Division of Neurosurgery, Toronto Western Hospital, University of Toronto, 399 Bathurst St, Toronto, ON, M5T 2S8, Canada.
Brain Topogr. 2014 May;27(3):403-11. doi: 10.1007/s10548-013-0343-5. Epub 2013 Dec 18.
The subcortical connectivity underlying verbal perseveration (VP) remains poorly understood. We have previously reported that intraoperative electrical stimulation of the caudate nucleus during awake surgery resulted in VP. Here, our purpose is to study the white matter pathway underlying VP using subcortical stimulation mapping in a series of patients who underwent glioma resection. Eleven patients with a left hemispheric low grade glioma were operated on while awake. Intraoperative direct electrical stimulation was used both at cortical and subcortical levels while the patients carried out motor and naming tasks during the resection. All patients experienced VP during electrical stimulation performed at the level of different subcortical locations, which corresponded in the 11 cases to different parts of the left inferior fronto-occipital fascicle. Perseveration persisted into the postoperative days, but resolved completely by three months.Our original findings provide further insight into the neuroanatomical basis of VP, by supporting the role of left inferior fronto-occipital fascicle. Such data may have both fundamental and clinical implications.
皮层下连接在言语持续现象（VP）中仍未得到很好的理解。我们之前曾报道过，在清醒手术中对尾状核进行术中电刺激会导致 VP。在这里，我们的目的是使用一系列接受胶质瘤切除术的患者的皮层下刺激图来研究 VP 的白质通路。11 名左侧低级别胶质瘤患者在清醒时接受手术。在患者在切除过程中进行运动和命名任务的同时，在皮层和皮层下水平上使用术中直接电刺激。所有患者在不同皮层下位置的电刺激下均经历 VP，在 11 例中，VP 与左额枕下束的不同部位相对应。持续存在于术后几天，但三个月后完全解决。我们的原始发现通过支持左额枕下束的作用，进一步深入了解 VP 的神经解剖学基础。这些数据可能具有基础和临床意义。
