Authors: Philipp T Meyer Laszlo Sturz Mathias Schreckenberger Uwe Spetzger Georg F Meyer Keyvan S Setani Osama Sabri Udalrich Buell
Publish Date: 2003/05/14
Volume: 30, Issue: 7, Pages: 951-960
Abstract
In patients scheduled for the resection of perisylvian brain tumours knowledge of the cortical topography of language functions is crucial in order to avoid neurological deficits We investigated the applicability of statistical parametric mapping SPM without stereotactic normalisation for individual preoperative language function brain mapping using positron emission tomography PET Seven righthanded adult patients with leftsided brain tumours six frontal and one temporal underwent 12 oxygen15 labelled water PET scans during overt verb generation and rest Individual activation maps were calculated for P0005 and P0001 without anatomical normalisation and overlaid onto the individuals magnetic resonance images for preoperative planning Activations corresponding to Brocas and Wernickes areas were found in five and six cases respectively for P0005 and in three and six cases respectively for P0001 One patient with a glioma located in the classical Brocas area without aphasic symptoms presented an activation of the adjacent inferior frontal cortex and of a rightsided area homologous to Brocas area Four additional patients with left frontal tumours also presented activations of the rightsided Brocas homologue two of these showed aphasic symptoms and two only a weak or no activation of Brocas area Other frequently observed activations included bilaterally the superior temporal gyri prefrontal cortices anterior insulae motor areas and the cerebellum The middle and inferior temporal gyri were activated predominantly on the left An SPM group analysis P005 corrected in patients with left frontal tumours confirmed the activation pattern shown by the individual analyses We conclude that SPM analyses without stereotactic normalisation offer a promising alternative for analysing individual preoperative language function brain mapping studies The observed right frontal activations agree with proposed reorganisation processes but they may also reflect an unspecific recruitment of the rightsided Brocas homologue in the effort to perform the task
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