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67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS)

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12. - 15. Juni 2016, Frankfurt am Main

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Loss of subcortical language pathways correlate with surgery-related aphasia in brain tumor patients: an investigation via nTMS-based DTI fiber tracking

Meeting Abstract

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  • Eva Beurskens - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Germany
  • Chiara Negwer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Germany
  • Nico Sollmann - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Germany
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Germany
  • Sandro M. Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Germany

Deutsche Gesellschaft für Neurochirurgie. 67. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), 1. Joint Meeting mit der Koreanischen Gesellschaft für Neurochirurgie (KNS). Frankfurt am Main, 12.-15.06.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocDI.20.03

doi: 10.3205/16dgnc221, urn:nbn:de:0183-16dgnc2214

Veröffentlicht: 8. Juni 2016

© 2016 Beurskens et al.
Dieser Artikel ist ein Open-Access-Artikel und steht unter den Lizenzbedingungen der Creative Commons Attribution 4.0 License (Namensnennung). Lizenz-Angaben siehe http://creativecommons.org/licenses/by/4.0/.

Gliederung

Text

Objective: Diffusion tensor imaging fiber tracking is well established to visualize subcortical fiber tracts. Yet, a new and more standardized way is to use cortical regions mapped via (nTMS) as seed regions for DTI fiber tracking. This study investigates if preoperatively acquired nTMS language areas are useful for pre- and postoperative nTMS-based DTI FT to track language pathways and whether postoperative fiber changes correlate with clinical status.

Method: nTMS-based DTI fiber tracking was performed pre- and postoperatively in 24 patients with left-hemispheric perisylvian tumors. nTMS-based DTI fiber tracking was performed and pre- and postoperative language pathways were analyzed individually (corticonuclear tract, arcuate fascicle (AF), uncinate fascicle, superior longitudinal fascicle inferior, longitudinal fascicle, arcuate fibers, commissural fibers, corticothalamic fibers, and frontooccipital fascicle). Transient aphasia was defined as up to three months. Since postoperative aphasia does not allow nTMS language mapping, we used preoperative nTMS data throughout.

Results: The transient aphasia group had a significant reduction in fiber count due to surgery (pre: 489 ± 339; post: 156 ± 130 fibers; p=0.027) compared to patients without deficit (pre: 337 ± 317; post: 249 ± 206 fibers; p=0.145). In the 'transient aphasia' group, the AF was lost in 60% compared to the 'no new' group where it was only 29% (p=0.124).

Conclusions: This study proves preoperative nTMS language mapping to be useful for pre- and postoperative nTMS-based DTI fiber tracking of language pathways. Moreover, changes in pre- vs. postoperative fibers correlate with clinical status and impairment of the AF can be compensated well.

Note: Eva Beurskens and Chiara Negwer contributed equally to this work.