Middle short gyrus of the insula implicated in speech production: intracerebral electric stimulation of patients with epilepsy.
OBJECTIVE
Different lines of evidence have suggested an involvement of the insular cortex in speech production. These have included results from lesion studies, functional imaging techniques, and electrical stimulation of the human insular cortex during invasive evaluation of epileptic patients.


METHODS
We evaluated 25 patients who had drug refractory focal epilepsy with at least one electrode stereotactically implanted in the insular cortex.


RESULTS
Eight responses to insular cortex electrical stimulation were reported by five patients as speech arrest (five responses) and a lowering of voice intensity (three responses).


CONCLUSIONS
Data from this study implicate the middle short gyrus of the insula in the production of speech and show the importance of intrainsular electrode implantation during invasive pre-resection evaluation by stereo-electroencephalography (SEEG) when speech arrest occurs early in seizure semiology.
Afif
Afif
A
Department of Neurosurgery, Neurological Hospital, Hospices Civils de Lyon, Lyon, France. afif_acc@hotmail.com
Minotti
Lorella
L
Kahane
Philippe
P
Hoffmann
Dominique
D
D000293:Adolescent; D000927:Anticonvulsants / Q000627:therapeutic use; D001037:Aphasia / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D001931:Brain Mapping / Q000379:methods / Q000706:statistics & numerical data; D002540:Cerebral Cortex / Q000502:physiology* / Q000503:physiopathology / Q000601:surgery; D002648:Child; D004351:Drug Resistance; D004558:Electric Stimulation / Q000379:methods*; D004567:Electrodes, Implanted; D004569:Electroencephalography / Q000379:methods / Q000706:statistics & numerical data*; D004828:Epilepsies, Partial / Q000503:physiopathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care / Q000379:methods; D013060:Speech / Q000502:physiology*; D013238:Stereotaxic Techniques; D014833:Voice Quality / Q000502:physiology*
D000927:Anticonvulsants