The articulatory loop: study of the subcortical connectivity by electrostimulation.
Although a cortical network involving Broca's area and the supramarginal gyrus (SMG) was widely studied using neurofunctional imaging, the functional connectivity underlying this so-called articulatory loop remains poorly documented. We describe a patient operated on for a glioma invading the left parietal operculum, using intraoperative electrical functional mapping under local anesthesia. Following the identification of cortical language sites within Broca's area and SMG, the subcortical pathways connecting these regions were detected and preserved during the resection. Postoperatively, the patient presented a slight dysarthria, then recovered. This is the first report of direct tracking of the subcortical connectivity underlying the fronto-parietal articulatory loop, allowing to better understand the pathophysiology of this network and the consequences of its damage.
Duffau
Hugues
H
Department of Neurosurgery, Hôpital de la Salpêtrière, Paris, Cedex 13, France. hugues.duffau@psl.ap-hop-paris.fr
Gatignol
Peggy
P
Denvil
Dominique
D
Lopes
Manuel
M
Capelle
Laurent
L
D000328:Adult; D001931:Brain Mapping; D001932:Brain Neoplasms / Q000503:physiopathology / Q000601:surgery; D002540:Cerebral Cortex / Q000502:physiology*; D004558:Electric Stimulation; D005260:Female; D005625:Frontal Lobe / Q000473:pathology / Q000502:physiology*; D005910:Glioma / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008279:Magnetic Resonance Imaging; D009415:Nerve Net / Q000502:physiology*; D019635:Neurosurgical Procedures; D010296:Parietal Lobe / Q000473:pathology