Impact of connectivity between the pars triangularis and orbitalis on identifying the frontal language area in patients with dominant frontal gliomas

  • Taiichi SaitoEmail author
  • Yoshihiro Muragaki
  • Manabu Tamura
  • Takashi Maruyama
  • Masayuki Nitta
  • Shunsuke Tsuzuki
  • Takakazu Kawamata
Original Article


We have previously revealed that identification of the frontal language area (FLA) can be difficult in patients with dominant frontal glioma involving the pars triangularis (PT). The present study added new cases and performed additional analyses. We noticed a new finding that the presence of extension to the pars orbitalis (POr) was associated with negative response to the FLA. The aim of the present study was to evaluate the impact of PT involvement with extension to the POr on the failure to identify the FLA. From 2000 to 2017, awake craniotomy was performed on 470 patients. Of these patients, the present study included 148 consecutive patients with frontal glioma on the dominant side. We evaluated whether tumors involved the PT or extended to the POr. Thirty one of 148 patients showed involvement of the PT, and we examined the detailed characteristics of these 31 patients. The rate of negative response for the FLA was 61% in patients with involvement of the PT. In 31 patients with frontal glioma involving the PT, univariate analyses showed significant correlation between extension to the POr and failure to identify the FLA (P = 0.0070). Similarly, multivariate analysis showed only extension to the POr correlated significantly with failure to identify the FLA (P = 0.0129). We found new evidence that extension to the POr which impacts connectivity between the PT and POr correlated significantly with negative response to the FLA of patients with dominant frontal glioma.


Awake craniotomy Language function Frontal glioma Pars triangularis Pars orbitalis 



Special thanks are extended to Dr. Takashi Komori, Ms. Soko Ikuta, Satoko Fukuchi, Asuka Komori, and Mr. Takashi Sakayori for valuable help with clinical work and data analysis.


This study was supported by the Japan Society for the Promotion of Science (JSPS) KAKENHI Grant No. 18K09006.

Compliance with ethical standards

Ethical approval

Ethical approval was obtained from the ethics committee at the Tokyo Women’s Medical University (No. 3540).

Informed consent

Given the retrospective design, the institutional review board waived the requirement for informed consent. We took the opt-out method. To protect patient privacy, we removed all identifiers from our records upon completion of our analyses.

Conflict of interest

The authors declare that they have no potential conflicts of interest.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of NeurosurgeryTokyo Women’s Medical UniversityShinjuku-kuJapan
  2. 2.Faculty of Advanced Techno-SurgeryTokyo Women’s Medical UniversityTokyoJapan

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