with prosopagnosia, which may occur as a side effect of neurosurgical procedures. Face selective regions on the ventral temporal cortex have been localized with electrical cortical stimulation (ECS), electrocorticography (ECoG), and functional magnetic resonance imagining (fMRI). This is the first group study using within-patient comparisons to validate face selective regions mapping, utilizing the aforementioned modalities. Five patients underwent surgical treatment of intractable epilepsy and joined the study. Subdural grid electrodes were implanted on their ventral temporal cortices to localize seizure foci and face selective regions as part of the functional mapping protocol. Face selective regions were identified in all patients with fMRI, four patients with ECoG, and two patients with ECS. From 177 tested electrode locations in the region of interest (ROI), which is defined by the fusiform gyrus and the inferior temporal gyrus, 54 face locations were identified by at least one modality in all patients. fMRI mapping showed the highest detection rate, revealing 70.4% for face selective locations, whereas ECoG and ECS identified 64.8 and 31.5%, respectively. Thus, 28 face locations were co-localized by at least two modalities, with detection rates of 89.3% for fMRI, 85.7% for ECoG and 53.6 % for ECS. All five patients had no face recognition deficits after surgery, even though five of the face selective locations, one obtained by ECoG and the other four by fMRI, were within 10 mm to the resected volumes. Moreover, fMRI included a quite large volume artifact on the ventral temporal cortex in the ROI from the anatomical structures of the temporal base. In conclusion, ECS was not sensitive in several patients, whereas ECoG and fMRI even showed activation within 10 mm to the resected volumes. Considering the potential signal drop-out in fMRI makes ECoG the most reliable tool to identify face selective locations in this study. A multimodal approach can improve the specificity of ECoG and fMRI, while simultaneously minimizing the number of required ECS sessions. Hence, all modalities should be considered in a clinical mapping protocol entailing combined results of co-localized face selective locations.
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Affiliation(s)
- Takahiro Sanada
- Department of Neurosurgery, Nayoro City General Hospital, Nayoro, Japan.,Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Christoph Kapeller
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Michael Jordan
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Johannes Grünwald
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
| | - Takumi Mitsuhashi
- Department of Neurosurgery, Juntendo University, Tokyo, Japan.,Department of Pediatrics, Children's Hospital of Michigan, Detroit Medical Center, Wayne State University, Detroit, MI, United States
| | - Hiroshi Ogawa
- Division of Neurology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Ryogo Anei
- Department of Neurosurgery, Asahikawa Medical University, Asahikawa, Japan
| | - Christoph Guger
- g.tec Medical Engineering GmbH, Schiedlberg, Austria.,Guger Technologies OG, Graz, Austria
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14
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Konakanchi D, de Jongh Curry AL, Waters RS, Narayana S. Focality of the Induced E-Field Is a Contributing Factor in the Choice of TMS Parameters: Evidence from a 3D Computational Model of the Human Brain. Brain Sci 2020; 10:E1010. [PMID: 33353125 PMCID: PMC7766380 DOI: 10.3390/brainsci10121010] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/05/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a promising, non-invasive approach in the diagnosis and treatment of several neurological conditions. However, the specific results in the cortex of the magnitude and spatial distribution of the secondary electrical field (E-field) resulting from TMS at different stimulation sites/orientations and varied TMS parameters are not clearly understood. The objective of this study is to identify the impact of TMS stimulation site and coil orientation on the induced E-field, including spatial distribution and the volume of activation in the cortex across brain areas, and hence demonstrate the need for customized optimization, using a three-dimensional finite element model (FEM). A considerable difference was noted in E-field values and distribution at different brain areas. We observed that the volume of activated cortex varied from 3000 to 7000 mm3 between the selected nine clinically relevant coil locations. Coil orientation also changed the induced E-field by a maximum of 10%, and we noted the least optimal values at the standard coil orientation pointing to the nose. The volume of gray matter activated varied by 10% on average between stimulation sites in homologous brain areas in the two hemispheres of the brain. This FEM simulation model clearly demonstrates the importance of TMS parameters for optimal results in clinically relevant brain areas. The results show that TMS parameters cannot be interchangeably used between individuals, hemispheres, and brain areas. The focality of the TMS induced E-field along with its optimal magnitude should be considered as critical TMS parameters that should be individually optimized.
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Affiliation(s)
- Deepika Konakanchi
- Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (A.L.d.J.C.); (R.S.W.)
| | - Amy L. de Jongh Curry
- Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (A.L.d.J.C.); (R.S.W.)
- Department of Orthopaedic Surgery and Biomedical Engineering, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Robert S. Waters
- Biomedical Engineering, University of Memphis, Memphis, TN 38152, USA; (A.L.d.J.C.); (R.S.W.)
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Shalini Narayana
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Department of Pediatrics, University of Tennessee Health Science Center, Memphis, TN 38163, USA
- Neuroscience Institute, Le Bonheur Children’s Hospital, Memphis, TN 38163, USA
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15
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Schiller K, Choudhri AF, Jones T, Holder C, Wheless JW, Narayana S. Concordance Between Transcranial Magnetic Stimulation and Functional Magnetic Resonance Imaging (MRI) Derived Localization of Language in a Clinical Cohort. J Child Neurol 2020; 35:363-379. [PMID: 32122221 DOI: 10.1177/0883073820901415] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Transcranial magnetic stimulation (TMS) is a newer noninvasive language mapping tool that is safe and well-tolerated by children. We examined the accuracy of TMS-derived language maps in a clinical cohort by comparing it against functional magnetic resonance imaging (MRI)-derived language map. The number of TMS-induced speech disruptions and the volume of activation during functional MRI tasks were localized to Brodmann areas for each modality in 40 patients with epilepsy or brain tumor. We examined the concordance between TMS- and functional MRI-derived language maps by deriving statistical performance metrics for TMS including sensitivity, specificity, accuracy, and diagnostic odds ratio. Brodmann areas 6, 44, and 9 in the frontal lobe and 22 and 40 in the temporal lobe were the most commonly identified language areas by both modalities. Overall accuracy of TMS compared to functional MRI in localizing language cortex was 71%, with a diagnostic odds ratio of 1.27 and higher sensitivity when identifying left hemisphere regions. TMS was more accurate in determining the dominant hemisphere for language with a diagnostic odds ratio of 6. This study is the first to examine the accuracy of the whole brain language map derived by TMS in the largest cohort examined to date. While this comparison against functional MRI confirmed that TMS reliably localizes cortical areas that are not essential for speech function, it demonstrated only slight concordance between TMS- and functional MRI-derived language areas. That the localization of specific language cortices by TMS demonstrated low accuracy reveals a potential need to use concordant tasks between the modalities and other avenues for further optimization of TMS parameters.
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Affiliation(s)
- Katherine Schiller
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Asim F Choudhri
- Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Radiology, University of Tennessee Health Science Center, Memphis, TN, USA.,Department of Neurosurgery, University of Tennessee Health Science Center, Memphis, TN, USA
| | - Tamekia Jones
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Children's Foundation Research Institute, Le Bonheur Children's Hospital, Memphis, TN, USA
| | - Christen Holder
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - James W Wheless
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA
| | - Shalini Narayana
- Department of Pediatrics, Division of Pediatric Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.,Le Bonheur Children's Hospital, Le Bonheur Neuroscience Institute, Memphis, TN, USA.,Department of Neurobiology and Anatomy, University of Tennessee Health Science Center, Memphis, TN, USA
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16
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Yang X, Zhang K. Navigated transcranial magnetic stimulation brain mapping: Achievements, opportunities, and prospects. GLIOMA 2020. [DOI: 10.4103/glioma.glioma_13_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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17
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Role of Functional Imaging Techniques to Assess Motor and Language Cortical Plasticity in Glioma Patients: A Systematic Review. Neural Plast 2019; 2019:4056436. [PMID: 31814822 PMCID: PMC6878806 DOI: 10.1155/2019/4056436] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Accepted: 10/05/2019] [Indexed: 01/19/2023] Open
Abstract
Cerebral plasticity is the ability of the central nervous system to reorganize itself in response to different injuries. The reshaping of functional areas is a crucial mechanism to compensate for damaged function. It is acknowledged that functional remodeling of cortical areas may occur also in glioma patients. Principal limits of previous investigations on cortical plasticity of motor and language functions included scarce reports of longitudinal evaluations and limited sample sizes. This systematic review is aimed at elucidating cortical brain plasticity for motor and language functions, in adult glioma patients, by means of preoperative and intraoperative mapping techniques. We systematically reviewed the literature for prospective studies, assessing cortical plasticity of motor and language functions in low-grade and high-grade gliomas. Eight longitudinal studies investigated cortical plasticity, evaluated by motor and language task-based functional MRI (fMRI), motor navigated transcranial magnetic stimulation (n-TMS), and intraoperative mapping with cortical direct electrocortical stimulation (DES) of language and motor function. Motor function reorganization appeared relatively limited and mostly characterized by intrahemispheric functional changes, including secondary motor cortices. On the other hand, a high level of functional reshaping was found for language function in DES studies. Occurrence of cortical functional reorganization of language function was described focusing on the intrahemispheric recruitment of perilesional areas. However, the association between these functional patterns and recovery of motor and language deficits still remains partially clear. A number of relevant methodological issues possibly affecting the finding generalization emerged, such as the complexity of plasticity outcome measures and the lack of large longitudinal studies. Future studies are required to further confirm these evidences on cortical plasticity in larger samples, combining both functional imaging and intraoperative mapping techniques in longitudinally evaluations.
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