Hemispheric Dominance for Language and Side Effects in Mapping the Inferior Frontal Junction Area with Transcranial Magnetic Stimulation.


Journal

Journal of neurological surgery. Part A, Central European neurosurgery
ISSN: 2193-6323
Titre abrégé: J Neurol Surg A Cent Eur Neurosurg
Pays: Germany
ID NLM: 101580767

Informations de publication

Date de publication:
Mar 2020
Historique:
pubmed: 12 2 2020
medline: 12 9 2020
entrez: 12 2 2020
Statut: ppublish

Résumé

 Language mapping by navigated transcranial magnetic stimulation (TMS) is commonly applied over the left language-dominant hemisphere to indicate the language-related cortex. Detailed language mapping of Broca's region including stimulation targets in the immediate vicinity to the premotor cortex may raise concern about confounding unspecific motor effects. We performed interhemispheric comparisons to delineate such possible unspecific effects from true TMS-induced language inhibition.  Fifteen healthy German speakers named object pictures during navigated TMS over a left- and right-hemispheric target array covering the left inferior frontal junction area. Six mapping repetitions were conducted per hemisphere. Order of stimulation side was randomized between participants. Self-rating of discomfort was assessed after each stimulation; language errors and motor side effects were evaluated offline.  Naming errors were observed significantly more frequently during left- than right-hemispheric stimulation. The same pattern was found for the most frequent error category of performance errors. Hierarchical cluster analyses of normalized ratings of error severity revealed a clear focus of TMS susceptibility for language inhibition in object naming at the dorsoposterior target sites only in the left hemisphere. We found no statistical difference in discomfort ratings between both hemispheres and also no interhemispheric difference in motor side effects, but we observed significantly stronger muscle contractions of the eyes as compared with the mouth.  Our results of (1) unspecific pre-/motor effects similarly induced in both hemispheres, and (2) a specific focus of TMS susceptibility in the language-dominant hemisphere render any substantial contribution of nonlanguage-specific effects in TMS language mapping of the inferior frontal junction area highly unlikely.

Sections du résumé

BACKGROUND AND STUDY AIMS OBJECTIVE
 Language mapping by navigated transcranial magnetic stimulation (TMS) is commonly applied over the left language-dominant hemisphere to indicate the language-related cortex. Detailed language mapping of Broca's region including stimulation targets in the immediate vicinity to the premotor cortex may raise concern about confounding unspecific motor effects. We performed interhemispheric comparisons to delineate such possible unspecific effects from true TMS-induced language inhibition.
MATERIAL AND METHODS METHODS
 Fifteen healthy German speakers named object pictures during navigated TMS over a left- and right-hemispheric target array covering the left inferior frontal junction area. Six mapping repetitions were conducted per hemisphere. Order of stimulation side was randomized between participants. Self-rating of discomfort was assessed after each stimulation; language errors and motor side effects were evaluated offline.
RESULTS RESULTS
 Naming errors were observed significantly more frequently during left- than right-hemispheric stimulation. The same pattern was found for the most frequent error category of performance errors. Hierarchical cluster analyses of normalized ratings of error severity revealed a clear focus of TMS susceptibility for language inhibition in object naming at the dorsoposterior target sites only in the left hemisphere. We found no statistical difference in discomfort ratings between both hemispheres and also no interhemispheric difference in motor side effects, but we observed significantly stronger muscle contractions of the eyes as compared with the mouth.
CONCLUSION CONCLUSIONS
 Our results of (1) unspecific pre-/motor effects similarly induced in both hemispheres, and (2) a specific focus of TMS susceptibility in the language-dominant hemisphere render any substantial contribution of nonlanguage-specific effects in TMS language mapping of the inferior frontal junction area highly unlikely.

Identifiants

pubmed: 32045945
doi: 10.1055/s-0040-1701236
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

130-137

Informations de copyright

Georg Thieme Verlag KG Stuttgart · New York.

Déclaration de conflit d'intérêts

None declared.

Auteurs

Katrin Sakreida (K)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Johanna Blume-Schnitzler (J)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Grit Frankemölle (G)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Vanessa Drews (V)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Stefan Heim (S)

Department of Psychiatry, Psychotherapy and Psychosomatics, Medical Faculty, RWTH Aachen University, Aachen, Germany.
Research Centre Jülich, Institute of Neuroscience and Medicine (INM-1), Jülich, Germany.
JARA - Translational Brain Medicine, Aachen, Germany.

Klaus Willmes (K)

Department of Neurology, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Hans Clusmann (H)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.

Georg Neuloh (G)

Department of Neurosurgery, Medical Faculty, RWTH Aachen University, Aachen, Germany.

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