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70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

12.05. - 15.05.2019, Würzburg

Cortical language function in glioma patients as measured by nrTMS

Kortikale Lokalisation von Sprachfunktion in Gliom-Patienten gemessen mit nrTMS

Meeting Abstract

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  • presenting/speaker Sebastian Ille - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Alina Fendel - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Bernhard Meyer - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland
  • Sandro Krieg - Neurochirurgische Klinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 70. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Skandinavischen Gesellschaft für Neurochirurgie. Würzburg, 12.-15.05.2019. Düsseldorf: German Medical Science GMS Publishing House; 2019. DocV283

doi: 10.3205/19dgnc302, urn:nbn:de:0183-19dgnc3020

Published: May 8, 2019

© 2019 Ille et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution 4.0 License. See license information at http://creativecommons.org/licenses/by/4.0/.


Outline

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Objective: The cortical localization of brain function is often altered in glioma patients due to tumor growth. Particularly, this must be considered for the language network, whose localization is disseminated over the whole perisylvian area. Moreover, cortical language function is highly individualized and frequently changes due to functional reorganization. The present study aims to provide a probability map for the cortical localization of language function in glioma patients as visualized by a new protocol for the fusion of language maps.

Methods: We included 30 patients with a mean age of 51.17±17.36 years who underwent language mapping by navigated repetitive transcranial magnetic stimulation (nrTMS) prior to resection of a left-sided perisylvian glioma. DICOM files were converted to the NIfTI file format. We normalized and smoothed the maps using SPM12. The resulting image files were then applied to the normalization brain image template as an overlay in MRIcron. Subsequently, we created a heat map as a fusion of all nrTMS mappings.

Results: Histopathology showed glioma in all cases (2 WHO grade I, 5 WHO grade II, 5 WHO grade III, 18 WHO grade IV). Tumors were located frontal in 16 cases (53.3%), parietal in 7 cases (23.3%), and temporal in 7 cases (23.3%). We found high density of cortical language function within the opercular and triangular part of the inferior frontal gyrus, the posterior middle frontal gyrus, the ventral precentral gyrus, and the middle superior temporal gyrus. Localizations with a lower intensity were the anterior part of the supramarginal gyrus and the posterior part of the superior temporal gyrus.

Conclusion: By the present results we present a new protocol for the fusion of language mappings. Furthermore, the cortical localization of language function in glioma patients as measured by preoperative nrTMS matches with those measured by direct cortical stimulation during awake surgery in former publications.