Gil Robles S, Gatignol P, Capelle L, Mitchell M-C, Duffau H
Department of Neurosurgery, Hospital Clinico San Carlos, Universidad Complutense de Madrid, Spain.
J Neurol Neurosurg Psychiatry. 2005 Jul;76(7):940-6. doi: 10.1136/jnnp.2004.045948.
The role of the striatum in language remains poorly understood. Intraoperative electrical stimulation during surgery for tumours involving the caudate nucleus or putamen in the dominant hemisphere might be illuminating.
To study the role of these structures in language, with the aim of avoiding postoperative definitive aphasia.
11 patients with cortico-subcortical low grade gliomas were operated on while awake, and striatal functional mapping was done. Intraoperative direct electrical stimulation was used while the patients carried out motor and naming tasks during the resection.
In five cases of glioma involving the dominant putamen, stimulations induced anarthria, while in six cases of glioma involving the dominant caudate, stimulations elicited perseveration. There was no motor effect. The striatum was systematically preserved. Postoperatively, all patients except one had transient dysphasia which resolved within three months.
There appear to be two separate basal ganglia systems in language, one mediated by the putamen which might have a motor role, and one by the caudate which might have a role in cognitive control. These findings could have implications for surgical strategy in lesions involving the dominant striatum.
纹状体在语言中的作用仍知之甚少。在对优势半球尾状核或壳核肿瘤进行手术时进行术中电刺激可能会有所启发。
研究这些结构在语言中的作用，以避免术后出现永久性失语。
对11例皮质-皮质下低级别胶质瘤患者进行清醒手术，并进行纹状体功能定位。在切除过程中，患者执行运动和命名任务时使用术中直接电刺激。
在5例累及优势壳核的胶质瘤病例中，刺激导致构音障碍，而在6例累及优势尾状核的胶质瘤病例中，刺激引发持续言语。没有运动效应。纹状体均被系统性保留。术后，除1例患者外，所有患者均有短暂性失语，在三个月内恢复。
在语言中似乎存在两个独立的基底神经节系统，一个由壳核介导，可能具有运动作用，另一个由尾状核介导，可能在认知控制中起作用。这些发现可能对涉及优势纹状体病变的手术策略有影响。
