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Cooperability
| Project leader |
Deletis Vedran |
| Project co-leader: |
Duje Tadin, PhD |
| Administering organization: |
Full name: Department for Neuroscience, Medical School, University of Split
Address: Šoltanska 2, 21000, Split, Croatia
Web address: http://www2.mefst.hr/
Contact person details: Prof. dr. sc. Matko Marušić
Telephone: +385 (0) 21 557 895
Mobile phone: +385 (0) 99 407 1190
E-mail address: matko.marusic@mefst.hr |
| Partner Institution/Company: |
Department of Brain and Cognitive Sciences,University of Rochester |
| Grant type: |
1B |
| Project title: |
Neurophysiologic markers generated by electrical and magnetic stimulation of motor speech related cortical areas |
| Project summary: |
One of the neurosurgical goals when operating within the brain eloquent areas is to preserve their function by avoiding speech and language deficits. A standard neurophysiologic method in achieving this goal is to locate the presumable motor speech related cortical areas by producing speech arrest while electrically stimulating these areas. A prerequisite for inducing speech arrest is having an awake patient or healthy subject actively participating in a speech task (i.e. counting task).
Surgical practice and data published in literature showed that injuries to certain motor speech related cortical areas (primary negative motor area, supplementary negative motor area and primary motor area for laryngeal muscles) do not produce permanent deficits of speech production (expressive aphasia). However, it does not hold for lesions in the phonological part of the Broca’s area (Brodmann’s area 44), which produces permanent expressive aphasia.
The final common organ for speech is the larynx and its muscles. Phylogeneticaly, in speech development, laryngeal muscles are more specialized than other oropharyngeal muscles. Therefore, in this study we will use them as a target organ from which we will record neurophysiologic markers generated by electrical/magnetic stimulation of motor speech related cortical areas.
Our preliminary data, which utilizes novel neurophysiologic methodology, indicates that, while electrically stimulated, most of the motor speech related cortical areas produce distinctive responses in the intrinsic laryngeal muscles. This approach allows us to intraoperatively find neurophysiologic markers (signatures) of the motor speech related areas.
In addition to electrical stimulation of the cerebral cortex through the implanted grid electrodes or during brain surgery of awake patients, we will also conduct parallel experiments using magnetic stimulation on healthy subjects. A MRI stereotactic neuronavigation system will be used to ensure that the same cortical areas are targeted by electrical and magnetic stimulation.
This approach will significantly contribute to the surgeries of frontal cortex by preserving motor speech related cortical areas and in the future, in the patient having surgery under general anesthesia.
The aims of this study are:
1) To identify the neurophysiologic markers of motor speech related cortical areas of the frontal cortex: a) in a group of healthy volunteers, b) patients with implanted subdural electrodes, and c) patients during awake craniotomy.
2) For the first time using neurophysiologic markers to: preoperatively/intraoperatively localize motor speech related cortical areas (phonological part of Broca’s area, primary motor cortex (M1) for laryngeal muscles and negative motor areas). |
| Hrvatski sažetak: |
Jedan od neurokirurških ciljeva za vrijeme operacija na elokventnim područjima kore mozga je očuvanje njihovih funkcija a osobito govora. Standardna neurofiziološka metoda u ostvarivanju tog cilja je intraoperativna lokalizacija pretpostavljenih motoričkih kortikalnih područja za govor. Ovaj cilj se ostvaruje pomoću električne stimulacije tih područja i izazivanja prekida u govoru dok je bolesnik pod lokalnom anestezijom.
Kirurška praksa kao i podatci objavljeni u literaturi ukazuju da oštećenja određenih motoričkih kortikalnih područja za govor (primarna negativna motorička regija, suplementarna motorička regija i primarna motorička regija za mišiće grkljana) ne rezultiraju trajnim oštećenjem govora (ekspresivna afazija). Međutim, to ne vrijedi i za lezije fonološkog dijela Brocinog područja (Brodmannovo područje 44), čije oštećenje dovodi do trajne afazije.
Krajnji organ koji sudjeluje u stvaranju govora je grkljan i njegovi mišići. Filogenetski, u razvoju govora, mišići grkljana su najviše specijalizirani od svih mišića usta i ždrijela koji sudjeluju u govoru. Zbog toga smo u ovom radu upotrijebili mišiće grkljana kao krajnji organ iz kojih smo registrirali neurofiziološke markere nakon električne/magnetske stimulacije motoričkih kortikalnih područja za govor.
Naši preliminarni podaci ukazuje na to da pojedina motorička kortikalna područja za govor stvaraju, dok se električno stimuliraju, specifične i prepoznatljive neurofiziološke markere u mišićima grkljana. Ova metodologija omogućava intraoperativno prepoznavanje pojedinih kortikalnih motoričkih regija za govor.
Osim električne stimulacije moždane kore putem implantiranih elektroda ili tijekom operacija mozga kod budnog bolesnika, također ćemo provoditi testiranje koristeći magnetski stimulator kod zdravih ispitanika.
Ovaj pristup će značajno doprinijeti sigurnosti neurokirurških operacija frontalne kore mozga i očuvanje motoričkih kortikalnih područja za govor. Ova metodologija ima potencijal da se u budućnosti upotrijebi kod bolesnika u općoj anesteziji.
Ciljevi ove studije su:
1) Prepoznavanje neurofizioloških markera motoričkih kortikalnih područja za govor kod : a) skupine zdravih dobrovoljaca, b) bolesnika s implantiranim subduralnim elektrodama, i c) bolesnika tijekom operacija na mozgu u lokalnoj anesteziji.
2) Po prvi put koristeći metodologiju neurofizioloških markera preoperativno / intraoperativno prepoznati motorička kortikalna područja za govor (fonološki dio Brocinog područje, primarni motorički korteks (M1) za mišiće grkljana i negativna motorička područja).
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| Amount requested from UKF: |
1.163.747,57 HRK |
| Amount of matching funding: |
232.749,64 HRK |
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