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Coexistence of language/social cognitive centers in the unilateral cerebrum: awake mapping study

Poster No:

Submission Type:

Abstract Submission

Authors:

Masashi Kinoshita¹, Riho Nakajima², Xiong Ruochu¹, Mitsutoshi Nakada¹

Institutions:

¹Department of Neurosurgery, Kanazawa University, Kanazawa, Japan, ²Department of Occupational Therapy, Kanazawa University, Kanazawa, Japan

First Author:

Masashi Kinoshita
Department of Neurosurgery, Kanazawa University
Kanazawa, Japan

Co-Author(s):

Riho Nakajima
Department of Occupational Therapy, Kanazawa University
Kanazawa, Japan

Xiong Ruochu
Department of Neurosurgery, Kanazawa University
Kanazawa, Japan

Mitsutoshi Nakada
Department of Neurosurgery, Kanazawa University
Kanazawa, Japan

Introduction:

In brain functional mapping during awake craniotomy for brain tumors, especially in left-handed patients, the language-related cortical sites defined by stimulation are sometimes identified in the right cerebral hemisphere. On the other hand, the impact of the dominant hand on the cortical sites associated with social cognitive function, which is involved in interpersonal relationship recognition, is well unknown. In this study, we investigated the cerebral localization of cognitive functions that can be evaluated intraoperatively in patients with gliomas, focusing on the relationship with handedness.

Methods:

Of the 36 consecutive patients who underwent awake craniotomy for gliomas between April 2021 and March 2023, 28 patients (11 left and 17 right cerebral hemispheres) who successfully completed intraoperative brain mapping were included in the study. Patients were classified into right-handed (25 cases) and left-handed (3 cases) groups using the Edinburgh handedness inventory. In the right-handed group, language tasks (object naming, semantics) were performed in the left cerebral hemisphere, and both language and non-language tasks (eyes emotion recognition, theory of mind, visuospatial recognition) were to be performed in the right cerebral hemisphere. On the other hand, in the left-handed group (1 left parietal lobe, 1 left frontal lobe, 1 right frontal lobe), both language and non-language examinations in brain function mapping were to be applied. The cortical areas defined as positive by direct electrical stimulation were preserved and recorded in standardized three-dimensional space. The positive mapping rates for language and non-language responses were calculated and compared for each group. In addition, the functional localization of the cerebral cortex was analyzed in terms of spatial position (MNI152 template) and structural connectivity (diffusion tensor imaging), and the characteristics of the left-handed group were examined in detail.

Results:

In the right-handed group, the rate of positive mapping in the left cerebral cortex in language tasks was 77.8% (7/9), compared to 0% in the right cerebral cortex. In non-language tasks, the rate of positive mapping in the right cerebral cortex was 56.3% (9/16). Notably, the cortical distribution of positive mapping sites in language and social cognition tasks was almost symmetrical between the left and right cerebral hemispheres. On the other hand, left-handed group showed positive mapping areas in both language and non-language tasks (3/3, 100%) (see Figure). They were all located in the same or adjacent cortex (mean distance 15.0 [8.5-20.3] mm) and were independent of each other without fiber-tracking connections.

·Intraoperative photographs and illustrations of left-handed cases

Conclusions:

The cortical centers of language and social cognition form homologous structures in the left and right cerebral hemispheres. It is noteworthy that in left-handed glioma patients, these cortical centers of cognitive function coexist adjacent to each other on the same side of the cerebral hemisphere.

Brain Stimulation:

Direct Electrical/Optogenetic Stimulation ¹

Neuroanatomy, Physiology, Metabolism and Neurotransmission:

Cortical Anatomy and Brain Mapping ²

Keywords:

Cognition

Cortex

Emotions

Language

^1|2Indicates the priority used for review

Abstract Information

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Please indicate below if your study was a "resting state" or "task-activation” study.

Task-activation

Healthy subjects only or patients (note that patient studies may also involve healthy subjects):

Patients

Was this research conducted in the United States?

Were any human subjects research approved by the relevant Institutional Review Board or ethics panel? NOTE: Any human subjects studies without IRB approval will be automatically rejected.

Yes

Were any animal research approved by the relevant IACUC or other animal research panel? NOTE: Any animal studies without IACUC approval will be automatically rejected.

Yes

Please indicate which methods were used in your research:

Other, Please specify - awake brain mapping

For human MRI, what field strength scanner do you use?

3.0T

Which processing packages did you use for your study?

SPM

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