Intraoperative subcortical mapping of a language-associated deep frontal tract connecting the superior frontal gyrus to Broca's area in the dominant hemisphere of patients with glioma.


OBJECT:The deep frontal pathway connecting the superior frontal gyrus to Broca's area, recently named the frontal aslant tract (FAT), is assumed to be associated with language functions, especially speech initiation and spontaneity. Injury to the deep frontal lobe is known to cause aphasia that mimics the aphasia caused by damage to the supplementary motor area. Although fiber dissection and tractography have revealed the existence of the tract, little is known about its function. The aim of this study was to determine the function of the FAT via electrical stimulation in patients with glioma who underwent awake surgery. METHODS:The authors analyzed the data from subcortical mapping with electrical stimulation in 5 consecutive cases (3 males and 2 females, age range 40-54 years) with gliomas in the left frontal lobe. Diffusion tensor imaging (DTI) and tractography of the FAT were performed in all cases. A navigation system and intraoperative MRI were used in all cases. During the awake phase of the surgery, cortical mapping was performed to find the precentral gyrus and Broca's area, followed by tumor resection. After the cortical layer was removed, subcortical mapping was performed to assess language-associated fibers in the white matter. RESULTS:In all 5 cases, positive responses were obtained at the stimulation sites in the subcortical area adjacent to the FAT, which was visualized by the navigation system. Speech arrest was observed in 4 cases, and remarkably slow speech and conversation was observed in 1 case. The location of these sites was also determined on intraoperative MR images and estimated on preoperative MR images with DTI tractography, confirming the spatial relationships among the stimulation sites and white matter tracts. Tumor removal was successfully performed without damage to this tract, and language function did not deteriorate in any of the cases postoperatively. CONCLUSIONS:The authors identified the left FAT and confirmed that it was associated with language functions. This tract should be recognized by clinicians to preserve language function during brain tumor surgery, especially for tumors located in the deep frontal lobe on the language-dominant side.


J Neurosurg


Journal of neurosurgery


Fujii M,Maesawa S,Motomura K,Futamura M,Hayashi Y,Koba I,Wakabayashi T




Has Abstract


2015-06-01 00:00:00












  • Development of experimental meningeal gliomatosis models in rats.

    abstract::Experimental models of meningeal gliomatosis (MG) have been produced by intracisternal inoculation of rat C6 and 9L glioma cells into Wistar and Fischer 344 rats, respectively. Tumor growth was steady and rapid in both MG models when more than 10(6) tumor cells were implanted. The median survival time of the rats inoc...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Yoshida T,Shimizu K,Ushio Y,Hayakawa T,Arita N,Mogami H

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  • Sex-specific effects of subthalamic nucleus stimulation on pain in Parkinson's disease.

    abstract:OBJECTIVE:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is known to reduce motor symptoms of Parkinson's disease (PD). The effects of DBS on various nonmotor symptoms often differ from patient to patient. The factors that determine whether or not a patient will respond to treatment have not been elucida...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:2020-10-09 00:00:00

  • Cognitive impairment and adjustment in patients without neurological deficits after aneurysmal SAH and early operation.

    abstract::The mortality rate has recently been reduced to only a small percentage of patients selected for early aneurysm surgery. Despite recovery without neurological deficits, however, a diffuse encephalopathy may remain, with emotional and psychological sequelae that will interfere with rehabilitation and social reintegrati...

    journal_title:Journal of neurosurgery

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    journal_title:Journal of neurosurgery

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  • Lymphomatoid granulomatosis apparently confined to one temporal lobe. Case report.

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    journal_title:Journal of neurosurgery

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  • Aneurysms protruding from the dorsal wall of the internal carotid artery.

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    journal_title:Journal of neurosurgery

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    journal_title:Journal of neurosurgery

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    abstract::OBJECTIVEExcessive dissatisfaction and stress among physicians can precipitate burnout, which results in diminished productivity, quality of care, and patient satisfaction and treatment adherence. Given the multiplicity of its harms and detriments to workforce retention and in light of the growing physician shortage, ...

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    pub_type: 杂志文章


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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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  • Cerebral aneurysms in childhood and adolescence.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章,评审


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  • Potentiation of response to low doses of levodopa in MPTP-injected monkeys by chemical unilateral subthalamotomy.

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:2013-01-01 00:00:00

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    pub_type: 杂志文章


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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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  • Transcranial approach to the orbit: microsurgical anatomy.

    abstract::An anatomical study of three microsurgical intraorbital routes to the optic nerve and orbital apex, which can be reached through a fronto-orbital craniotomy, was conducted on cadaver specimens. The structures that could be exposed via the medial, central, or lateral approaches directed through the orbital roof were de...

    journal_title:Journal of neurosurgery

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    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:2001-12-01 00:00:00

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    abstract::To determine if dexamethasone administered by osmotic pump directly to brain tumors would control peritumoral edema and at the same time suppress tumor growth and prolong survival, the authors studied experimental brain tumors produced in 102 rabbits by implanting VX2 carcinoma cells. Of these, 58 animals were separat...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ikeda Y,Carson BS,Lauer JA,Long DM

    更新日期:1993-11-01 00:00:00

  • Risk factors for postoperative neurosurgical wound infection. A case-control study.

    abstract::A case-control analysis was performed to evaluate the association of 15 potential risk factors with postoperative infection in neurosurgical patients. All infections that developed postoperatively on the neurosurgical service at the University of Minnesota from January, 1970, to March, 1984, were identified. Among the...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Mollman HD,Haines SJ

    更新日期:1986-06-01 00:00:00

  • Cavernous hemangioma of the orbit.

    abstract::The clinical and pathological data of 66 patients with orbital cavernous hemangioma are presented. This tumor occurs in females more frequently than in males, and has its peak incidence in early middle age. Visual disability results from a high degree of relative hyperopia or from optic-nerve compression. Postural or ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Harris GJ,Jakobiec FA

    更新日期:1979-08-01 00:00:00

  • Evaluation of prognostic factors and clinical outcome in elderly patients in whom expansive laminoplasty is performed for cervical myelopathy due to multisegmental spondylotic canal stenosis. A retrospective comparison with younger patients.

    abstract:OBJECT:It remains unclear whether elderly patients with compressive cervical myelopathy can be expected to experience a promising surgery-related outcome after undergoing expansive laminoplasty. The purposes of this study were to evaluate the efficacy of expansive laminoplasty in elderly patients with cervical myelopat...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Handa Y,Kubota T,Ishii H,Sato K,Tsuchida A,Arai Y

    更新日期:2002-03-01 00:00:00

  • Seizure outcome from anterior and complete corpus callosotomy.

    abstract::Eighty patients underwent anterior corpus callosotomy for treatment of generalized seizures. The patients' mean age was 18.3 years (range 4 to 53 years); the mean age at seizure onset was 5.27 years (range 0.1 to 27 years). The mean intelligence quotient (IQ) of 41 testable patients was 71.12 (range less than 30 to 11...

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    pub_type: 杂志文章


    authors: Fuiks KS,Wyler AR,Hermann BP,Somes G

    更新日期:1991-04-01 00:00:00

  • Experimental intraoperative localization of retained intracerebral bone fragments using transdural ultrasound.

    abstract::Precise intraoperative localization of retained bone fragments and foreign bodies avoids extensive brain disseciton, cerebral edema, damage to vital structures, incomplete debridement, and prolonged surgical procedures. Such localization after head trauma is often hampered by cerebral distortion, previous incomplete d...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Wood JH,Parver M,Doppman JL,Ommaya AK

    更新日期:1977-01-01 00:00:00

  • Immune surveillance and tumors of the nervous system.

    abstract::The theory of immune surveillance postulates that one function of the immune system is to eliminate small numbers of malignant cells that arise spontaneously within the organism. Although there has been a great deal of both clinical and experimental evidence in favor of thistheory as it applies to general oncology, th...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


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    更新日期:1978-07-01 00:00:00

  • Low-grade glioma surgery in eloquent areas: volumetric analysis of extent of resection and its impact on overall survival. A single-institution experience in 190 patients: clinical article.

    abstract:OBJECT:A growing number of published studies have recently demonstrated the role of resection in overall survival (OS) for patients with gliomas. In this retrospective study, the authors objectively investigated the role of the extent of resection (EOR) in OS in patients with low-grade gliomas (LGGs). METHODS:Between ...

    journal_title:Journal of neurosurgery

    pub_type: 杂志文章


    authors: Ius T,Isola M,Budai R,Pauletto G,Tomasino B,Fadiga L,Skrap M

    更新日期:2012-12-01 00:00:00