Subcortical electrostimulation to identify network subserving motor control

Schucht, Philippe; Moritz‐Gasser, Sylvie; Herbet, Guillaume; Raabe, Andreas; Duffau, Hugues

doi:10.1002/hbm.22122

Cited by 99 publications

(39 citation statements)

References 34 publications

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“…This is a large circuit which passes anterior to the corticospinal bundle (probably coming from the supplementary motor area, the lateral premotor cortex and the depth of the precentral sulcus) and also another posterior circuit with primary somatosensory fibers, both of these being interconnected by U fibers passing beneath the central region. In all situations, stimulation of this network generates movement control problems, which may range from complete arrest of movement (unilateral or even bilateral in a bimanual coordination task) to involuntary acceleration of movement [53,67]. Damage to this connectivity may cause a permanent deficit in complex movements even after recovery from a possible transient postoperative supplementary motor area syndrome [60].…”

Section: The Connectome: a Limiting Factor For Neuroplasticitymentioning

confidence: 98%

Diffuse low-grade gliomas and neuroplasticity

Duffau

2014

Diagnostic and Interventional Imaging

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The traditional approach in neuro-oncology is to study the tumor in great detail and ultimately give little consideration to the brain itself. Choosing the best treatment strategy for each patient with a diffuse low-grade glioma, in other words optimizing the oncologic and functional balance, implies not only a full knowledge of the natural history of this chronic disease, but also an understanding of the adaptation of the brain in response to growth and spread of the glioma. The aim of this review is to examine the mechanisms underlying this neuroplasticity, allowing functional compensation when the tumor progresses, and opening the way to new treatments with the principle of shifting towards "functional personalized neuro-oncology", improving both median survival and quality of life.

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Section: The Connectome: a Limiting Factor For Neuroplasticitymentioning

confidence: 98%

Diffuse low-grade gliomas and neuroplasticity

Duffau

2014

Diagnostic and Interventional Imaging

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“…These findings suggest that this symptom was not related to the specific hand movement necessary in forming letter shapes, meaning that a disruption in subcortical activity might not be associated with the negative motor network. 37 With respect to the patient's cessation of reading following stimulation, it was difficult to assess whether this symptom was due to alexia or to complete anarthria. However, the brain region that was responsible for producing the disruption in reading (as assessed through response to stimulation) was very close to the deep parts of the IFOF, far apart from the SLF III (the main pathway connecting the superior marginal gyrus to the ventral premotor and prefrontal areas) according to postoperative DTI tractography.…”

Section: Judgment Of No Reading or Writingmentioning

confidence: 99%

Association of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study

Motomura¹,

Fujii²,

Maesawa³

et al. 2014

JNS

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T he ability to read and write is associated with a widely distributed cortical or subcortical neuronetwork. Brain lesions in cases of acquired alexia or agraphia are distributed throughout the dominant network of the frontal to occipital lobes. These lesions are thought to be related to various subcortical fibers.40 Previous reports of alexia and agraphia have localized the disorders to a restricted area, the left inferior parietal lobule and, more specifically, the angular and supramarginal gyri. 1,2,9,10,33,40 These findings imply that lesions resulting in alexia with agraphia may be related to damage in common subcortical pathways necessary for reading and writing, including cerebral white matter tracts.Recent noninvasive diagnostic techniques such as functional MRI (fMRI) and diffusion tensor imaging (DTI) have enabled characterization of the neuroanatomical distribution of various functions within the brain.Regarding reading and alexia, previous fMRI studies have revealed that reading is performed by a dominanthemisphere network of inferior frontal and temporoparietal areas that constitute a dorsal phonological route and occipitotemporal cortical regions that form a ventral orthographic reading route. 18,46,47 The arcuate fasciculus (AF), which is part of the superior longitudinal fasciculus (SLF), may subserve the dorsal phonological route, while the inferior frontooccipital fasciculus (IFOF) and the inferior longitudinal fasciculus (ILF) may subserve the ventral orthographic route. However, DTI fiber tracking studies for reading are relatively sparse, and most prior studies have made assumptions regarding the specific white matter tracts that may be involved. 29,46,50 In terms of functional and structural aspects, the writing process has been associated with the lateral posterior parietal cortex in the dominant hemisphere. 8,16 Within the lateral posterior parietal cortex, lesions inAssociation of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study Alexia and agraphia are disorders common to the left inferior parietal lobule, including the angular and supramarginal gyri. However, it is still unclear how these cortical regions interact with other cortical sites and what the most important white matter tracts are in relation to reading and writing processes.Here, the authors present the case of a patient who underwent an awake craniotomy for a left inferior parietal lobule glioma using direct cortical and subcortical electrostimulation. The use of subcortical stimulation allowed identification of the specific white matter tracts associated with reading and writing. These tracts were found as portions of the dorsal inferior frontooccipital fasciculus (IFOF) fibers in the deep parietal lobe that are responsible for connecting the frontal lobe to the superior parietal lobule. These findings are consistent with previous diffusion tensor imaging tractography and functional MRI studies, which suggest that the IFOF may play a r...

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“…We recorded the occurrence of any modification of the movement (slowness, arrest, lack of accuracy) or the occurrence of involuntary movement. 21,48 In addition, the patient was asked to inform us immediately when he/she perceived any abnormal sensation (hypesthesia, paresthesias, and so on), and to describe it. If the same motor, somatosensory, and/or language response was obtained during at least 3 subcortical stimulations, the stimulated zone was marked with a sterile tag, as was done at the cortical level.…”

Section: Surgical Proceduresmentioning

confidence: 99%

“…Before resection (left), cortical mapping allowed the detection of eloquent areas as follows: ventral premotor cortex that elicited speech arrest when stimulated (10), midpart of superior temporal gyrus that provoked anomia (15) and phonemic paraphasia (11) when stimulated, and posterior part of superior temporal gyrus that elicited semantic paraphasia during stimulation (12)(13)(14). After resection (right), the deep functional boundaries have been identified by subcortical electrical mapping as follows: in the SS, ILF that provoked alexia (46), OR that evoked visual disturbances (phosphenes) (48), and IFOF that generated semantic paraphasia (49); in addition, in the anterior part of the cavity (in front of SS) the AF that induced phonemic paraphasia (47). C: Postoperative axial FLAIR-weighted MRI and coronal T2-weighted MRI demonstrating a subtotal resection, due to a tumoral residue (5 ml) that was purposely not removed because it involved the left SS, in which functional pathways were running.…”

Section: Intraoperative Brain Mappingmentioning

confidence: 99%

Awake mapping for low-grade gliomas involving the left sagittal stratum: anatomofunctional and surgical considerations

Chan-Seng¹,

Moritz‐Gasser

Duffau

2014

JNS

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P atients with diffuse low-grade glioma ([DLGG]; that is, Grade II glioma according the WHO classification) tend to live many years after diagnosis, with surgery helping to further extend survival time. 2,29,49,50,53 Indeed, despite the lack of Class I evidence demonstrating that DLGG surgery improved survival, Jakola et al. 29 recently investigated survival in population-based parallel cohorts of patients with DLGGs from 2 Norwegian university hospitals with different surgical treatment strategies. They demonstrated that treatment at a center that favored early resection was associated with better overall survival (median survival not reached) than treat- Object. Preserving function while optimizing the extent of resection is the main goal in surgery for diffuse lowgrade glioma (DLGG). This is particularly relevant for DLGG involving the sagittal stratum (SS), where damage can have severe consequences. Indeed, this structure is a major crossroad in which several important fascicles run. Thus, its complex functional anatomy is still poorly understood. Subcortical electrical stimulation during awake surgery provides a unique opportunity to investigate white matter pathways. This study reports the findings on anatomofunctional correlations evoked by stimulation during resection for gliomas involving the left SS. Surgical outcomes are also detailed.Methods. The authors performed a review of patients who underwent awake surgery for histopathologically confirmed WHO Grade II glioma involving the left SS in the neurosurgery department between August 2008 and August 2012. Information regarding clinicoradiological features, surgical procedures, and outcomes was collected and analyzed. Intraoperative electrostimulation was used to map the eloquent structures within the SS.Results. Eight consecutive patients were included in this study. There were 6 men and 2 women, whose mean age was 41.7 years (range 32-61 years). Diagnosis was made because of seizures in 7 cases and slight language disorders in 1 case. After cortical mapping, subcortical stimulation detected functional fibers running in the SS in all patients: semantic paraphasia was generated by stimulating the inferior frontooccipital fascicle in 8 cases; alexia was elicited by stimulating the inferior longitudinal fascicle in 3 cases; visual disorders were induced by stimulating the optic radiations in 5 cases. Moreover, in front of the SS, phonemic paraphasia was evoked by stimulating the temporal part of the arcuate fascicle in 5 patients. The resection was stopped according to these functional limits in the 8 patients. After a transient postsurgical worsening, all patients recovered to normal results on examination, except for the persistence of a right superior quadrantanopia in 5 cases, with no consequences for quality of life. The 8 patients returned to a normal social and professional life. Total or subtotal resection was achieved in all cases but one.Conclusions. The authors suggest that the use of intrasurgical electrical mapping of the white matter pathway...

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Subcortical electrostimulation to identify network subserving motor control

Cited by 99 publications

References 34 publications

Diffuse low-grade gliomas and neuroplasticity

Diffuse low-grade gliomas and neuroplasticity

Association of dorsal inferior frontooccipital fasciculus fibers in the deep parietal lobe with both reading and writing processes: a brain mapping study

Awake mapping for low-grade gliomas involving the left sagittal stratum: anatomofunctional and surgical considerations

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