Correlating subcortical interhemispheric connectivity and cortical hemispheric dominance in brain tumor patients: A repetitive navigated transcranial magnetic stimulation study

Clin Neurol Neurosurg. 2016 Feb:141:56-64. doi: 10.1016/j.clineuro.2015.12.010. Epub 2015 Dec 19.

Abstract

Objective: The present study aims to investigate the relationship between transcallosal interhemispheric connectivity (IC) and hemispheric language lateralization by using a novel approach including repetitive navigated transcranial magnetic stimulation (rTMS), hemispheric dominance ratio (HDR) calculation, and rTMS-based diffusion tensor imaging fiber tracking (DTI FT).

Methods: 31 patients with left-sided perisylvian brain lesions underwent diffusion tensor imaging (DTI) and rTMS language mapping. Cortical language-positive rTMS spots were used to calculate HDRs (HDR: quotient of the left-sided divided by right-sided naming error rates for corresponding left- and right-sided cortical regions) and to create regions of interest (ROIs) for DTI FT. Then, fibers connecting the rTMS-based ROIs of both hemispheres were tracked, and the correlation of IC to HDRs was calculated via Spearman's rank correlation coefficient (rs).

Results: Fibers connecting rTMS-based ROIs of both hemispheres were detected in 12 patients (38.7%). Within the patients in which IC was detected, the mean number of subcortical IC fibers ± standard deviation (SD) was 138.0 ± 346.5 (median: 7.5; range: 1-1,217 fibers). Regarding rs for the correlation of HDRs and fiber numbers of patients that showed IC, only moderate correlation was revealed.

Conclusion: Our approach might be beneficial and technically feasible for further investigation of the relationship between IC and language lateralization. However, only moderate correlation was revealed in the present study.

Keywords: Diffusion tensor imaging; Fiber tracking; Hemispheric dominance; Language; Object naming; Transcranial magnetic stimulation.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Brain Neoplasms / diagnosis
  • Brain Neoplasms / metabolism*
  • Cerebral Cortex / metabolism*
  • Cerebral Cortex / pathology
  • Diffusion Tensor Imaging / methods*
  • Female
  • Functional Laterality / physiology*
  • Humans
  • Male
  • Middle Aged
  • Nerve Net / metabolism*
  • Nerve Net / pathology
  • Transcranial Magnetic Stimulation / methods*
  • Young Adult