Loss of Subcortical Language Pathways Correlates with Surgery-Related Aphasia in Patients with Brain Tumor: An Investigation via Repetitive Navigated Transcranial Magnetic Stimulation–Based Diffusion Tensor Imaging Fiber Tracking

Negwer, Chiara; Beurskens, Eva; Sollmann, Nico; Maurer, Stefanie; Ille, Sebastian; Giglhuber, Katrin; Kirschke, Jan S.; Ringel, Florian; Meyer, Bernhard; Krieg, Sandro M.

doi:10.1016/j.wneu.2017.12.163

Cited by 26 publications

(22 citation statements)

References 61 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A standardized assessment of sensory function, coordination, muscle strength, and cranial nerve function was performed as part of the initial clinical examination. In particular, the language status was evaluated by a neuropsychologist using the Aachen Aphasia Test and by categorizing language deficits on a four-point scale [14,[35][36][37]. In detail, four grades were established, which were no deficit (grade 0), mild deficit (grade 1: normal language comprehension and/or conversational language with slight amnesic aphasia, adequate communication ability), medium deficit (grade 2: minor disruption of language comprehension and/or conversational language, adequate communication ability), and severe deficit (grade 3: major disruption of language comprehension and/or conversational language, clear impairment of communication ability) [14,[35][36][37].…”

Section: Clinical Examinationmentioning

confidence: 99%

“…In this context, previous studies have evaluated the agreement between preoperative nTMS language mapping and intraoperative DES [13,16,24]; however, on the subcortical level, such correlation analyses in representative samples are largely missing to date. First evidence of associations between preoperative nTMS-based tractography and intraoperative DES results or surgery-related aphasia has been obtained [20,37]. Upcoming studies may use more sophisticated approaches for diffusion-weighted MRI and fiber tractography, ideally combining it with functional data such as nTMS maps after further confirmatory studies.…”

Section: Limitations and Perspectivesmentioning

confidence: 99%

See 1 more Smart Citation

Function-Based Tractography of the Language Network Correlates with Aphasia in Patients with Language-Eloquent Glioblastoma

et al. 2020

Self Cite

View full text Add to dashboard Cite

To date, the structural characteristics that distinguish language-involved from non-involved cortical areas are largely unclear. Particularly in patients suffering from language-eloquent brain tumors, reliable mapping of the cortico-subcortical language network is of high clinical importance to prepare and guide safe tumor resection. To investigate differences in structural characteristics between language-positive and language-negative areas, 20 patients (mean age: 63.2 ± 12.9 years, 16 males) diagnosed with language-eloquent left-hemispheric glioblastoma multiforme (GBM) underwent preoperative language mapping by navigated transcranial magnetic stimulation (nTMS) and nTMS-based diffusion tensor imaging fiber tracking (DTI FT). The number of language-positive and language-negative points as well as the gray matter intensity (GMI), normalized volumes of U-fibers, interhemispheric fibers, and fibers projecting to the cerebellum were assessed and compared between language-positive and language-negative nTMS mappings and set in correlation with aphasia grades. We found significantly lower GMI for language-positive nTMS points (5.7 ± 1.7 versus 7.1 ± 1.6, p = 0.0121). Furthermore, language-positive nTMS points were characterized by an enhanced connectivity profile, i.e., these points showed a significantly higher ratio in volumes for U-fibers (p ≤ 0.0056), interhemispheric fibers (p = 0.0494), and fibers projecting to the cerebellum (p = 0.0094). The number of language-positive nTMS points (R ≥ 0.4854, p ≤ 0.0300) as well as the ratio in volumes for U-fibers (R ≤ −0.4899, p ≤ 0.0283) were significantly associated with aphasia grades, as assessed pre- or postoperatively and during follow-up examinations. In conclusion, this study provides evidence for structural differences on cortical and subcortical levels between language-positive and language-negative areas, as detected by nTMS language mapping. The results may further increase confidence in the technique of nTMS language mapping and nTMS-based tractography in the direct clinical setting. Future studies may confirm our results in larger cohorts and may expand the findings to patients with other tumor entities than GBM.

show abstract

Section: Clinical Examinationmentioning

confidence: 99%

Section: Limitations and Perspectivesmentioning

confidence: 99%

Function-Based Tractography of the Language Network Correlates with Aphasia in Patients with Language-Eloquent Glioblastoma

et al. 2020

Self Cite

View full text Add to dashboard Cite

show abstract

“…This dynamic FC (dFC) exhibits highly structured spatiotemporal patterns in which a set of metastable FC patterns, known as dFC states, reliably recur across time and subjects. A number of studies have focused on dFC states and found that they may be associated with ongoing human cognition (Gonzalez-Castillo et al ., 2015), consciousness level (Barttfeld et al ., 2015), flexible behavior (Shanahan, 2010; Tognoli and Kelso, 2014), brain development (Hutchison and Morton, 2015), and neuropsychiatric disorders (Zhao et al ., 2017; Negwer et al ., 2018). Specifically, in remitted BD patients, Nguyen et al .…”

Section: Introductionmentioning

confidence: 99%

Abnormal dynamic functional network connectivity in unmedicated bipolar and major depressive disorders based on the triple-network model

et al. 2019

View full text Add to dashboard Cite

BackgroundPrevious studies have analyzed brain functional connectivity to reveal the neural physiopathology of bipolar disorder (BD) and major depressive disorder (MDD) based on the triple-network model [involving the salience network, default mode network (DMN), and central executive network (CEN)]. However, most studies assumed that the brain intrinsic fluctuations throughout the entire scan are static. Thus, we aimed to reveal the dynamic functional network connectivity (dFNC) in the triple networks of BD and MDD.MethodsWe collected resting state fMRI data from 51 unmedicated depressed BD II patients, 51 unmedicated depressed MDD patients, and 52 healthy controls. We analyzed the dFNC by using an independent component analysis, sliding window correlation and k-means clustering, and used the parameters of dFNC state properties and dFNC variability for group comparisons.ResultsThe dFNC within the triple networks could be clustered into four configuration states, three of them showing dense connections (States 1, 2, and 4) and the other one showing sparse connections (State 3). Both BD and MDD patients spent more time in State 3 and showed decreased dFNC variability between posterior DMN and right CEN (rCEN) compared with controls. The MDD patients showed specific decreased dFNC variability between anterior DMN and rCEN compared with controls.ConclusionsThis study revealed more common but less specific dFNC alterations within the triple networks in unmedicated depressed BD II and MDD patients, which indicated their decreased information processing and communication ability and may help us to understand their abnormal affective and cognitive functions clinically.

show abstract

“…For the present analysis we evaluated the patients' neurological statuses including an aphasia grading adapted from the Aachener Aphasia Test (AAT) (24) at no fewer than six points in time: before surgery 1 (PRE-1), 5 days after surgery 1 (POD5-1), 3 months after surgery 1 (POM3-1), before surgery 2 or during long-term standard follow-up in case of no tumor recurrence (PRE-2), 5 days after surgery 2 (POD5-2), and 3 months after surgery 2 (POM3-2). We graded aphasias from 0 to 3 (0 = no impairment of language function; 1 = slight impairment of daily communication; 2 = moderate impairment of language function, daily communication possible; 3 = severe impairment of language function, daily communication not possible), and in case of an aphasia by the addition of an A (non-fluent) or B (fluent) (15–18, 20, 24, 25).…”

Section: Methodsmentioning

confidence: 99%

“…For nrTMS-based DTI FT of language-eloquent white matter pathways we used our standard deterministic algorithm with a fiber assignment by continuous tracking (FACT) (iPlanNet Cranial 3.0.1, Brainlab AG, Munich, Germany). The DTI FTs were performed according to our standard protocol (18, 20, 25). The DTI FTs at PRE-1 and PRE-2 were performed by the use of nrTMS language mapping results and the according DTI sequences at PRE-1 and PRE-2.…”

Section: Methodsmentioning

confidence: 99%

Language-Eloquent White Matter Pathway Tractography and the Course of Language Function in Glioma Patients

et al. 2018

Self Cite

View full text Add to dashboard Cite

Object: As various recent studies show, damage to white matter pathways leads to permanent functional deficits in a high percentage of patients. Particularly the subcortical language network is complex, and its visualization has a tremendous relevance for neurosurgeons. This pilot study aims to correlate language-eloquent white matter pathways with the course of language function after the resection of left-sided perisylvian gliomas.Methods: We included 10 patients who underwent resection of highly language-eloquent high- (9 pts) and low-grade gliomas (1 pts). We performed navigated repetitive transcranial magnetic stimulation (nrTMS)-based tractography via diffusion tensor imaging fiber trackings (DTI FT) preoperatively (PRE-1), postoperatively (POST-1), and at long-term follow up or tumor recurrence (PRE-2). We separately tracked the inferior fronto-occipital fascicle (IFOF), the frontal aslant tract (FAT), and the superior longitudinal (SLF), and arcuate fascicle (AF), and correlated the amount of visualized fibers to the patients' language function at each date.Results: The changes of nrTMS-based DTI FTs of single white matter pathways correlated with the according status of language function for any of the pathways in 80% of patients and in 19 of 30 (63%) single pathway comparisons between PRE-1 and POST-1. Between POST-1 and PRE-2 the nrTMS-based DTI FTs correlated with the status of language function for any of the pathways in all patients and in 24 of 30 (80%) single pathway comparisons. Single FT results correlated with the according status of language function at POST-1 in 60, 70, and 60% of cases, and with the according status of language function at PRE-2 in 60, 90, and 90% of cases for the tracking of the IFOF, FAT, and SLF/AF, respectively.Conclusion: By the present results we were able to show that nrTMS-based DTI FT of the IFOF, FAT, and SLF/AF mainly correlates with the according status of language function preoperatively, postoperatively, and at long-term follow up after the resection of left-sided perisylvian gliomas.

show abstract

Loss of Subcortical Language Pathways Correlates with Surgery-Related Aphasia in Patients with Brain Tumor: An Investigation via Repetitive Navigated Transcranial Magnetic Stimulation–Based Diffusion Tensor Imaging Fiber Tracking

Cited by 26 publications

References 61 publications

Function-Based Tractography of the Language Network Correlates with Aphasia in Patients with Language-Eloquent Glioblastoma

Function-Based Tractography of the Language Network Correlates with Aphasia in Patients with Language-Eloquent Glioblastoma

Abnormal dynamic functional network connectivity in unmedicated bipolar and major depressive disorders based on the triple-network model

Language-Eloquent White Matter Pathway Tractography and the Course of Language Function in Glioma Patients

Contact Info

Product

Resources

About