From the Neurological Institute (M.Z.K., G.F.-B.V., R.M., C.S.), Departments of Neurology and Neurosurgery, Case Western Reserve University, Cleveland, OH; Department for Clinical Neurophysiology (C.S.), University Medical Center Goettingen, Germany; and Department of Neurology (M.Z.K.), George Washington University, Washington, DC.
Neurology. 2016 Jan 12;86(2):177-9. doi: 10.1212/WNL.0000000000002246. Epub 2015 Dec 7.
To investigate the effects of extraoperative electrical stimulation of fiber tracts connecting the language territories.
We describe results of extraoperative electrical stimulation of stereotactic electrodes in 3 patients with epilepsy who underwent presurgical evaluation for epilepsy surgery. Contacts of these electrodes sampled, among other structures, the suprainsular white matter of the left hemisphere.
Aside from speech disturbance and speech arrest, subcortical electrical stimulation of white matter tracts directly superior to the insula representing the anterior part of the arcuate fascicle, reproducibly induced complex verbal auditory phenomena including (1) hearing one's own voice in the absence of overt speech, and (2) lack of perception of arrest or alteration in ongoing repetition of words.
These results represent direct evidence that the anterior part of the arcuate fascicle is part of a network that is important in the mediation of speech planning and awareness likely by linking the language areas of the inferior parietal and posterior inferior frontal cortices. More specifically, our observations suggest that this structure may be relevant to the pathophysiology of thought disorders and auditory verbal hallucinations.
探讨连接语言区域的纤维束的术中电刺激的效果。
我们描述了 3 例癫痫患者手术评估期间进行的立体定向电极术中电刺激的结果。这些电极的触点除了其他结构外，还采样了左侧半球额上回白质。
除了言语障碍和言语中断外，直接位于岛叶上方的白质束的皮质下电刺激，可重复性地引起复杂的言语听觉现象，包括（1）在没有明显言语的情况下听到自己的声音，以及（2）在持续重复单词时缺乏对中断或改变的感知。
这些结果直接证明了弓状束的前部是一个重要的网络的一部分，该网络在言语规划和意识的中介中很重要，可能通过连接下顶叶和后下额前皮质的语言区域。更具体地说，我们的观察结果表明，该结构可能与思维障碍和听觉言语幻觉的病理生理学有关。
