John K Lyo1, Julio Arevalo-Perez1, Nicole Petrovich Brennan2, Kyung K Peck3, Andrei I Holodny4. 1. Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA. 2. Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA. 3. Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, USA peckk@mskcc.org. 4. Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA Functional MRI Laboratory of the Department of Radiology, Memorial Sloan-Kettering Cancer Center, USA.
Abstract
INTRODUCTION: Neurosurgery of the supplementary motor area (SMA) is associated with transient speech defects. We investigated whether SMA laterality correlates with postoperative speech defects. MATERIALS AND METHODS: The authors reviewed 17 patients with SMA-area lesion resection and preoperative language fMRI. SMA laterality was calculated by comparison of voxel activation in paired SMAs by hand-drawn regions of interest (ROIs) (drawn by a neuroradiologist), and compared with qualitative assessment by two neuroradiologists. Postoperative speech defects before and after surgery were assessed by chart review. RESULTS: Six patients developed new speech defects that resolved within several months. Two of the patients had a pre-existing speech defect that had developed after prior SMA-area surgery. All these patients had left-sided lesions, while none of the four patients with a right-sided lesion developed a speech defect. Neuroradiologists' assessment of SMA laterality agreed with ROI calculation for the SMAs that were lateralized. However, for the SMAs in the "codominant" range by ROI, the neuroradiologists felt that all but one of the cases clearly lateralized, with the exception deemed indeterminate or codominant. No correlation between laterality of SMA and speech defect was identified. Twelve patients showed lateralization contralateral to the lesion. CONCLUSIONS: fMRI lateralization does not correlate with transient speech defects that developed from SMA-area surgery. Qualitative/visual assessment of SMA laterality was superior to ROI calculation because of the close proximity and possible overlap of signal from midline SMA. A majority of patients showed SMA lateralization contralateral to the SMA lesion.
INTRODUCTION: Neurosurgery of the supplementary motor area (SMA) is associated with transient speech defects. We investigated whether SMA laterality correlates with postoperative speech defects. MATERIALS AND METHODS: The authors reviewed 17 patients with SMA-area lesion resection and preoperative language fMRI. SMA laterality was calculated by comparison of voxel activation in paired SMAs by hand-drawn regions of interest (ROIs) (drawn by a neuroradiologist), and compared with qualitative assessment by two neuroradiologists. Postoperative speech defects before and after surgery were assessed by chart review. RESULTS: Six patients developed new speech defects that resolved within several months. Two of the patients had a pre-existing speech defect that had developed after prior SMA-area surgery. All these patients had left-sided lesions, while none of the four patients with a right-sided lesion developed a speech defect. Neuroradiologists' assessment of SMA laterality agreed with ROI calculation for the SMAs that were lateralized. However, for the SMAs in the "codominant" range by ROI, the neuroradiologists felt that all but one of the cases clearly lateralized, with the exception deemed indeterminate or codominant. No correlation between laterality of SMA and speech defect was identified. Twelve patients showed lateralization contralateral to the lesion. CONCLUSIONS: fMRI lateralization does not correlate with transient speech defects that developed from SMA-area surgery. Qualitative/visual assessment of SMA laterality was superior to ROI calculation because of the close proximity and possible overlap of signal from midline SMA. A majority of patients showed SMA lateralization contralateral to the SMA lesion.
Authors: John L Ulmer; Hendrikus G Krouwer; Wade M Mueller; M Sahin Ugurel; Mehmet Kocak; Leighton P Mark Journal: AJNR Am J Neuroradiol Date: 2003-02 Impact factor: 3.825
Authors: S Lehéricy; L Cohen; B Bazin; S Samson; E Giacomini; R Rougetet; L Hertz-Pannier; D Le Bihan; C Marsault; M Baulac Journal: Neurology Date: 2000-04-25 Impact factor: 9.910
Authors: A Krainik; S Lehéricy; H Duffau; L Capelle; H Chainay; P Cornu; L Cohen; A-L Boch; J-F Mangin; D Le Bihan; C Marsault Journal: Neurology Date: 2003-02-25 Impact factor: 9.910
Authors: Luca Pasquini; Alberto Di Napoli; Maria Camilla Rossi-Espagnet; Emiliano Visconti; Antonio Napolitano; Andrea Romano; Alessandro Bozzao; Kyung K Peck; Andrei I Holodny Journal: Front Hum Neurosci Date: 2022-02-18 Impact factor: 3.169