Reorganized language network connectivity after left arcuate fasciculus resection: A case study.

Autor: Chernoff BL; Department of Psychology, Carnegie Mellon University, USA., Teghipco A; Department of Cognitive Sciences, University of California Irvine, USA., Garcea FE; Moss Rehabilitation Research Institute, USA., Belkhir R; Department of Psychology, Carnegie Mellon University, USA., Sims MH; Department of Neurology, University of Rochester, USA., Paul DA; Department of Neurosurgery, University of Rochester Medical Center, USA., Tivarus ME; Department of Imaging Sciences, University of Rochester Medical Center, USA; Department of Neuroscience, University of Rochester Medical Center, USA., Smith SO; Department of Neurosurgery, University of Rochester Medical Center, USA., Hintz E; Department of Neurosurgery, University of Rochester Medical Center, USA., Pilcher WH; Department of Neurosurgery, University of Rochester Medical Center, USA., Mahon BZ; Department of Psychology, Carnegie Mellon University, USA; Department of Neurology, University of Rochester, USA; Department of Neurosurgery, University of Rochester Medical Center, USA. Electronic address: bmahon@andrew.cmu.edu.
Jazyk: angličtina
Zdroj: Cortex; a journal devoted to the study of the nervous system and behavior [Cortex] 2020 Feb; Vol. 123, pp. 173-184. Date of Electronic Publication: 2019 Nov 05.
DOI: 10.1016/j.cortex.2019.07.022
Abstrakt: Understanding the neural mechanisms that support spontaneous recovery of cognitive abilities can place important constraints on mechanistic theories of brain organization and function, and holds potential to inform clinical interventions. Connectivity-based MRI measures have emerged as a way to study how recovery from brain injury is modulated by changes in intra- and inter-hemispheric connectivity. Here we report a detailed and multi-modal case study of a 26 year-old male who presented with a left inferior parietal glioma infiltrating the left arcuate fasciculus. The patient underwent pre- and post-operative functional MRI and Diffusion Tensor Imaging, as well as behavioral assessments of language, motor, vision and praxis. The surgery for removal of the tumor was carried out with the patient awake, and direct electrical stimulation mapping was used to evaluate cortical language centers. The patient developed a specific difficulty with repeating sentences toward the end of the surgery, after resection of the tumor and partial transection of the arcuate fasciculus. The patient recovered from the sentence repetition impairments over several months after the operation. Coincident with the patient's cognitive recovery, we document a pattern whereby intra-hemispheric functional connectivity was reduced in the left hemisphere, while inter-hemispheric connectivity increased between classic left hemisphere language regions and their right hemisphere homologues. These findings suggest that increased synchrony between the two hemispheres, in the setting of focal transection of the left arcuate fasciculus, can facilitate functional recovery.
(Copyright © 2019 The Authors. Published by Elsevier Ltd.. All rights reserved.)
Databáze: MEDLINE
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