gms | German Medical Science

58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e. V. (DGNC)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

26. bis 29.04.2007, Leipzig

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Correlation of speech fMRI activation spots and speech associated cortical areas – as defined by intraoperative language testing – in patients with lesion around the eloquent speech cortex

Korrelation der Felder der Sprachaktivierung im fMRT und des sprachassoziierten Kortex bei Patienten mit Läsionen in der Nähe des Sprachzentrums

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  • corresponding author R. Gerlach - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • T. Gasser - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • A. Szelenyi - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • I. Kropf - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • E. Hattingen - Institut für Neuroradiologie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • H. Lanfermann - Institut für Neuroradiologie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • A. Raabe - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main
  • V. Seifert - Klinik für Neurochirurgie der Johann-Wolfgang-Goethe-Universität, Frankfurt/Main

Deutsche Gesellschaft für Neurochirurgie. 58. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie e.V. (DGNC). Leipzig, 26.-29.04.2007. Düsseldorf: German Medical Science GMS Publishing House; 2007. DocSA.01.02

Die elektronische Version dieses Artikels ist vollständig und ist verfügbar unter: http://www.egms.de/de/meetings/dgnc2007/07dgnc132.shtml

Veröffentlicht: 11. April 2007

© 2007 Gerlach et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.

Gliederung

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Objective: To define the spatial correlation of speech fMRI activated areas and stimulated cortical areas involved in language production in patients with lesions in eloquent speech areas.

Methods: Between November 2005 and November 2006, 8 patients with lesions near Brodmann's area 44 or 45, underwent awake craniotomy for the resection of low grade gliomas (LGG, 5), cavernoma (1), glioblastoma (1) and anaplastic astrocytoma (1). In all patients preoperative speech fMRI (for data acquisition Wild intelligence test and semantic- synonym-task were used) and a 3D MPRAGE data acquisition for neuronavigation were performed. For fMRI data analysis, iPLAN (not yet released version, BrainLAB, Heimstetten) was employed. Both data sets were merged and integrated into neuronavigation. Preoperative language testing according to the Aachener Aphasie Test was performed to verify the ability of patients to actively participate in intraoperative language testing. Intraoperative Language mapping was conducted by use of a bipolar cortical stimulator (Inomed) during oral naming tasks, counting and conversation.

Results: In all patients functional cortical areas involved in language production were identified by cortical stimulation. However, in 6 patients additional areas for language production were identified (1 bilingual patient). Although the spots of cortical stimulation were close to the fMRI activation, the applied fMRI paradigm did not sufficiently initiate cortical activation in multiple areas, with only about 10% of overlay in the coordinates between fMRI and cortical mapping.

Conclusions: Cortical sites involved in language generation, which were activated by fMRI paradigms, corresponded to some degree tp intraoperative cortical surface mapping. However, additional eloquent language cortical sites were identified by cortical mapping. Therefore awake testing during surgery is required.