• World Neurosurg · Apr 2020

    Refined Functional Magnetic Resonance Imaging and Magnetoencephalography mapping reveals reorganization in language-relevant areas of lesioned brains.

    • Max Zimmermann, Karl Rössler, Martin Kaltenhäuser, Peter Grummich, Bing Yang, Michael Buchfelder, Arnd Doerfler, Konrad Kölble, and Andreas Stadlbauer.
    • Department of Neurosurgery, University of Erlangen-Nürnberg, Erlangen, Germany; Department of Neuroradiology, University of Erlangen-Nürnberg, Erlangen, Germany. Electronic address: max.zimmermann@uk-erlangen.de.
    • World Neurosurg. 2020 Apr 1; 136: e41-e59.

    BackgroundNeurosurgical decisions regarding interventions close to brain areas with language-related functions remain highly challenging because of the risk of postoperative dysfunction. To minimize these risks, improvements in the preoperative mapping of language-related regions are required, especially as space-occupying lesions often lead to altered cortical topography and language area reorganization.MethodsThe degree of deviation and language area reorganization were investigated in 26 functional magnetic resonance imaging- and magnetoencephalography-dissociable cortical sub-areas displaying language-related activations in each of 18 patients with brain lesions and 3 healthy volunteers (during visual language tasks).ResultsBoth modalities showed good congruency of the language areas. The mean spatial distance of the centroids and maxima was 9.06 mm and 10.58 mm, respectively, allowing us to define more specific anatomical positions. Postoperatively, language abilities increased in 11% (2 of 18) of the patients, remained unchanged in 83% (15 of 18) of the patients, and decreased in 6% (1 of 18) of the patients, respectively. Signs of language function reorganization detected on both functional magnetic resonance imaging and magnetoencephalography were present in 29% (5 of 17) of the patients. Attenuation of neurovascular coupling was found postoperatively in 17% (3 of 18) of the patients. Monohemispheric language processing cannot be assumed always in patients with brain lesions.ConclusionsThe more detailed subdivision of language-relevant brain areas shown in this study can help to achieve more radical tumor resection without postoperative language deficits.Copyright © 2019. Published by Elsevier Inc.

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