Dissociated expressive and receptive language functions on magnetoencephalography, functional magnetic resonance imaging, and amobarbital studies - Case report and review of the literature
Dissociated expressive and receptive language functions on magnetoencephalography, functional magnetic resonance imaging, and amobarbital studies - Case report and review of the literature
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DOI：
10.3171/jns.2006.104.4.598
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发表时间：
2006-04-01
影响因子：
4.1
通讯作者：
Sawamura, Y
中科院分区：
文献类型：
--
作者：
Kamada, K;Takeuchi, F;Sawamura, Y
标准技术（例如异戊巴比妥测试和皮质刺激）很大程度上使分离的语言功能失效。在语言研究中，使用脑磁图 (MEG) 和功能磁共振 (fMR) 成像在患者执行词汇语义任务时记录数据，使研究人员能够对颞叶和额叶语言功能进行独立的大脑绘图（MEG 用于额叶功能的颞叶和 fMR 成像）。在本病例报告中，作者描述了一位惯用右手的患者，该患者被诊断出患有右侧岛状胶质瘤。该患者的接受性语言区位于右侧，但通过功能磁共振成像和脑磁图绘图，在左半球发现了表达性语言功能。对 20 名患有低级别神经胶质瘤的右利手患者（对照组）进行了检查，以仔细比较和解释该患者的结果。在这些测试中，所有患者都被要求为 fMR 成像生成与声学呈现的名词（动词生成）相关的动词，并将一组由 fMR 成像和 MEG 的三个日语字母组成的视觉呈现单词分类为抽象或具体。在所有参与者（包括此处介绍的患者）的左下回和额中回中，通过动词生成任务观察到最显着的 fMR 成像激活显示。在所有对照患者中，通过抽象/具体分类任务识别的估计偶极子集中在左半球的颞上回和边缘上回。然而，在该患者中，在抽象/具体分类任务中，右上颞区在 MEG 和 fMR 成像上表现出明显更强的激活。通过这两种成像方式成功地绘制了可疑的语言功能分离，并通过改良的异戊巴比妥试验和术后神经状态进行了验证。作者描述了在该患者中获得的详细功能概况，并回顾了先前描述的四名发现语言功能分离的患者的病例。
Dissociated language functions are largely invalidated by standard techniques Such as the amobarbital test and cortical stimulation. Language studies in which magnetoencephalography (MEG) and functional magnetic resonance (fMR) imaging are used to record data while the patient performs lexicosemantic tasks have enabled researchers to perform independent brain mapping for temporal and frontal language functions (MEG is used for temporal and fMR imaging for frontal functions). In this case report, the authors describe a right-handed patient in whom a right-sided insular glioma was diagnosed. The patient had a right-lateralized receptive language area, but expressive language function was identified in the left hemisphere on fMR imaging- and MEG-based mapping. Examinations were performed in 20 right-handed patients with low-grade gliomas (control group) for careful comparison with and interpretation of this patient's results. In these tests, all patients were asked to generate verbs related to acoustically presented nouns (verb generation) for fMR imaging, and to categorize as abstract or concrete a set Of Visually presented words consisting of three Japanese letters for fMR imaging and MEG.The most prominent display of fMR imaging activation by the verb-generation task was observed in the left inferior and middle frontal gyri in all participants, including the patient presented here. Estimated dipoles identified with the abstract/concrete categorization task were concentrated in the superior temporal and supramarginal gyri in the left hemisphere in all control patients. In this patient, however, the right superior temporal region demonstrated significantly stronger activations on MEG and fMR imaging with the abstract/concrete categorization task. Suspected dissociation of the language functions was successfully mapped with these two imaging modalities and was validated by the modified amobarbital test and the postoperative neurological status. The authors describe detailed functional profiles obtained in this patient and review the cases of four previously described patients in whom dissociated language functions were found.