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73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC)
Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie

Deutsche Gesellschaft für Neurochirurgie (DGNC) e. V.

29.05. - 01.06.2022, Köln

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Feasibility of nTMS-based language comprehension mapping in brain tumour patients with severe expressive aphasia – a case series

Durchführbarkeit von nTMS-basierter Sprachverständnis-Kartierungen bei Hirntumorpatienten mit ausgeprägten expressiven Aphasien: Serielle Fallstudie

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  • presenting/speaker Leonie Kram - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Ann-Katrin Ohlerth - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Sebastian Ille - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland; Klinikum rechts der Isar der TU München, TUM Neuroimaging Center, München, Deutschland
  • Simon N. Jacob - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Bernhard Meyer - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland
  • Sandro M. Krieg - Klinikum rechts der Isar der TU München, Klinik und Poliklinik für Neurochirurgie, München, Deutschland; Klinikum rechts der Isar der TU München, TUM Neuroimaging Center, München, Deutschland

Deutsche Gesellschaft für Neurochirurgie. 73. Jahrestagung der Deutschen Gesellschaft für Neurochirurgie (DGNC), Joint Meeting mit der Griechischen Gesellschaft für Neurochirurgie. Köln, 29.05.-01.06.2022. Düsseldorf: German Medical Science GMS Publishing House; 2022. DocV066

doi: 10.3205/22dgnc071, urn:nbn:de:0183-22dgnc0719

Published: May 25, 2022

© 2022 Kram 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: Pre- but also intraoperative language mapping predominantly relies on overt production tasks. However, many glioma patients present with highly impaired overt language production. Since the receptive language network may aid to assess the complexity of language more comprehensively in all patients, but also in patients with severe expressive aphasia, this pilot-study developed and examined the feasibility of a new comprehension task for pre- and intraoperative language mapping. As a first step, preoperative mapping by navigated transcranial magnetic stimulation (nTMS) was used.

Methods: Six brain tumor patients with severe expressive aphasia, unable to perform classical object naming, underwent preoperative language comprehension mapping. In this setup, patients had to identify 62 auditorily presented target items. While each was simultaneously depicted in a set of four black-and-white drawings on a screen, patients had to select the respective target item with a button-press.

Results: All patients were able to perform the comprehension task during nTMS. In all cases stimulation-induced comprehension disruptions were observed such as searching behavior, no or delayed responses or selection of a wrong target item with a mean error rate of 18.3% (range: 11.6-25.4%) across 46 left-hemispheric target sites and marked as comprehension-positive cortical sites.

Conclusion: The present study demonstrated that a language comprehension mapping is feasible. This protocol allowed a nTMS-based preoperative assessment of cortical language-relevant sites in patients with severe expressive aphasia who cannot perform classical overt production tasks and will now be transferred to intraoperative testing.