Sebastian Ille1, Nataliia Kulchytska2, Nico Sollmann3, Regina Wittig4, Eva Beurskens5, Vicki M Butenschoen6, Florian Ringel7, Peter Vajkoczy8, Bernhard Meyer9, Thomas Picht10, Sandro M Krieg11. 1. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Sebastian.Ille@tum.de. 2. Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Nataliia.Kulchytska@charite.de. 3. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Nico.Sollmann@tum.de. 4. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Regina.Wittig@online.de. 5. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Eva_Beurskens@hotmail.com. 6. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Vicki.Butenschoen@tum.de. 7. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: Florian.Ringel@tum.de. 8. Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Peter.Vajkoczy@charite.de. 9. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany. Electronic address: Bernhard.Meyer@tum.de. 10. Department of Neurosurgery, Charité-Universitätsmedizin Berlin, Augustenburger Platz 1, 13353 Berlin, Germany. Electronic address: Thomas.Picht@charite.de. 11. Department of Neurosurgery, Klinikum rechts der Isar, Technische Universität München, Ismaninger Str. 22, 81675 Munich, Germany; TUM Neuroimaging Center, Klinikum rechts der Isar, Technische Universität München, Germany. Electronic address: Sandro.Krieg@tum.de.
Abstract
OBJECT: The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that language function can shift between hemispheres in brain tumor patients, the preoperative knowledge of the patient's language dominance could be helpful. We therefore investigated the hemispheric language dominance by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related deficits of language function. METHODS: We pooled the bicentric language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR >1= left dominant; HDR <1= right dominant). The course of the patient's language function was evaluated and correlated with the preoperative HDR. RESULTS: Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (± standard deviation) of patients with new aphasia after five days was significantly higher (1.68±1.07) than the HDR of patients with no new language deficit (1.37±1.08) (p=0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. CONCLUSION: A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia.
OBJECT: The resection of left-sided perisylvian brain lesions harbors the risk of postoperative aphasia. Because it is known that language function can shift between hemispheres in brain tumorpatients, the preoperative knowledge of the patient's language dominance could be helpful. We therefore investigated the hemispheric language dominance by repetitive navigated transcranial magnetic stimulation (rTMS) and surgery-related deficits of language function. METHODS: We pooled the bicentric language mapping data of 80 patients undergoing the resection of left-sided perisylvian brain lesions in our two university neurosurgical departments. We calculated error rates (ERs; ER = errors per stimulations) for both hemispheres and defined the hemispheric dominance ratio (HDR) as the quotient of the left- and right-sided ER (HDR >1= left dominant; HDR <1= right dominant). The course of the patient's language function was evaluated and correlated with the preoperative HDR. RESULTS: Only three of 80 patients (4%) presented with permanent surgery-related aphasia and 24 patients (30%) with transient surgery-related aphasia. The mean HDR (± standard deviation) of patients with new aphasia after five days was significantly higher (1.68±1.07) than the HDR of patients with no new language deficit (1.37±1.08) (p=0.0482). With a predefined cut-off value of 0.5 for HDR, we achieved a sensitivity for predicting new aphasia of 100%. CONCLUSION: A higher preoperative HDR significantly correlates with an increased risk for transient aphasia. Moreover, the intensive preoperative workup in this study led to a considerably low rate of permanent aphasia.
Authors: Christian F Freyschlag; Sandro M Krieg; Johannes Kerschbaumer; Daniel Pinggera; Marie-Therese Forster; Dominik Cordier; Marco Rossi; Gabriele Miceli; Alexandre Roux; Andrés Reyes; Silvio Sarubbo; Anja Smits; Joanna Sierpowska; Pierre A Robe; Geert-Jan Rutten; Thomas Santarius; Tomasz Matys; Marc Zanello; Fabien Almairac; Lydiane Mondot; Asgeir S Jakola; Maria Zetterling; Adrià Rofes; Gord von Campe; Remy Guillevin; Daniele Bagatto; Vincent Lubrano; Marion Rapp; John Goodden; Philip C De Witt Hamer; Johan Pallud; Lorenzo Bello; Claudius Thomé; Hugues Duffau; Emmanuel Mandonnet Journal: J Neurooncol Date: 2018-07-10 Impact factor: 4.130
Authors: Alisa Pasichnik; Melissa Tsuboyama; Ali Jannati; Clemente Vega; Harper L Kaye; Ugur Damar; Jeffrey Bolton; Scellig S D Stone; Joseph R Madsen; Ralph O Suarez; Alexander Rotenberg Journal: Ann Clin Transl Neurol Date: 2022-08-24 Impact factor: 5.430
Authors: Anna Kelm; Nico Sollmann; Sebastian Ille; Bernhard Meyer; Florian Ringel; Sandro M Krieg Journal: Front Oncol Date: 2017-08-18 Impact factor: 6.244