Language system organization in a quadrilingual with a brain tumor: Implications for understanding of the language network

Połczyńska, Monika; Benjamin, Christopher; Japardi, Kevin; Frew, Andrew J.; Bookheimer, Susan Y.

doi:10.1016/j.neuropsychologia.2016.04.030

Cited by 20 publications

(21 citation statements)

References 57 publications

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“…This result is consistent with previous findings of distinct cortical areas and distributed patterns of neural activity associated with native and second languages in healthy subjects . In a recent case report of a late quadrilingual patient with a frontal brain tumor, authors found highly idiosyncratic organization of each language despite the shared template of traditional language zones . This was further reiterated in a comparable study assessing language switching in bilingual brain tumor patients, whereby single‐language naming sites for both L1 and L2 were found within similar regions, despite varying organization .…”

Section: Discussionsupporting

confidence: 90%

Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

Leung

Unadkat

Bertotti

et al. 2020

Journal of Neuroimaging

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BACKGROUND AND PURPOSE Previous literature has demonstrated disparity in the postoperative recovery of first and second language function of bilingual neurosurgical patients. However, it is unclear to whether preoperative brain mapping of both languages is needed. In this study, we aimed to evaluate the clinical utility of language task functional MRI (fMRI) implemented in both languages in bilingual patients. METHODS We retrospectively examined fMRI data of 13 bilingual brain tumor patients (age: 23 to 59 years) who performed antonym generation task‐based fMRIs in English and non‐English language. The usefulness of bilingual language mapping was evaluated using a structured survey administered to 5 neurosurgeons. Additionally, quantitative comparison between the brain activation maps of both languages was performed. RESULTS Survey responses revealed differences in raters’ surgical approach, including asleep versus awake surgery and extent of resection, after viewing the language fMRI maps. Additional non‐English fMRI led to changes in surgical decision‐making and bettered localization of language areas. Quantitative analysis revealed an increase in laterality index (LI) in non‐English fMRI compared to English fMRI. The Dice coefficient demonstrated fair overlap (.458 ± .160) between the activation maps. CONCLUSION Bilingual fMRI mapping of bilingual patients allows to better appreciate functionally active language areas that may be neglected in single language mapping. Utility of bilingual mapping was supported by changes in both surgical approach and LI measurements, suggesting its benefit on preoperative language mapping.

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Section: Discussionsupporting

confidence: 90%

Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

Leung

Unadkat

Bertotti

et al. 2020

Journal of Neuroimaging

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“…In particular, the standard lexico-semantic tasks activate the frontal language areas, e.g., an auditory responsive naming task has been shown to activate the orbital frontal regions. We typically do not see much neural activity outside Wernicke's area in the left posterior language regions, such as, e.g., the angular gyrus, supramarginal gyrus, or posterior middle temporal gyrus (e.g., Bookheimer, 2007 , Połczyńska et al, 2016 ). A recent study by Ivanova et al (2016) demonstrated that the integrity of the more posterior segments of the major language tracts in the dominant left hemisphere (e.g., the inferior fronto-occipital fasciculus) was strongly related to performance in grammar.…”

Section: Introductionmentioning

confidence: 95%

“…An increasing number of centers use functional MRI because it is a particularly valuable and non-invasive method assessing language organization in the brain (e.g., Sabsevitz et al, 2003 , Połczyńska et al, 2015 , Połczyńska et al, 2016 ). Frequently used language tests involve a wide range of lexical-semantic tasks, e.g., object naming, auditory responsive naming and word generation ( Bookheimer, 2007 , Fernández Coello et al, 2013 , Wang et al, 2012 ).…”

Section: Introductionmentioning

confidence: 99%

Improving language mapping in clinical fMRI through assessment of grammar

Połczyńska

Japardi

Curtiss³

et al. 2017

NeuroImage: Clinical

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IntroductionBrain surgery in the language dominant hemisphere remains challenging due to unintended post-surgical language deficits, despite using pre-surgical functional magnetic resonance (fMRI) and intraoperative cortical stimulation. Moreover, patients are often recommended not to undergo surgery if the accompanying risk to language appears to be too high. While standard fMRI language mapping protocols may have relatively good predictive value at the group level, they remain sub-optimal on an individual level. The standard tests used typically assess lexico-semantic aspects of language, and they do not accurately reflect the complexity of language either in comprehension or production at the sentence level. Among patients who had left hemisphere language dominance we assessed which tests are best at activating language areas in the brain.MethodWe compared grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking) with standard tests (object naming, auditory and visual responsive naming), using pre-operative fMRI. Twenty-five surgical candidates (13 females) participated in this study. Sixteen patients presented with a brain tumor, and nine with epilepsy. All participants underwent two pre-operative fMRI protocols: one including CYCLE-N grammar tests (items testing word order in actives and passives, wh-subject and object questions, relativized subject and object clauses and past tense marking); and a second one with standard fMRI tests (object naming, auditory and visual responsive naming). fMRI activations during performance in both protocols were compared at the group level, as well as in individual candidates.ResultsThe grammar tests generated more volume of activation in the left hemisphere (left/right angular gyrus, right anterior/posterior superior temporal gyrus) and identified additional language regions not shown by the standard tests (e.g., left anterior/posterior supramarginal gyrus). The standard tests produced more activation in left BA 47. Ten participants had more robust activations in the left hemisphere in the grammar tests and two in the standard tests. The grammar tests also elicited substantial activations in the right hemisphere and thus turned out to be superior at identifying both right and left hemisphere contribution to language processing.ConclusionThe grammar tests may be an important addition to the standard pre-operative fMRI testing.

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“…An important generalization, reviewed in Mazurek and Schieber (2019), is that using DES to map function in the brain critically depends on the patient being able to focus on and be engaged by an appropriate task. The type of task that is selected to map a given brain region is influenced by a number of factors, including the purported function of that region, results of pre-operative non-invasive mapping (e.g., fMRI, MEG), and patient-specific factors (e.g., if the patient is bilingual or monolingual, Benjamin et al, 2017;Fernández-Coello et al, 2013a;Połczyńska, Benjamin, Japardi, Frew, & Bookheimer, 2016;Połczyńska, Japardi, & Bookheimer, 2017). Regardless of the task or region, however, both patient participation and the clinical team's ability to "read" the patient's behaviour in real time are critical.…”

Section: Introductionmentioning

confidence: 99%

Direct electrical stimulation mapping of cognitive functions in the human brain

Mahon

Miozzo

Pilcher

2019

Cognitive Neuropsychology

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Direct electrical stimulation (DES) is a well-established clinical tool for mapping cognitive functions while patients are undergoing awake neurosurgery or invasive long-term monitoring to identify epileptogenic tissue. Despite the proliferation of a range of invasive and noninvasive methods for mapping sensory, motor and cognitive processes in the human brain, DES remains the clinical gold standard for establishing the margins of brain tissue that can be safely removed while avoiding long-term neurological deficits. In parallel, and principally over the last two decades, DES has emerged as a powerful scientific tool for testing hypotheses of brain organization and mechanistic hypotheses of cognitive function. DES can cause transient "lesions" and thus can support causal inferences about the necessity of stimulated brain regions for specific functions, as well as the separability of sensory, motor and cognitive processes. This Special Issue of Cognitive Neuropsychology emphasizes the use of DES as a research tool to advance understanding of normal brain organization and function.

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Language system organization in a quadrilingual with a brain tumor: Implications for understanding of the language network

Cited by 20 publications

References 57 publications

Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

Clinical Utility of Preoperative Bilingual Language fMRI Mapping in Patients with Brain Tumors

Improving language mapping in clinical fMRI through assessment of grammar

Direct electrical stimulation mapping of cognitive functions in the human brain

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