Abstract
Despite a better understanding of their anatomy, the functional role of frontal pathways, i.e., the fronto-striatal tract (FST) and frontal aslant tract (FAT), remains obscure. We studied 19 patients who underwent awake surgery for a frontal glioma (14 left, 5 right) by performing intraoperative electrical mapping of both fascicles during motor and language tasks. Furthermore, we evaluated the relationship between these tracts and the eventual onset of transient postoperative disorders. We also performed post-surgical tract-specific measurements on probabilistic tractography. All patients but one experienced intraoperative inhibition of movement and/or speech during subcortical electrostimulation. On postoperative tractography, the subcortical distribution of stimulated sites corresponded to the spatial course of the FST and/or FAT. Furthermore, we found a significant correlation between postoperative worsening and distances between these tracts and resection cavity. A resection close to the (right or left) FST was correlated with transitory motor initiation disorders (p = 0.026), while a resection close to the left FAT was associated with transient speech initiation disorders (p = 0.003). Moreover, the measurements of average distances between resection cavity and left FAT showed a positive correlation with verbal fluency in both semantic (p = 0.019) and phonemic scores (p = 0.017), while average distances between surgical cavity and left FST showed a positive correlation with verbal fluency scores in both semantic (p = 0.0003) and phonemic modalities (p = 0.037). We suggest that FST and FAT would cooperatively play a role in self-initiated movement and speech, as a part of “negative motor network” involving the pre-supplementary motor area, left inferior frontal gyrus and caudate nucleus.
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Abbreviations
- FAT:
-
Frontal aslant tract
- IQR:
-
Inter quantile range
- FST:
-
Fronto-striatal tract
- SMA:
-
Supplementary motor area
- WHO:
-
World Health Organization
- VOI:
-
Volume of interest
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Acknowledgments
This work was supported by Postdoctoral Fellowship 2011 from the Uehara Memorial Foundation (M.K.), and Research Abroad 2012 from the Kanae Foundation for the Promotion of Medical Science (M.K.).
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M. Kinoshita and N. M. de Champfleur contributed equally to this work.
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429_2014_863_MOESM1_ESM.tiff
Supplementary Fig. 1 Box plots of scores of language assessment separated in two groups with or without postoperative disorders of speech initiation in various periods. The scores of semantic verbal fluency (A), phonemic verbal fluency (B), and DO80 (C) were evaluated one day before surgery (D − 1), 5 days after surgery (D + 5), and 3 months after surgery (M + 3). Box plots are separately shown in each group with (red box plots) or without (blue box plots) postoperative disorders of speech initiation. Differences among each score are statistically compared between in each period, using Steel–Dwass multiple comparison test. n.s. = there is no significant difference. (TIFF 1257 kb) (TIFF 1257 kb)
429_2014_863_MOESM2_ESM.tiff
Supplementary Fig. 2 Box plots of volumes of tracts using various thresholds. (A) The volumes of the FAT (A) and FST (B) are shown for each threshold in 25, 15, 5 and 0.4 %. Differences of volumes are statistically compared between in each threshold using Steel–Dwass multiple comparison test. n.s. = there is no significant difference. (TIFF 565 kb) (TIFF 565 kb)
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Kinoshita, M., de Champfleur, N.M., Deverdun, J. et al. Role of fronto-striatal tract and frontal aslant tract in movement and speech: an axonal mapping study. Brain Struct Funct 220, 3399–3412 (2015). https://doi.org/10.1007/s00429-014-0863-0
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DOI: https://doi.org/10.1007/s00429-014-0863-0