• World Neurosurg · Nov 2017

    Frontal fibers connecting the superior frontal gyrus to Broca's area: A cortico-cortical evoked potential study.

    • Satoshi Ookawa, Rei Enatsu, Aya Kanno, Satoko Ochi, Yukinori Akiyama, Tamaki Kobayashi, Yukihiro Yamao, Takayuki Kikuchi, Riki Matsumoto, Takeharu Kunieda, and Nobuhiro Mikuni.
    • Department of Neurosurgery, Sapporo Medical University, Sapporo, Japan.
    • World Neurosurg. 2017 Nov 1; 107: 239-248.

    BackgroundThe frontal aslant tract is a deep frontal pathway connecting the superior frontal gyrus (SFG) to Broca area. This fiber is assumed to be associated with language functions, especially speech initiation and spontaneity. The aim of this study was to electrophysiologically investigate this network using corticocortical evoked potentials (CCEPs).MethodsThis study enrolled 8 patients with brain tumors or medically intractable focal epilepsies who underwent frontal craniotomy over the language-dominant side. All patients underwent CCEP recordings during tumor resection or during invasive evaluation for epilepsy surgery. Alternating 1-Hz electrical stimuli were delivered to pars opercularis (pO) and pars triangularis (pT), corresponding to Broca area, and SFG via the subdural grid electrodes with intensity of 10 mA. Electrocorticograms from SFG and pO/pT time-locked to 50 stimuli were averaged in each trial to obtain CCEP responses.ResultsIn all patients, stimulation of pO/pT induced CCEP responses in SFG. CCEP responses were recorded in lateral SFG in 5 patients and in supplementary motor areas in 4 patients. Reciprocality was observed in 7 patients in the stimulation of SFG. CCEP responses were significantly faster at SFG from pO/pT than at pO/pT from SFG (Wilcoxon signed rank test, P = 0.028).ConclusionsThe present study demonstrated a corticocortical network connecting Broca areas and SFG in a reciprocal manner. Our findings might provide new insight into language and motor integration.Copyright © 2017 Elsevier Inc. All rights reserved.

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