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Fresnoza S, Ischebeck A. Probing Our Built-in Calculator: A Systematic Narrative Review of Noninvasive Brain Stimulation Studies on Arithmetic Operation-Related Brain Areas. eNeuro 2024; 11:ENEURO.0318-23.2024. [PMID: 38580452 PMCID: PMC10999731 DOI: 10.1523/eneuro.0318-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/06/2024] [Accepted: 02/26/2024] [Indexed: 04/07/2024] Open
Abstract
This systematic review presented a comprehensive survey of studies that applied transcranial magnetic stimulation and transcranial electrical stimulation to parietal and nonparietal areas to examine the neural basis of symbolic arithmetic processing. All findings were compiled with regard to the three assumptions of the triple-code model (TCM) of number processing. Thirty-seven eligible manuscripts were identified for review (33 with healthy participants and 4 with patients). Their results are broadly consistent with the first assumption of the TCM that intraparietal sulcus both hold a magnitude code and engage in operations requiring numerical manipulations such as subtraction. However, largely heterogeneous results conflicted with the second assumption of the TCM that the left angular gyrus subserves arithmetic fact retrieval, such as the retrieval of rote-learned multiplication results. Support is also limited for the third assumption of the TCM, namely, that the posterior superior parietal lobule engages in spatial operations on the mental number line. Furthermore, results from the stimulation of brain areas outside of those postulated by the TCM show that the bilateral supramarginal gyrus is involved in online calculation and retrieval, the left temporal cortex in retrieval, and the bilateral dorsolateral prefrontal cortex and cerebellum in online calculation of cognitively demanding arithmetic problems. The overall results indicate that multiple cortical areas subserve arithmetic skills.
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Affiliation(s)
- Shane Fresnoza
- Department of Psychology, University of Graz, 8010 Graz, Austria
- BioTechMed, 8010 Graz, Austria
| | - Anja Ischebeck
- Department of Psychology, University of Graz, 8010 Graz, Austria
- BioTechMed, 8010 Graz, Austria
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2
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Salillas E, Benavides-Varela S, Semenza C. The brain lateralization and development of math functions: progress since Sperry, 1974. Front Hum Neurosci 2023; 17:1288154. [PMID: 37964804 PMCID: PMC10641455 DOI: 10.3389/fnhum.2023.1288154] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2023] [Accepted: 10/10/2023] [Indexed: 11/16/2023] Open
Abstract
In 1974, Roger Sperry, based on his seminal studies on the split-brain condition, concluded that math was almost exclusively sustained by the language dominant left hemisphere. The right hemisphere could perform additions up to sums less than 20, the only exception to a complete left hemisphere dominance. Studies on lateralized focal lesions came to a similar conclusion, except for written complex calculation, where spatial abilities are needed to display digits in the right location according to the specific requirements of calculation procedures. Fifty years later, the contribution of new theoretical and instrumental tools lead to a much more complex picture, whereby, while left hemisphere dominance for math in the right-handed is confirmed for most functions, several math related tasks seem to be carried out in the right hemisphere. The developmental trajectory in the lateralization of math functions has also been clarified. This corpus of knowledge is reviewed here. The right hemisphere does not simply offer its support when calculation requires generic space processing, but its role can be very specific. For example, the right parietal lobe seems to store the operation-specific spatial layout required for complex arithmetical procedures and areas like the right insula are necessary in parsing complex numbers containing zero. Evidence is found for a complex orchestration between the two hemispheres even for simple tasks: each hemisphere has its specific role, concurring to the correct result. As for development, data point to right dominance for basic numerical processes. The picture that emerges at school age is a bilateral pattern with a significantly greater involvement of the right-hemisphere, particularly in non-symbolic tasks. The intraparietal sulcus shows a left hemisphere preponderance in response to symbolic stimuli at this age.
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Affiliation(s)
- Elena Salillas
- Department of Psychology and Sociology, University of Zaragoza, Zaragoza, Spain
| | - Silvia Benavides-Varela
- Department of Developmental Psychology and Socialisation, University of Padova, Padua, Italy
| | - Carlo Semenza
- Padova Neuroscience Center, University of Padova, Padua, Italy
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3
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Ius T, Sabatino G, Panciani PP, Fontanella MM, Rudà R, Castellano A, Barbagallo GMV, Belotti F, Boccaletti R, Catapano G, Costantino G, Della Puppa A, Di Meco F, Gagliardi F, Garbossa D, Germanò AF, Iacoangeli M, Mortini P, Olivi A, Pessina F, Pignotti F, Pinna G, Raco A, Sala F, Signorelli F, Sarubbo S, Skrap M, Spena G, Somma T, Sturiale C, Angileri FF, Esposito V. Surgical management of Glioma Grade 4: technical update from the neuro-oncology section of the Italian Society of Neurosurgery (SINch®): a systematic review. J Neurooncol 2023; 162:267-293. [PMID: 36961622 PMCID: PMC10167129 DOI: 10.1007/s11060-023-04274-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 02/20/2023] [Indexed: 03/25/2023]
Abstract
PURPOSE The extent of resection (EOR) is an independent prognostic factor for overall survival (OS) in adult patients with Glioma Grade 4 (GG4). The aim of the neuro-oncology section of the Italian Society of Neurosurgery (SINch®) was to provide a general overview of the current trends and technical tools to reach this goal. METHODS A systematic review was performed. The results were divided and ordered, by an expert team of surgeons, to assess the Class of Evidence (CE) and Strength of Recommendation (SR) of perioperative drugs management, imaging, surgery, intraoperative imaging, estimation of EOR, surgery at tumor progression and surgery in elderly patients. RESULTS A total of 352 studies were identified, including 299 retrospective studies and 53 reviews/meta-analysis. The use of Dexamethasone and the avoidance of prophylaxis with anti-seizure medications reached a CE I and SR A. A preoperative imaging standard protocol was defined with CE II and SR B and usefulness of an early postoperative MRI, with CE II and SR B. The EOR was defined the strongest independent risk factor for both OS and tumor recurrence with CE II and SR B. For intraoperative imaging only the use of 5-ALA reached a CE II and SR B. The estimation of EOR was established to be fundamental in planning postoperative adjuvant treatments with CE II and SR B and the stereotactic image-guided brain biopsy to be the procedure of choice when an extensive surgical resection is not feasible (CE II and SR B). CONCLUSIONS A growing number of evidences evidence support the role of maximal safe resection as primary OS predictor in GG4 patients. The ongoing development of intraoperative techniques for a precise real-time identification of peritumoral functional pathways enables surgeons to maximize EOR minimizing the post-operative morbidity.
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Affiliation(s)
- Tamara Ius
- Division of Neurosurgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Udine, Italy
| | - Giovanni Sabatino
- Institute of Neurosurgery, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
- Unit of Neurosurgery, Mater Olbia Hospital, Olbia, Italy
| | - Pier Paolo Panciani
- Division of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy.
| | - Marco Maria Fontanella
- Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, 10094, Torino, Italy
| | - Roberta Rudà
- Department of Neuro-Oncology, University of Turin and City of Health and Science Hospital, 10094, Torino, Italy
- Neurology Unit, Hospital of Castelfranco Veneto, 31033, Castelfranco Veneto, Italy
| | - Antonella Castellano
- Department of Neuroradiology, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Giuseppe Maria Vincenzo Barbagallo
- Department of Medical and Surgical Sciences and Advanced Technologies (G.F. Ingrassia), Neurological Surgery, Policlinico "G. Rodolico - San Marco" University Hospital, University of Catania, Catania, Italy
- Interdisciplinary Research Center On Brain Tumors Diagnosis and Treatment, University of Catania, Catania, Italy
| | - Francesco Belotti
- Division of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | | | - Giuseppe Catapano
- Division of Neurosurgery, Department of Neurological Sciences, Ospedale del Mare, Naples, Italy
| | | | - Alessandro Della Puppa
- Neurosurgical Clinical Department of Neuroscience, Psychology, Pharmacology and Child Health, Careggi Hospital, University of Florence, Florence, Italy
| | - Francesco Di Meco
- Department of Neurosurgery, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
- Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
- Johns Hopkins Medical School, Baltimore, MD, USA
| | - Filippo Gagliardi
- Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | - Diego Garbossa
- Department of Neuroscience "Rita Levi Montalcini," Neurosurgery Unit, University of Turin, Torino, Italy
| | | | - Maurizio Iacoangeli
- Department of Neurosurgery, Università Politecnica Delle Marche, Azienda Ospedali Riuniti, Ancona, Italy
| | - Pietro Mortini
- Department of Neurosurgery and Gamma Knife Radiosurgery, San Raffaele Scientific Institute, Vita-Salute University, Milan, Italy
| | | | - Federico Pessina
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Milan, Italy
- Neurosurgery Department, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Milan, Italy
| | - Fabrizio Pignotti
- Institute of Neurosurgery, Fondazione Policlinico Gemelli, Catholic University, Rome, Italy
- Unit of Neurosurgery, Mater Olbia Hospital, Olbia, Italy
| | - Giampietro Pinna
- Unit of Neurosurgery, Department of Neurosciences, Hospital Trust of Verona, 37134, Verona, Italy
| | - Antonino Raco
- Division of Neurosurgery, Department of NESMOS, AOU Sant'Andrea, Sapienza University, Rome, Italy
| | - Francesco Sala
- Department of Neurosciences, Biomedicines and Movement Sciences, Institute of Neurosurgery, University of Verona, 37134, Verona, Italy
| | - Francesco Signorelli
- Department of Basic Medical Sciences, Neuroscience and Sense Organs, Neurosurgery Unit, University "Aldo Moro", 70124, Bari, Italy
| | - Silvio Sarubbo
- Department of Neurosurgery, Santa Chiara Hospital, Azienda Provinciale Per I Servizi Sanitari (APSS), Trento, Italy
| | - Miran Skrap
- Division of Neurosurgery, Head-Neck and NeuroScience Department, University Hospital of Udine, Udine, Italy
| | | | - Teresa Somma
- Division of Neurosurgery, Department of Neurosciences, Reproductive and Odontostomatological Sciences, Università Degli Studi Di Napoli Federico II, Naples, Italy
| | | | | | - Vincenzo Esposito
- Department of Neurosurgery "Giampaolo Cantore"-IRCSS Neuromed, Pozzilli, Italy
- Department of Human, Neurosciences-"Sapienza" University of Rome, Rome, Italy
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Abstract
Here, the functions of the angular gyrus (AG) are evaluated in the light of current evidence from transcranial magnetic/electric stimulation (TMS/TES) and EEG/MEG studies. 65 TMS/TES and 52 EEG/MEG studies were examined in this review. TMS/TES literature points to a causal role in semantic processing, word and number processing, attention and visual search, self-guided movement, memory, and self-processing. EEG/MEG studies reported AG effects at latencies varying between 32 and 800 ms in a wide range of domains, with a high probability to detect an effect at 300-350 ms post-stimulus onset. A three-phase unifying model revolving around the process of sensemaking is then suggested: (1) early AG involvement in defining the current context, within the first 200 ms, with a bias toward the right hemisphere; (2) attention re-orientation and retrieval of relevant information within 200-500 ms; and (3) cross-modal integration at late latencies with a bias toward the left hemisphere. This sensemaking process can favour accuracy (e.g. for word and number processing) or plausibility (e.g. for comprehension and social cognition). Such functions of the AG depend on the status of other connected regions. The much-debated semantic role is also discussed as follows: (1) there is a strong TMS/TES evidence for a causal semantic role, (2) current EEG/MEG evidence is however weak, but (3) the existing arguments against a semantic role for the AG are not strong. Some outstanding questions for future research are proposed. This review recognizes that cracking the role(s) of the AG in cognition is possible only when its exact contributions within the default mode network are teased apart.
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Affiliation(s)
- Mohamed L Seghier
- Department of Biomedical Engineering, Khalifa University of Science and Technology, Abu Dhabi, UAE. .,Healthcare Engineering Innovation Center (HEIC), Khalifa University of Science and Technology, Abu Dhabi, UAE.
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5
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Wagner J, Rusconi E. Causal involvement of the left angular gyrus in higher functions as revealed by transcranial magnetic stimulation: a systematic review. Brain Struct Funct 2023; 228:169-96. [PMID: 36260126 DOI: 10.1007/s00429-022-02576-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Accepted: 09/21/2022] [Indexed: 01/07/2023]
Abstract
Transcranial magnetic stimulation (TMS) is a non-invasive technique that can transiently interfere with local cortical functioning, thus enabling inferences of causal left AG involvement in higher functions from experimentation with healthy participants. Here, we examine 35 studies that measure behavioural outcomes soon after or during targeting TMS to the left AG, by design and as documented by individual magnetic resonance images, in healthy adult participants. The reviewed evidence suggests a specific causal involvement of the left AG in a wide range of tasks involving language, memory, number processing, visuospatial attention, body awareness and motor planning functions. These core findings are particularly valuable to inform theoretical models of the left AG role(s) in higher functions, due to the anatomical specificity afforded by the selected studies and the complementarity of TMS to different methods of investigation. In particular, the variety of the operations within and between functions in which the left AG appears to be causally involved poses a formidable challenge to any attempts to identify a single computational process subserved by the left AG (as opposed to just outlining a broad type of functional contribution) that could apply across thematic areas. We conclude by highlighting directions for improvement in future experimentation with TMS, in order to strengthen the available evidence, while taking into account the anatomical heterogeneity of this brain region.
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6
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Sokolowski HM, Matejko AA, Ansari D. The role of the angular gyrus in arithmetic processing: a literature review. Brain Struct Funct 2023; 228:293-304. [PMID: 36376522 DOI: 10.1007/s00429-022-02594-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 10/30/2022] [Indexed: 11/16/2022]
Abstract
Since the pioneering work of the early 20th century neuropsychologists, the angular gyrus (AG), particularly in the left hemisphere, has been associated with numerical and mathematical processing. The association between the AG and numerical and mathematical processing has been substantiated by neuroimaging research. In the present review article, we will examine what is currently known about the role of the AG in numerical and mathematical processing with a particular focus on arithmetic. Specifically, we will examine the role of the AG in the retrieval of arithmetic facts in both typically developing children and adults. The review article will consider alternative accounts that posit that the involvement of the AG is not specific to arithmetic processing and will consider how numerical and mathematical processing and their association with the AG overlap with other neurocognitive processes. The review closes with a discussion of future directions to further characterize the relationship between the angular gyrus and arithmetic processing.
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Affiliation(s)
- H Moriah Sokolowski
- Rotman Research Institute, Baycrest Hospital, North York, ON, M6A 2E1, Canada.,Numerical Cognition Laboratory, Department of Psychology & Brain and Mind Institute, University of Western Ontario, London, ON, N6A 3K, Canada
| | - Anna A Matejko
- Department of Psychology, Durham University, Durham, DH1 3LE, UK
| | - Daniel Ansari
- Numerical Cognition Laboratory, Department of Psychology & Brain and Mind Institute, University of Western Ontario, London, ON, N6A 3K, Canada.
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7
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Göbel SM, Terry R, Klein E, Hymers M, Kaufmann L. Impaired Arithmetic Fact Retrieval in an Adult with Developmental Dyscalculia: Evidence from Behavioral and Functional Brain Imaging Data. Brain Sci 2022; 12:735. [PMID: 35741620 PMCID: PMC9221370 DOI: 10.3390/brainsci12060735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Accepted: 05/31/2022] [Indexed: 02/04/2023] Open
Abstract
Developmental dyscalculia (DD) is a developmental disorder characterized by arithmetic difficulties. Recently, it has been suggested that the neural networks supporting procedure-based calculation (e.g., in subtraction) and left-hemispheric verbal arithmetic fact retrieval (e.g., in multiplication) are partially distinct. Here we compared the neurofunctional correlates of subtraction and multiplication in a 19-year-old student (RM) with DD to 18 age-matched controls. Behaviorally, RM performed significantly worse than controls in multiplication, while subtraction was unaffected. Neurofunctional differences were most pronounced regarding multiplication: RM showed significantly stronger activation than controls not only in left angular gyrus but also in a fronto-parietal network (including left intraparietal sulcus and inferior frontal gyrus) typically activated during procedure-based calculation. Region-of-interest analyses indicated group differences in multiplication only, which, however, did not survive correction for multiple comparisons. Our results are consistent with dissociable and processing-specific, but not operation-specific neurofunctional networks. Procedure-based calculation is not only associated with subtraction but also with (untrained) multiplication facts. Only after rote learning, facts can be retrieved quasi automatically from memory. We suggest that this learning process and the associated shift in activation patterns has not fully occurred in RM, as reflected in her need to resort to procedure-based strategies to solve multiplication facts.
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8
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Garcia-Sanz S, Ghotme KA, Hedmont D, Arévalo-Jaimes MY, Cohen Kadosh R, Serra-Grabulosa JM, Redolar-Ripoll D. Use of transcranial magnetic stimulation for studying the neural basis of numerical cognition: A systematic review. J Neurosci Methods 2022; 369:109485. [DOI: 10.1016/j.jneumeth.2022.109485] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/08/2021] [Accepted: 01/18/2022] [Indexed: 02/08/2023]
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9
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Maurer S, Butenschoen VM, Meyer B, Krieg SM. Non-invasive mapping of cortical categorization function by repetitive navigated transcranial magnetic stimulation. Sci Rep 2021; 11:24480. [PMID: 34966169 PMCID: PMC8716524 DOI: 10.1038/s41598-021-04071-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2021] [Accepted: 12/08/2021] [Indexed: 12/04/2022] Open
Abstract
Over the past years navigated repetitive transcranial magnetic stimulation (nrTMS) had become increasingly important for the preoperative examination and mapping of eloquent brain areas. Among other applications it was demonstrated that the detection of neuropsychological function, such as arithmetic processing or face recognition, is feasible with nrTMS. In order to investigate the mapping of further brain functions, this study aims to investigate the cortical mapping of categorization function via nrTMS. 20 healthy volunteers purely right-handed, with German as mother tongue underwent nrTMS mapping using 5 Hz/10 pulses. 52 cortical spots spread over each hemisphere were stimulated. The task consisted of 80 pictures of living and non-living images, which the volunteers were instructed to categorize while the simulation pulses were applied. The highest error rates for all errors of all subjects were observed in the left hemisphere’s posterior middle frontal gyrus (pMFG) with an error rate of 60%, as well as in the right pMFG and posterior supra marginal gyrus (pSMG) (45%). In total the task processing of non-living objects elicited more errors in total, than the recognition of living objects. nrTMS is able to detect cortical categorization function. Moreover, the observed bihemispheric representation, as well as the higher error incidence for the recognition of non-living objects is well in accordance with current literature. Clinical applicability for preoperative mapping in brain tumor patients but also in general neuroscience has to be evaluated as the next step.
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Affiliation(s)
- Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Vicki Marie Butenschoen
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, School of Medicine, Technische Universität München, Ismaningerstr. 22, 81675, Munich, Germany.
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10
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Haddad AF, Young JS, Berger MS, Tarapore PE. Preoperative Applications of Navigated Transcranial Magnetic Stimulation. Front Neurol 2021; 11:628903. [PMID: 33551983 PMCID: PMC7862711 DOI: 10.3389/fneur.2020.628903] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Accepted: 12/29/2020] [Indexed: 12/18/2022] Open
Abstract
Preoperative mapping of cortical structures prior to neurosurgical intervention can provide a roadmap of the brain with which neurosurgeons can navigate critical cortical structures. In patients undergoing surgery for brain tumors, preoperative mapping allows for improved operative planning, patient risk stratification, and personalized preoperative patient counseling. Navigated transcranial magnetic stimulation (nTMS) is one modality that allows for highly accurate, image-guided, non-invasive stimulation of the brain, thus allowing for differentiation between eloquent and non-eloquent cortical regions. Motor mapping is the best validated application of nTMS, yielding reliable maps with an accuracy similar to intraoperative cortical mapping. Language mapping is also commonly performed, although nTMS language maps are not as highly concordant with direct intraoperative cortical stimulation maps as nTMS motor maps. Additionally, nTMS has been used to localize cortical regions involved in other functions such as facial recognition, calculation, higher-order motor processing, and visuospatial orientation. In this review, we evaluate the growing literature on the applications of nTMS in the preoperative setting. First, we analyze the evidence in support of the most common clinical applications. Then we identify usages that show promise but require further validation. We also discuss developing nTMS techniques that are still in the experimental stage, such as the use of nTMS to enhance postoperative recovery. Finally, we highlight practical considerations when utilizing nTMS and, importantly, its safety profile in neurosurgical patients. In so doing, we aim to provide a comprehensive review of the role of nTMS in the neurosurgical management of a patient with a brain tumor.
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Affiliation(s)
- Alexander F Haddad
- School of Medicine, University of California, San Francisco, San Francisco, CA, United States
| | - Jacob S Young
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Mitchel S Berger
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
| | - Phiroz E Tarapore
- Department of Neurological Surgery, University of California, San Francisco, San Francisco, CA, United States
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11
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Abstract
Although intraoperative mapping of brain areas was shown to promote greater extent of resection and reduce functional deficits, this was shown only recently for some noninvasive techniques. Yet, proper surgical planning, indication, and patient consultation require reliable noninvasive techniques. Because functional magnetic resonance imaging, tractography, and neurophysiologic methods like navigated transcranial magnetic stimulation and magnetoencephalography allow identifying eloquent areas prior to resective surgery and tailor the surgical approach, this article provides an overview on the individual strengths and limitations of each modality.
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Affiliation(s)
- Sebastian Ille
- Department of Neurosurgery, Technical University of Munich, Germany, School of Medicine, Klinikum rechts der Isar, Ismaninger Strasse 22, Munich 81675, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Technical University of Munich, Germany, School of Medicine, Klinikum rechts der Isar, Ismaninger Strasse 22, Munich 81675, Germany.
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12
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Jeltema HR, Ohlerth AK, de Wit A, Wagemakers M, Rofes A, Bastiaanse R, Drost G. Comparing navigated transcranial magnetic stimulation mapping and "gold standard" direct cortical stimulation mapping in neurosurgery: a systematic review. Neurosurg Rev 2020; 44:1903-1920. [PMID: 33009990 PMCID: PMC8338816 DOI: 10.1007/s10143-020-01397-x] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2020] [Revised: 09/05/2020] [Accepted: 09/17/2020] [Indexed: 12/14/2022]
Abstract
The objective of this systematic review is to create an overview of the literature on the comparison of navigated transcranial magnetic stimulation (nTMS) as a mapping tool to the current gold standard, which is (intraoperative) direct cortical stimulation (DCS) mapping. A search in the databases of PubMed, EMBASE, and Web of Science was performed. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and recommendations were used. Thirty-five publications were included in the review, describing a total of 552 patients. All studies concerned either mapping of motor or language function. No comparative data for nTMS and DCS for other neurological functions were found. For motor mapping, the distances between the cortical representation of the different muscle groups identified by nTMS and DCS varied between 2 and 16 mm. Regarding mapping of language function, solely an object naming task was performed in the comparative studies on nTMS and DCS. Sensitivity and specificity ranged from 10 to 100% and 13.3–98%, respectively, when nTMS language mapping was compared with DCS mapping. The positive predictive value (PPV) and negative predictive value (NPV) ranged from 17 to 75% and 57–100% respectively. The available evidence for nTMS as a mapping modality for motor and language function is discussed.
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Affiliation(s)
- Hanne-Rinck Jeltema
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ann-Katrin Ohlerth
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Aranka de Wit
- Faculty of Medical Sciences, University of Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, the Netherlands
| | - Michiel Wagemakers
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Adrià Rofes
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands
| | - Roelien Bastiaanse
- Center for Language and Cognition Groningen, University of Groningen, Oude Kijk in 't Jatstraat 26, 9712 EK, Groningen, the Netherlands.,Center for Language and Brain, National Research University, Higher School of Economics, Moscow, Russian Federation
| | - Gea Drost
- Department of Neurosurgery, University Medical Center Groningen, Hanzeplein 1, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
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13
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Fresnoza S, Christova M, Purgstaller S, Jehna M, Zaar K, Hoffermann M, Mahdy Ali K, Körner C, Gallasch E, von Campe G, Ischebeck A. Dissociating Arithmetic Operations in the Parietal Cortex Using 1 Hz Repetitive Transcranial Magnetic Stimulation: The Importance of Strategy Use. Front Hum Neurosci 2020; 14:271. [PMID: 32765240 PMCID: PMC7378795 DOI: 10.3389/fnhum.2020.00271] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 06/16/2020] [Indexed: 11/13/2022] Open
Abstract
The triple-code model (TCM) of number processing suggests the involvement of distinct parietal cortex areas in arithmetic operations: the bilateral horizontal segment of the intraparietal sulcus (hIPS) for arithmetic operations that require the manipulation of numerical quantities (e.g., subtraction) and the left angular gyrus (AG) for arithmetic operations that require the retrieval of answers from long-term memory (e.g., multiplication). Although neuropsychological, neuroimaging, and brain stimulation studies suggest the dissociation of these operations into distinct parietal cortex areas, the role of strategy (online calculation vs. retrieval) is not yet fully established. In the present study, we further explored the causal involvement of the left AG for multiplication and left hIPS for subtraction using a neuronavigated repetitive transcranial magnetic stimulation (rTMS) paradigm. Stimulation sites were determined based on an fMRI experiment using the same tasks. To account for the effect of strategy, participants were asked whether they used retrieval or calculation for each individual problem. We predicted that the stimulation of the left AG would selectively disrupt the retrieval of the solution to multiplication problems. On the other hand, stimulation of the left hIPS should selectively disrupt subtraction. Our results revealed that left AG stimulation was detrimental to the retrieval and online calculation of solutions for multiplication problems, as well as, the retrieval (but not online calculation) of the solutions to subtraction problems. In contrast, left hIPS stimulation had no detrimental effect on both operations regardless of strategy.
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Affiliation(s)
- Shane Fresnoza
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
| | - Monica Christova
- Otto Loewi Research Center, Physiology Section, Medical University of Graz, Graz, Austria.,Department of Physiotherapy, University of Applied Sciences FH-Joanneum Graz, Graz, Austria
| | | | - Margit Jehna
- Department of Radiology, Medical University of Graz, Graz, Austria
| | - Karla Zaar
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Markus Hoffermann
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Kariem Mahdy Ali
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Christof Körner
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
| | - Eugen Gallasch
- BioTechMed, Graz, Austria.,Otto Loewi Research Center, Physiology Section, Medical University of Graz, Graz, Austria
| | - Gord von Campe
- Department of Neurosurgery, Medical University of Graz, Graz, Austria
| | - Anja Ischebeck
- Institute of Psychology, University of Graz, Graz, Austria.,BioTechMed, Graz, Austria
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14
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Abstract
One of the most critical skills behind consumer's behavior is the ability to assess whether a price after a discount is a real bargain. Yet, the neural underpinnings and cognitive mechanisms associated with such a skill are largely unknown. While there is general agreement that the posterior parietal cortex (PPC) on the left is critical for mental calculations, and there is also recent repetitive transcranial magnetic stimulation (rTMS) evidence pointing to the supramarginal gyrus (SMG) of the right PPC as crucial for consumer-like arithmetic (e.g., multi-digit mental addition or subtraction), it is still unknown whether SMG is involved in calculations of sale prices. Here, we show that the neural mechanisms underlying discount arithmetic characteristic for shopping are different from complex addition or subtraction, with discount calculations engaging left SMG more. We obtained these outcomes by remodeling our laboratory to resemble a shop and asking participants to calculate prices after discounts (e.g., $8.80-25 or $4.80-75%), while stimulating left and right SMG with neuronavigated rTMS. Our results indicate that such complex shopping calculations as establishing the price after a discount involve SMG asymmetrically, whereas simpler calculations such as price addition do not. These findings have some consequences for neural models of mathematical cognition and shed some preliminary light on potential consumer's behavior in natural settings.
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Affiliation(s)
- Michal Klichowski
- Faculty of Educational Studies, Adam Mickiewicz University, Poznan, Poland
| | - Gregory Kroliczak
- Action and Cognition Laboratory, Faculty of Psychology and Cognitive Science, Adam Mickiewicz University, Poznan, Poland
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15
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Schramm S, Sollmann N, Ille S, Meyer B, Krieg SM. Application of Navigated Transcranial Magnetic Stimulation to Map the Supplementary Motor Area in Healthy Subjects. J Clin Neurophysiol 2020; 37:140-9. [DOI: 10.1097/wnp.0000000000000530] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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16
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Faye A, Jacquin-Courtois S, Reynaud E, Lesourd M, Besnard J, Osiurak F. Numerical cognition: A meta-analysis of neuroimaging, transcranial magnetic stimulation and brain-damaged patients studies. Neuroimage Clin 2019; 24:102053. [PMID: 31795045 PMCID: PMC6978218 DOI: 10.1016/j.nicl.2019.102053] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/15/2019] [Revised: 10/01/2019] [Accepted: 10/21/2019] [Indexed: 01/29/2023]
Abstract
We review neuroimaging, TMS, and patients studies on numerical cognition. We focused on the predictions derived from the Triple Code Model (TCM). Our findings generally agree with TCM predictions. Our results open avenues for the study of the neural bases of numerical cognition.
This article offers the first comprehensive review examining the neurocognitive bases of numerical cognition from neuroimaging, Transcranial Magnetic Stimulation (TMS) and brain-damaged patients studies. We focused on the predictions derived from the Triple Code Model (TCM), particularly the assumption that the representation of numerical quantities rests on a single format-independent representation (i.e., the analogical code) involving both intraparietal sulci (IPS). To do so, we conducted a meta-analysis based on 28 neuroimaging, 12 TMS and 12 brain-damaged patients studies, including arithmetic and magnitude tasks in symbolic and non-symbolic formats. Our findings generally agree with the TCM predictions indicating that both IPS are engaged in all tasks. Nonetheless, the results of brain-damaged patients studies conflicted with neuroimaging and TMS studies, suggesting a right hemisphere lateralization for non-symbolic formats. Our findings also led us to discuss the involvement of brain regions other than IPS in the processing of the analogical code as well as the neural substrate of other codes underlying numerical cognition (i.e., the auditory-verbal code).
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Affiliation(s)
- Alexandrine Faye
- Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université de Lyon, France.
| | - Sophie Jacquin-Courtois
- Integrative, Multisensory, Perception, Action, & Cognition Team (INSERM-CNRS-UMR 5292), Université de Lyon, France; Mouvement et Handicap, Hospices Civils de Lyon et Centre de Recherche en Neurosciences de Lyon, Hôpital Henry Gabrielle, St Genis Laval, France
| | - Emanuelle Reynaud
- Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université de Lyon, France
| | - Mathieu Lesourd
- Aix Marseille Université, CNRS, LNC, Laboratoire de Neurosciences Cognitives, Marseille, France; Aix Marseille Université, CNRS, Fédération 3C, Marseille, France
| | - Jérémy Besnard
- Laboratoire de Psychologie des Pays de la Loire (EA 4638), Université de Nantes et d'Angers, France
| | - François Osiurak
- Laboratoire d'Etude des Mécanismes Cognitifs (EA 3082), Université de Lyon, France; Institut Universitaire de France, Paris, France
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17
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Raffa G, Quattropani MC, Germanò A. When imaging meets neurophysiology: the value of navigated transcranial magnetic stimulation for preoperative neurophysiological mapping prior to brain tumor surgery. Neurosurg Focus 2019; 47:E10. [DOI: 10.3171/2019.9.focus19640] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2019] [Accepted: 09/04/2019] [Indexed: 11/06/2022]
Abstract
Maximal safe resection is the modern goal for surgery of intrinsic brain tumors located in or close to brain eloquent areas. Nowadays different neuroimaging techniques provide important anatomical and functional information regarding the brain functional organization that can be used to plan a customized surgical strategy to preserve functional networks, and to increase the extent of tumor resection. Among these techniques, navigated transcranial magnetic stimulation (nTMS) has recently gained great favor among the neurosurgical community for preoperative mapping and planning prior to brain tumor surgery. It represents an advanced neuroimaging technique based on the neurophysiological mapping of the functional cortical brain organization. Moreover, it can be combined with other neuroimaging techniques such as diffusion tensor imaging tractography, thus providing a reliable reconstruction of brain eloquent networks. Consequently, nTMS mapping may provide reliable noninvasive brain functional mapping, anticipating information that otherwise may be available to neurosurgeons only in the operating theater by using direct electrical stimulation. The authors describe the reliability and usefulness of the preoperative nTMS-based approach in neurosurgical practice, and briefly discuss their experience using nTMS as well as currently available evidence in the literature supporting its clinical use. In particular, special attention is reserved for the discussion of the role of nTMS as a novel tool for the preoperative neurophysiological mapping of motor and language networks prior to surgery of intrinsic brain tumors located in or close to eloquent networks, as well as for future and promising applications of nTMS in neurosurgical practice.
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Affiliation(s)
- Giovanni Raffa
- 1Division of Neurosurgery, BIOMORF Department, University of Messina, Italy; and
| | | | - Antonino Germanò
- 1Division of Neurosurgery, BIOMORF Department, University of Messina, Italy; and
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18
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Schramm S, Albers L, Ille S, Schröder A, Meyer B, Sollmann N, Krieg SM. Navigated transcranial magnetic stimulation of the supplementary motor cortex disrupts fine motor skills in healthy adults. Sci Rep 2019; 9:17744. [PMID: 31780823 DOI: 10.1038/s41598-019-54302-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Accepted: 11/06/2019] [Indexed: 11/08/2022] Open
Abstract
Navigated transcranial magnetic stimulation (nTMS) over the supplementary motor area (SMA) may impact fine motor skills. This study evaluates different nTMS parameters in their capacity to affect fine motor performance on the way to develop an SMA mapping protocol. Twenty healthy volunteers performed a variety of fine motor tests during baseline and nTMS to the SMA using 5 Hz, 10 Hz, and theta-burst stimulation (TBS). Effects on performance were measured by test completion times (TCTs), standard deviation of inter-tap interval (SDIT), and visible coordination problems (VCPs). The predominant stimulation effect was slowing of TCTs, i.e. a slowdown of test performances during stimulation. Furthermore, participants exhibited VCPs like accidental use of contralateral limbs or inability to coordinate movements. More instances of significant differences between baseline and stimulation occurred during stimulation of the right hemisphere compared to left-hemispheric stimulation. In conclusion, nTMS to the SMA could enable new approaches in neuroscience and enable structured mapping approaches. Specifically, this study supports interhemispheric differences in motor control as right-hemispheric stimulation resulted in clearer impairments. The application of our nTMS-based setup to assess the function of the SMA should be applied in patients with changed anatomo-functional representations as the next step, e.g. among patients with eloquent brain tumors.
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Fang X, Liu M, Lu C, Zhao Y, Liu X. Current status and potential application of navigated transcranial magnetic stimulation in neurosurgery: a literature review. Chin Neurosurg J 2019; 5:12. [PMID: 32922912 PMCID: PMC7398385 DOI: 10.1186/s41016-019-0159-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 04/25/2019] [Indexed: 12/13/2022] Open
Abstract
Transcranial magnetic stimulation (TMS) is a noninvasive neurophysiologic technique that can stimulate the human brain. Positioning of the coil was often performed based merely on external landmarks on the head, meaning that the anatomical target in the cortex remains inaccurate. Navigated transcranial magnetic stimulation (nTMS) combines a frameless stereotactic navigational system and TMS coil and can provide a highly accurate delivery of TMS pulses with the guidance of imaging. Therefore, many novel utilities for TMS could be explored due to the ability of precise localization. Many studies have been published, which indicate nTMS enables presurgical functional mapping. This review aimed to provide a comprehensive literature review on nTMS, especially the principles and clinical applications of nTMS. All articles in PubMed with keywords of "motor mapping," "presurgical mapping," "navigated transcranial magnetic stimulation," and "language mapping" published from 2000 to 2018 were included in the study. Frequently cited publications before 2000 were also included. The most valuable published original and review articles related to our objective were selected. Motor mapping of nTMS is validated to be a trustful tool to recognize functional areas belonging to both normal and lesioned primary motor cortex. It can offer reliable mapping of speech and motor regions at cortex prior to operation and has comparable accuracy as direct electrical cortical stimulation. nTMS is a powerful tool for mapping of motor and linguistic function prior to operation, has high application value in neurosurgery and the treatment of neurological and psychiatric diseases, and has gained increasing acceptance in neurosurgical centers across the world.
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Affiliation(s)
- Xiaojing Fang
- Department of Neurology, Peking University International Hospital, 1 Life Science St, Changping District, Beijing, 102206 China
| | - Meige Liu
- Department of Neurology, Peking University People's Hospital, Beijing, 100044 China
| | - Changyu Lu
- Department of Neurosurgery, Peking University International Hospital, Beijing, 102206 China
| | - Yuanli Zhao
- Neurosurgery Center, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070 China.,Department of Neurosurgery, Peking University International Hospital, Beijing, 102206 China
| | - Xianzeng Liu
- Department of Neurology, Peking University International Hospital, 1 Life Science St, Changping District, Beijing, 102206 China
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20
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Abstract
The role of the left hemisphere in calculation has been unequivocally demonstrated in numerous studies in the last decades. The right hemisphere, on the other hand, had been traditionally considered subsidiary to the left hemisphere functions, although its role was less clearly defined. Recent clinical studies as well as investigations conducted with other methodologies (e.g. neuroimaging, transcranial magnetic stimulation and direct cortical electro-stimulation) leave several unanswered questions about the contribution of the right hemisphere in calculation. In particular, novel clinical studies show that right hemisphere acalculia encompasses a wide variety of symptoms, affecting even simple calculation, which cannot be easily attributed to spatial disorders or to a generic difficulty effect as previously believed. The studies reported here also show how the right hemisphere has its own specific role and that only a bilateral orchestration between the respective functions of each hemisphere guarantees, in fact, precise calculation. Vis-à-vis these data, the traditional wisdom that attributes to the right hemisphere a role mostly confined to spatial aspects of calculation needs to be significantly reshaped. The question for the future is whether it is possible to precisely define the specific contribution of the right hemisphere in several aspects of calculation while highlighting the nature of the cross-talk between the two hemispheres.This article is part of a discussion meeting issue 'The origins of numerical abilities'.
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Affiliation(s)
- Carlo Semenza
- Department of Neuroscience, University of Padova, via Giustiniani 5, 35128 Padova, Italy .,IRCCS Ospedale S. Camillo, Lido di Venezia, Italy
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21
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Giglhuber K, Maurer S, Zimmer C, Meyer B, Krieg SM. Mapping visuospatial attention: the greyscales task in combination with repetitive navigated transcranial magnetic stimulation. BMC Neurosci 2018; 19:40. [PMID: 29996777 PMCID: PMC6042394 DOI: 10.1186/s12868-018-0440-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Accepted: 07/04/2018] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Visuospatial attention is executed by the frontoparietal cortical areas of the brain. Damage to these areas can result in visual neglect. We therefore aimed to assess a combination of the greyscales task and repetitive navigated transcranial magnetic stimulation (rTMS) to identify cortical regions involved in visuospatial attention processes. This pilot study was designed to evaluate an approach in a cohort of healthy volunteers, with the future aim of using this technique to map brain tumor patients before surgery. Ten healthy, right-handed subjects underwent rTMS mapping of 52 cortical spots in both hemispheres. The greyscales task was presented tachistoscopically and was time-locked to rTMS pulses. The task pictures showed pairs of horizontal rectangles shaded continuously from black at one end to white at the other, mirror-reversed. On each picture the subject was asked to report which of the two greyscales appeared darker overall. The responses were categorized into "leftward" and "rightward," depending on whether the subject had chosen the rectangle with the darker end on the left or the right. rTMS applied to cortical areas involved in visuospatial attention is supposed to affect lateral shifts in spatial bias. These shifts result in an altered performance on the greyscales task compared to the baseline performance without rTMS stimulation. RESULTS In baseline conditions, 9/10 subjects showed classic pseudoneglect to the left. Leftward effects also occurred more often in mapping conditions. Yet, calculated rightward deviations were strikingly greater in magnitude (p < 0.0001). Overall, the right hemisphere was found to be more suggestible than the left hemisphere. Both rightward and leftward deviation scores were higher for the rTMS of this brain side (p < 0.0001). Right hemispheric distributions accord well with current models of visuospatial attention (Corbetta et al. Nat Neurosci 8(11):1603-1610, 2005). We observed leftward deviations triggered by rTMS within superior frontal and posterior parietal areas and rightward deviations within inferior frontal areas and the temporoparietal junction (TPJ). CONCLUSION The greyscales task, in combination with rTMS, yields encouraging results in the examination of the visuospatial attention function. Future clinical implications should be evaluated.
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Affiliation(s)
- Katrin Giglhuber
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Claus Zimmer
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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22
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Tabei KI, Satoh M, Ogawa JI, Tokita T, Nakaguchi N, Nakao K, Kida H, Tomimoto H. Cognitive Function and Brain Atrophy Predict Non-pharmacological Efficacy in Dementia: The Mihama-Kiho Scan Project2. Front Aging Neurosci 2018; 10:87. [PMID: 29706882 PMCID: PMC5906569 DOI: 10.3389/fnagi.2018.00087] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Accepted: 03/14/2018] [Indexed: 12/18/2022] Open
Abstract
We aimed to determine whether neuropsychological deficits and brain atrophy could predict the efficacy of non-pharmacological interventions. Forty-six participants with mild-to-moderate dementia were monitored for 6 months; 25 underwent an intervention involving physical exercise with music, and 21 performed cognitive stimulation tasks. Participants were categorized into improvement (IMP) and no-IMP subgroups. In the exercise-with-music group, the no-IMP subgroup performed worse than the IMP subgroup on the Rivermead Behavioural Memory Test at baseline. In the cognitive-stimulation group, the no-IMP subgroup performed worse than the IMP subgroup on Raven's Colored Progressive Matrices and the cognitive functional independence measure at baseline. In the no-IMP subgroup, voxel-based morphometric analysis at baseline revealed more extensive gray matter loss in the anterior cingulate gyrus and left middle frontal gyrus in the exercise-with-music and cognitive-stimulation groups, respectively. Participants with mild-to-moderate dementia with cognitive decline and extensive cortical atrophy are less likely to show improved cognitive function after non-pharmaceutical therapy.
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Affiliation(s)
- Ken-ichi Tabei
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Tsu, Japan
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Masayuki Satoh
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Tsu, Japan
| | | | - Tomoko Tokita
- Department of Health and Welfare, Mihama Town Hall, Mihama, Japan
| | | | - Koji Nakao
- Department of Neurosurgery, Kinan Hospital, Mihama, Japan
| | - Hirotaka Kida
- Department of Dementia Prevention and Therapeutics, Graduate School of Medicine, Mie University, Tsu, Japan
| | - Hidekazu Tomimoto
- Department of Neurology, Graduate School of Medicine, Mie University, Tsu, Japan
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23
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Ille S, Drummer K, Giglhuber K, Conway N, Maurer S, Meyer B, Krieg SM. Mapping of Arithmetic Processing by Navigated Repetitive Transcranial Magnetic Stimulation in Patients with Parietal Brain Tumors and Correlation with Postoperative Outcome. World Neurosurg 2018; 114:e1016-e1030. [PMID: 29597021 DOI: 10.1016/j.wneu.2018.03.136] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 03/18/2018] [Accepted: 03/19/2018] [Indexed: 11/26/2022]
Abstract
BACKGROUND Preserving functionality is important during neurosurgical resection of brain tumors. Specialized centers also map further brain functions apart from motor and language functions, such as arithmetic processing (AP). The mapping of AP by navigated repetitive transcranial magnetic stimulation (nrTMS) in healthy volunteers has been reported. OBJECTIVE The present study aimed to correlate the results of mapping AP with functional patient outcomes. METHODS We included 26 patients with parietal brain tumors. Because of preoperative impairment of AP, mapping was not possible in 8 patients (31%). We stimulated 52 cortical sites by nrTMS while patients performed a calculation task. Preoperatively and postoperatively, patients underwent a standardized number-processing and calculation test (NPCT). Tumor resection was blinded to nrTMS results, and the change in NPCT performance was correlated to resected AP-positive spots as identified by nrTMS. RESULTS The resection of AP-positive sites correlated with a worsening of the postoperative NPCT result in 12 cases. In 3 cases, no AP-positive sites were resected and the postoperative NPCT result was similar to or better than preoperatively. Also, in 3 cases, the postoperative NPCT result was better than preoperatively, although AP-positive sites were resected. CONCLUSIONS Despite presenting only a few cases, nrTMS might be a useful tool for preoperative mapping of AP. However, the reliability of the present results has to be evaluated in a larger series and by intraoperative mapping data.
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Affiliation(s)
- Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Katharina Drummer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Katrin Giglhuber
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Neal Conway
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Munich, Germany.
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24
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Maurer S, Giglhuber K, Sollmann N, Kelm A, Ille S, Hauck T, Tanigawa N, Ringel F, Boeckh-Behrens T, Meyer B, Krieg SM. Non-invasive Mapping of Face Processing by Navigated Transcranial Magnetic Stimulation. Front Hum Neurosci 2017; 11:4. [PMID: 28167906 PMCID: PMC5253359 DOI: 10.3389/fnhum.2017.00004] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 01/04/2017] [Indexed: 01/31/2023] Open
Abstract
Background: Besides motor and language function, tumor resections within the frontal and parietal lobe have also been reported to cause neuropsychological impairment like prosopagnosia. Objective: Since non-navigated transcranial magnetic stimulation (TMS) has previously been used to map neuropsychological cortical function, this study aims to evaluate the feasibility and spatial discrimination of repetitive navigated TMS (rTMS) mapping for detection of face processing impairment in healthy volunteers. The study was also designed to establish this examination for preoperative mapping in brain tumor patients. Methods: Twenty healthy and purely right-handed volunteers (11 female, 9 male) underwent rTMS mapping for cortical face processing function using 5 Hz/10 pulses. Both hemispheres were investigated randomly with an interval of 2 weeks between mapping sessions. Fifty-two predetermined cortical spots of the whole hemispheres were mapped after baseline measurement. The task consisted of 80 portraits of popular persons, which had to be named while rTMS was applied. Results: In 80% of all subjects rTMS elicited naming errors in the right middle middle frontal gyrus (mMFG). Concerning anomia errors, the highest error rate (35%) was achieved in the bilateral triangular inferior frontal gyrus (trIFG). With regard to similarly or wrongly named persons, we observed 10% error rates mainly in the bilateral frontal lobes. Conclusion: It seems feasible to map the cortical face processing function and to generate face processing impairment via rTMS. The observed localizations are well in accordance with the contemporary literature, and the mapping did not interfere with rTMS-induced language impairment. The clinical usefulness of preoperative mapping has to be evaluated subsequently.
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Affiliation(s)
- Stefanie Maurer
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Katrin Giglhuber
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Nico Sollmann
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Anna Kelm
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Theresa Hauck
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Noriko Tanigawa
- Faculty of Linguistics, Philology, and Phonetics, University of Oxford Oxford, UK
| | - Florian Ringel
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Tobias Boeckh-Behrens
- Section of Neuroradiology, Department of Radiology, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum Rechts der Isar, Technische Universität München Munich, Germany
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Sollmann N, Hauck T, Tussis L, Ille S, Maurer S, Boeckh-Behrens T, Ringel F, Meyer B, Krieg SM. Results on the spatial resolution of repetitive transcranial magnetic stimulation for cortical language mapping during object naming in healthy subjects. BMC Neurosci 2016; 17:67. [PMID: 27776478 PMCID: PMC5078936 DOI: 10.1186/s12868-016-0305-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2016] [Accepted: 10/19/2016] [Indexed: 11/20/2022] Open
Abstract
Background The spatial resolution of repetitive navigated transcranial magnetic stimulation (rTMS) for language mapping is largely unknown. Thus, to determine a minimum spatial resolution of rTMS for language mapping, we evaluated the mapping sessions derived from 19 healthy volunteers for cortical hotspots of no-response errors. Then, the distances between hotspots (stimulation points with a high error rate) and adjacent mapping points (stimulation points with low error rates) were evaluated. Results Mean distance values of 13.8 ± 6.4 mm (from hotspots to ventral points, range 0.7–30.7 mm), 10.8 ± 4.8 mm (from hotspots to dorsal points, range 2.0–26.5 mm), 16.6 ± 4.8 mm (from hotspots to apical points, range 0.9–27.5 mm), and 13.8 ± 4.3 mm (from hotspots to caudal points, range 2.0–24.2 mm) were measured. Conclusions According to the results, the minimum spatial resolution of rTMS should principally allow for the identification of a particular gyrus, and according to the literature, it is in good accordance with the spatial resolution of direct cortical stimulation (DCS). Since measurement was performed between hotspots and adjacent mapping points and not on a finer-grained basis, we only refer to a minimum spatial resolution. Furthermore, refinement of our results within the scope of a prospective study combining rTMS and DCS for resolution measurement during language mapping should be the next step.
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Affiliation(s)
- Nico Sollmann
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Theresa Hauck
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Lorena Tussis
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sebastian Ille
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Stefanie Maurer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Tobias Boeckh-Behrens
- Section of Neuroradiology, Department of Radiology, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Florian Ringel
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Bernhard Meyer
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany
| | - Sandro M Krieg
- Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany. .,TUM-Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675, Munich, Germany.
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